People In Prison Research Articles

Explaining the collapse of the prison population in the Netherlands: Testing the theories

Between 2005 and 2015 the Dutch prison population decreased by 44 percent. Such a rapid yet sustained reduction in the number of prisoners has no parallel in the Western world in this period. What are the factors that underlie this unique development? This article charts the decline of prisoner numbers in the Netherlands and considers areas that may account for it. It takes a systemic approach which considers publicly available data that has involved the whole of the criminal justice system. It finds that a serious decline in crimes reported to the police is part of the explanation. Although the overall percentage of cases solved by the police has not changed and the prosecution office has not become more reluctant to forward cases to court, fewer cases that warrant imprisonment have come before the court over this period. In addition, the average sentence length imposed by judges has gone down. The proportion of acquittals has gone up. This shows that any explanation should involve developments in policing as well as in the courtroom. However, questions regarding police capacity to deal with serious and organized crime call into question any conclusion that the Dutch carceral collapse is simply due to a decrease in crime. The reality underlying this remarkable reduction in the number of people in prison at any one time in the Netherlands requires a more multifaceted answer than this.

Thirty-day readmission after medical-surgical hospitalization for people who experience imprisonment in Ontario, Canada: A retrospective cohort study.

We aimed to compare 30-day readmission after medical-surgical hospitalization for people who experience imprisonment and matched people in the general population in Ontario, Canada. We used linked population-based correctional and health administrative data. Of people released from Ontario prisons in 2010, we identified those with at least one medical or surgical hospitalization between 2005 and 2015 while they were in prison or within 6 months after release. For those with multiple eligible hospitalizations, we randomly selected one hospitalization. We stratified people by whether they were in prison or recently released from prison at the time of hospital discharge. We matched each person with a person in the general population based on age, sex, hospitalization case mix group, and hospital discharge year. Our primary outcome was 30-day hospital readmission. We included 262 hospitalizations for people in prison and 1,268 hospitalizations for people recently released from prison. Readmission rates were 7.7% (95%CI 4.4-10.9) for people in prison and 6.9% (95%CI 5.5-8.3) for people recently released from prison. Compared with matched people in the general population, the unadjusted HR was 0.72 (95%CI 0.41-1.27) for people in prison and 0.78 (95%CI 0.60-1.02) for people recently released from prison. Adjusted for baseline morbidity and social status, hospitalization characteristics, and post-discharge health care use, the HR for 30-day readmission was 0.74 (95%CI 0.40-1.37) for people in prison and 0.48 (95%CI 0.36-0.63) for people recently released from prison. In conclusion, people recently released from prison had relatively low rates of readmission. Research is needed to elucidate reasons for lower readmission to ensure care quality and access.

The Feminization of Transgender Women in Prisons for Men: How Prison as a Total Institution Shapes Gender

In this article, we investigate the degree to which prison shapes transgender women’s perceptions of themselves as gendered people in prisons for men. Drawing on original data collected from 315 transgender women in 27 prisons for men in California, a mixed-methods analysis reveals that transgender women in prisons for men report higher levels of self-perceptions of femininity while incarcerated, especially for those who report sexual victimization by other prisoners. The implications of these and other findings are discussed in light of recent calls for more theory and research on femininities as well as the policies and practices that undergird prisons as one of the most sex-segregated institutions.

FACT: a randomised controlled trial to assess the feasibility of QbTest in the assessment process of attention deficit hyperactivity disorder (ADHD) for young people in prison—a feasibility trial protocol

IntroductionThe prevalence of attention deficit hyperactivity disorder (ADHD) within the Children and Young People Secure Estate (CYPSE) is much higher than seen in the general population. To make a diagnosis...

Silent Cells: The Secret Drugging of Captive America by Anthony Ryan Hatch

Reviewed by: Silent Cells: The Secret Drugging of Captive America by Anthony Ryan Hatch Carolyn Sufrin Anthony Ryan Hatch. Silent Cells: The Secret Drugging of Captive America. Minneapolis: University of Minnesota Press, 2019. viii + 176 pp. Ill. $19.95 (978-1-5179-0744-0). It is no secret that institutions of incarceration in the United States remain some of the most opaque establishments in our society. Anthony Ryan Hatch delves into the logics and consequential harms of such secrecy in Silent Cells: The Secret Drugging of Captive America, exploring the deployment of psychotropics in the U.S. carceral apparatus. Just as important to his analysis of how psychoactive pharmaceuticals are used in carceral institutions is his epistemological excavation of the absence of knowledge about such activities. Silent Cells offers a compelling analysis that is both nuanced and clear, affirming in newly harrowing ways the unchecked mechanisms through which the United States' particular form of carceral violence inflicts psychic and physical suffering, both through direct action on people and through data elisions about these processes. Using publicly available archives, statistical reports, government audits, media accounts, pharmacy databases, prison records, corporate accounting, and court cases, Hatch shows how knowledge about mental illness management in the broader carceral state is produced and concealed. In Chapter 1, Hatch dissects the surveys through which federal agencies codify demographic and health data about people in prison, a venture he deems "prison pharmacoepidemiology." Government institutions, perhaps not surprisingly, document only limited information about the use of psychotropic medications in prisons, and this partial presentation of data not only precludes further questions, but enables abuses to flourish. Indeed, the same could be said of any health-related phenomenon in prison, as they all remain under-documented and partially construed. Chapter 2 reviews the results of thirty-one publicly available prison pharmacy audits from 2001–2015. Cost data, prescription logs, and auditors' comments on [End Page 174] missing data demonstrate the dysfunctional management of prison pharmacies. Some are managed by for-profit companies, which connects to Hatch's political economic analysis of the pharmaceutical industry's long-standing and profitable prisoner experimental apparatus in Chapter 3. The racist foundations of prisoner experimentation are complex, with under- and over-representation of black subjects being difficult to confidently know, and both with racist implications. Chapter 4 broadens the mechanics of psychotropic secrecy to other nonprison, total institutions like nursing homes, the military, and foster care to illustrate how similar controlling processes and epistemic elisions operate in the so-called free-world—reaffirming that the punitive, subjugating, controlling logics of incarceration sustain our entire, late-capitalist society. Hatch, in Chapter 5, uses contemporary instances of the role of psychotropics in prosecuting racially motivated gun violence, deporting unauthorized immigrants, CIA interrogations, and with sex offenders to show the expanse of how drugs are weaponized. He concludes with liberatory intimations, the contradictions of the anti-psychiatry movement; ultimately Hatch's intervention is to show that lack of knowledge is power—which opens space to rectify the gaps. Prisons and prison officials are notoriously difficult for researchers to access; for Hatch, this methodological fact was brilliantly central to his analysis of secrecy in prisons; that is, he wanted to document what can be known about these state institutions through public records. Yet ethnographers have entered prisons to study their everyday workings, and national correctional health accrediting organizations' standards and reports also delineate service delivery realities, and these data are not described. The omission of such on-the-ground information to contextualize Hatch's archival research is curious (especially since it contradicts Hatch's over-generalization that "most medications are administered by correctional officers" [p. 61]), given his formidable efforts to document what we do and do not know about prison psychiatric care. Hatch reviews several theoretical concepts on the workings of power on bodies and souls—Michel Foucault's "biopower," Achille Mbembe's "necropower," and Giorgio Agamben's "state of emergency." The applicability of these theories to U.S. carceral institutions is unquestionable. However, Hatch's data and arguments are cogent and sophisticated enough without needing to invoke these well-worn theories that appear mostly as accessory bookends. These are minor limitations to a thoughtful...

Engaged Philosophy: Showcasing Philosophers-Activists Working with the Media, Community Groups, Political Groups, Prisons, and Students

By drawing on a selection of interviews from the website Engaged Philosophy, this paper highlights the work of philosopher-activists within their classrooms and communities. These philosophers have stepped out of the ivory towers and work directly with media, community and political groups, people in prison; or they encourage their students to engage in activist projects. The variety of approaches presented here shows the many ways philosophically inspired activism can give voice to those who are marginalized, shine a light on injustices, expose the root of social problems, and empower others to seek solutions. This work shows the relevance of philosophy to practical problems and the powerful effects it can have in the world.

A Case for Reform: Florida's Cap on Rehabilitation Credits

Florida’s arbitrary cap on the ability of people in prison to earn time off their sentence for good behavior — also known as “gain time” — effectively requires people to serve a minimum of 85 percent of any sentence. This cap on rehabilitation credits toward time served on prison sentences inflates the length of time people spend incarcerated to satisfy prison sentences, but without a definite benefit to public safety and at great cost to taxpayers. Even for people convicted of minor offenses, the cap on rehabilitation credits makes it impossible to satisfy any sentence in a reasonable amount of time after rehabilitation. It not only significantly increased the average prison stay by 22 percent over the last decade, but also took away incentives for good behavior or participation in rehabilitation programs aimed at reducing recidivism. With over 96,000 people incarcerated in state prisons, Florida has the 11th‑highest incarceration rate in the nation — costing the state over $2.7 billion a year. People of color are also imprisoned at a disproportionate rate; African Americans, for example, make up 47 percent of the Florida prison population, but only 17 percent of the state population. Reinstating the system for good behavior rehabilitation credits as it existed before 1995, and increasing incentive or education, training and program rehabilitation credits would make an immediate impact on unnecessarily long prison sentences.

Research on Indoor and Outdoor Positioning System for Special Population

Special populations, such as empty-nesters, people with a mental health condition, active children, prison inmates, etc., have a considerable number. The WHO noted that there were 47.5 million people with dementia worldwide in 2016. As the number of people with dementia in low- and middle-income countries continue to increase, it is predicted that the total number of people with dementia will reach 75.6 million in 2030 and reach 135.5 million in 2050. The National Health and Family Planning Commission released the “China Family Development Report (2015)”, which is half of the total number of elderly people. The number of severely mentally disabled patients registered in the country reached 4.297 million, and there were 1, 650 national mental health professional institutions and more than 20, 000 psychiatrists. As of 2012, there were 681 prisons in the country, 300, 000 people in prison, and 1.64 million prisoners. More than 80% of the prisons have established video surveillance systems. The Ministry of Public Security’s “Emergency Release Platform for Children’s Missing Information” is about 100 people abducted every year. The number of missing children who are about one-millionth of a year is not found, and the missing rate is about three-tenths of a million. The real-time positioning of the above-mentioned special population has become the key to solving related problems. Relevant nursing homes, community institutions, mental health institutions, and prisons have become the main demand side.

Corona Virus Disease 2019 Pandemic: The Necessity for Outbreak Readiness and Response Plan in Prison Settings

The pandemic of Corona Virus Disease-2019 (COVID-19) has overwhelmed the health care delivery system and compelled the public health authorities to mount an unprecedented response against the novel viral infection. People who are deprived of their freedom and who are residing in prison or other detention centers, usually stay in close proximity and therefore there is a definite possibility that they can be a source of infection or multiplication and thus play an important role in the transmission of this viral infection within and beyond the prison settings. Thus, there is a definite need for each of the nation to improve their outbreak readiness and response system to identify and manage the cases of the disease in prison settings. In conclusion, in the ongoing battle against COVID-19 pandemic, the health and safety of people in prison cannot be ignored, as there is a definite possibility for the introduction and amplification of the disease in the prison as well as in the community

Reproductive Justice Disrupted: Mass Incarceration as a Driver of Reproductive Oppression.

We describe how mass incarceration directly undermines the core values of reproductive justice and how this affects incarcerated and nonincarcerated women.Mass incarceration, by its very nature, compromises and undermines bodily autonomy and the capacity for incarcerated people to make decisions about their reproductive well-being and bodies; this is done through institutionalized racism and is disproportionately done to the bodies of women of color. This violates the most basic tenets of reproductive justice-the right to have a child, not to have a child, and to parent the children you have with dignity and in safety.By undermining motherhood and safe pregnancy care, denying access to abortion and contraception, and preventing people from parenting their children at all and by doing so in overpoliced, unsafe environments, mass incarceration has become a driver of forms of reproductive oppression for people in prison and jails and in the community.

Mapping the prison mental health service workforce in Australia.

The rapidly growing number of people in prison in Australia, combined with the high prevalence of mental disorder in this population, results in high demand for mental health services in prison settings. Despite their critical role as part of a national mental health response, prison mental health services (PMHS) in Australia have been poorly characterised. In this paper, we describe findings of the first national survey of PMHS in Australia. We distributed a survey to key representatives of PMHS in all Australian states and territories in 2016. Our method constitutes a replicable process for quantifying and comparing PMHS in Australia. We describe the structure, governance and staffing models in seven jurisdictions. When compared against international recommendations, only one Australian jurisdiction (the ACT) is funded to provide services at a level equivalent to mental health services provided in the community. Prison mental health services in Australia are delivered by a complex mix of government, private sector and non-government services. Services appear to be severely under-resourced when compared with the available benchmarks.

Incarcerated people in prisons: A public health priority in resource-poor settings

Brazil has the third largest prison population on the planet. In this situational framework, Brazil's state prisons experience brutal riots. Here we show that, the risks of prison violence are exacerbated by a lack of opportunities for inmates once they've entered the penal system. Prisoners in Brazil do not have adequate access to healthcare services and neither is properly reached by the healthcare system. Overcrowding makes it hard for prison authorities to keep rival factions separate. The identification of the presence of mental problems when the individuals are admitted to prisons is a necessary task that may guide the adoption of measures to reduce suffering beyond the penalty of deprivation of freedom. The burden of psychiatric disorders in the prisoner's population is not known. The prevalence of major psychiatric disorders is high. Regardless of whether mental disorders are the cause or consequence of prison, it is elucidated that the stressing factors inherent to the inmate condition do not contribute to the prevention of mental disorders.

Decentralization, Integration, and Task-Shifting in Hepatitis C Virus Infection Testing and Treatment: A Global Systematic Review and Meta-Analysis

Background: Worldwide, a limited proportion of hepatitis C virus (HCV)-infected persons have been diagnosed and treated. Increasing access to HCV care and treatment will require simplified service delivery models. We conducted a systematic review and meta-analysis to examine the effectiveness of decentralization of care, integrated HCV testing and treatment with harm-reduction services, and task-shifting to non-specialists on outcomes across the HCV care continuum. Methods: We searched bibliographic databases and conference abstracts for studies published 01/01/2008-20/02/2018 that evaluated uptake of HCV testing, linkage to care, treatment, cure assessment, and sustained virologic response at 12 weeks (SVR12) in people who inject drugs (PWID), people in prisons, people living with HIV (PLHIV), and the general population. Decentralization was categorised as full (testing and treatment at same site), partial (testing at decentralised site and referral elsewhere for treatment), or none. Task-shifting was categorised as treatment by specialists- or non-specialists. Data were pooled using random-effects meta-analysis. Findings: We included 139 studies from 34 countries (20 from low- and middle-income countries). Among PWID and people in prisons, full compared to partial or no decentralization had higher testing uptake, linkage to care and treatment, and comparable high SVR rates. The general population results were more heterogenous. In all populations, task-shifting of care and treatment to non-specialists showed similar SVR12 rates as treatment delivered by specialists. Interpretation: Decentralization of care to primary-care or harm-reduction sites and task-shifting of care and treatment to non-specialists achieved high levels of treatment cure across a range of populations and settings. These findings provide strong support for the adoption of these approaches in national HCV programmes. Funding Statement: This project was funded through an enabler grant to the WHO Global Hepatitis Programme from UNITAID. WHO experts were involved in the technical and scientific discussions of this project. The writing of this paper was done solely by the authors. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: PRISMA guidelines were followed.

Hepatitis C virus (HCV) care in Canadian correctional facilities: Whereare we and where do we need to be?

Approximately 25% of people in Canadian correctional facilities have been previously exposed to hepatitis C virus (HCV). Despite being a high-prevalence setting, most Canadian prisons have thus far failed to engage the majority of those with chronic HCV infection in care. Several factors, including the lack of systematic screening programs, lack of on-site and trained health care personnel to improve access to care and treatment during incarceration, and the absence of standardized procedures needed to facilitate linkage to care following release likely contribute to poor engagement along the HCV care cascade for people in prison. HCV screening and engagement in care for people in prison can be improved through the implementation of universal opt-out screening upon admission and consideration of multidisciplinary care models for the provision of care. As well, the dissemination of prison-based needle and syringe programs to avert new HCV infections and re-infections should be considered. To meet the World Health Organization (WHO) 2030 HCV elimination goals, engaging researchers, clinicians and other health care providers, policy makers, correctional officials, and members of community in dialogue will be an essential first step going forward.

Using qualitative data to produce an animated clinical engagement tool: secondary health-care experiences of people in prison

BackgroundHealth care service access and health outcomes are poorer in prisoners than the wider population. The closed prison environment restricts access to community (ie, external to prison) secondary care. Prisoners can feel discriminated against when attending hospital appointments, leading to self-exclusion from health services while imprisoned. Hospitals that are informed about these issues can make simple changes to address inequalities. We aimed to influence community health professionals to design improved services through the use of an animation based on prisoner experiences of secondary care. MethodsWe developed the key ideas for this arts-based approach to clinical engagement through collaboration with people with lived experience, a prison charity, prison clinicians, and an animation company. We collected focus group and interview data about hospital health-care experiences with people in prison and analysed these data with input from the collaborative group. A rapid two-stage thematic analysis identified key themes and phrases to support the animation narrative. We interviewed prisoners to collect audio. We developed the 5-min animation through our collaborative key ideas, qualitative themes, and audio collected. We will evaluate our methods and the animation's impact through post-screening activities with clinicians to determine how effectively knowledge is transferred to target groups. If proven effective, opportunities for using the method to increase knowledge about other excluded groups (eg, homeless people) will be explored. FindingsWe have produced an animation that will be evaluated for its ability to engage hospital clinicians in service change. The animation provokes engagement by explaining the effects of the prison regime and security measures on prisoners admitted to hospital. Such effects include humiliation and fear, the unwanted presence of prison officers in medical consultations, and individuals’ inability to manage their own health care. InterpretationIncarcerated patients have shared their experiences to show the need for service change, not to simply invoke empathy. We hope to produce a tool to engage secondary care staff and not simply tell prisoners’ stories. These will act as the vehicle for change. FundingWellcome Trust Public Engagement grant scheme and Surrey Heartlands Health and Care Partnership Citizen Engagement work stream.

Case study: HCV micro-elimination in prison

Abstract The presentation will explore the concept of HCV micro-elimination in prison settings end its application in the context of French prisons. Hepatitis C is a chronic pathology of the liver and can significantly affect quality of life, with significant mortality rates. Hepatitis C is of great relevance for prison population due to the overlap of risk factors for both incarceration and HCV infection, including substance use disorders. Historically, HCV interferon-based therapy has not always been offered to people in prison due to various factors, including homelessness, active injecting drug use, and liver disease. With the advent of direct-acting antivirals, almost 100% of patients are experiencing successful HCV treatment, with no medical contra-indication for incarcerated individuals, drug users and/or individuals on opioid substitution treatment. Approaches based on HCV test and treat have proven to be successful in prison settings to achieve micro-elimination and to offer HCV appropriate care to individuals belonging to socially-deprived groups and characterised by limited access to care when in the community. The elimination of hepatitis C in prison, among people who use drugs, also requires effective Harm Reduction programmes, an important tool to prevent re-infections.

The health of people in prison in Europe

Abstract This presentation will explore the rationale behind a public health approach to prison health covering aspects such as the socio-demographic composition of the prison population in Europe, its health status and main health needs, based on the current sources of data. The link between the prison population and the wider community will be analyzed alongside the concept of community dividend, defined as the benefit of prison-related intervention for general population health.

Well-being and mental health interventions for Indigenous people in prison: systematic review.

Indigenous people are overrepresented in prison populations of colonised justice systems, and Indigenous prisoners in these countries are at a particularly high risk of poor mental health and well-being. There is an acute need to ensure the access of these groups to culturally appropriate, evidence-based interventions. To conduct a systematic review, evaluating quantitative and qualitative evaluations of mental health and well-being interventions designed for Indigenous people in custody. A search of relevant peer-reviewed journal articles to August 2019 was conducted. The focus was on colonised countries under a Western model of justice and health, including Canada, Australia, New Zealand and the USA. The review utilised Scopus, Web of Science, PubMed, PsycNET, EBSCO, Proquest Criminal Justice Database and Informit. Of the 9283 articles initially found, only three quantitative and two qualitative evaluations of mental health or well-being interventions for Indigenous people in custody were identified. None were randomised controlled trials. Culturally based interventions appeared to have high acceptability and potential for increased recovery from trauma, reduced alcohol-related problems and lower reoffending. However, no studies quantitatively assessed mental health or well-being outcomes. As yet there is no high-quality evidence on the impact on mental health and well-being from interventions specifically for Indigenous prisoners, although existing studies suggest programme features that may maximise acceptability and impact. There is a moral, social and practical imperative to build a strong evidence base on this topic.

Case study: Drug related problems in prison settings

Abstract Persons in prison generally have poorer physical and mental health and social well-being than their peers in the community, reporting high rates of acute and chronic physical and mental disorders, including, substance use disorders and drug related infectious diseases. People in prison report high prevalence of illicit drug use before and during incarceration and high rates of drug related infections. Acute risks for those using drugs are found in the first period after prison release. Available interventions in prison setting lower life expectancy than their peers in the community. Common risk and social factors are related to poor health and imprisonment and those two components should be addressed in a comprehensive way. The presentation will provide an overview of the last available data on drug use, drug related problems and prevalence of infectious diseases in prison in the European countries.

First diagnosis of psychosis in the prison: results from a data-linkage study

Psychosis is more prevalent among people in prison compared with the community. Early detection is important to optimise health and justice outcomes; for some, this may be the first time they have been clinically assessed. Determine factors associated with a first diagnosis of psychosis in prison and describe time to diagnosis from entry into prison. This retrospective cohort study describes individuals identified for the first time with psychosis in New South Wales (NSW) prisons (2006-2012). Logistic regression was used to identify factors associated with a first diagnosis of psychosis. Cox regression was used to describe time to diagnosis from entry into prison. Of the 38 489 diagnosed with psychosis for the first time, 1.7% (n = 659) occurred in prison. Factors associated with an increased likelihood of being diagnosed in prison (versus community) were: male gender (odds ratio (OR) = 2.27, 95% CI 1.79-2.89), Aboriginality (OR = 1.81, 95% CI 1.49-2.19), older age (OR = 1.70, 95% CI 1.37-2.11 for 25-34 years and OR = 1.63, 95% CI 1.29-2.06 for 35-44 years) and disadvantaged socioeconomic area (OR = 4.41, 95% CI 3.42-5.69). Eight out of ten were diagnosed within 3 months of reception. Among those diagnosed with psychosis for the first time, only a small number were identified during incarceration with most identified in the first 3 months following imprisonment. This suggests good screening processes are in place in NSW prisons for detecting those with serious mental illness. It is important these individuals receive appropriate care in prison, have the opportunity to have matters reheard and possibly diverted into treatment, and are subsequently connected to community mental health services on release. None.