People In Prison Research Articles

‘In This Prison We Have Our Main Meal at 11:30 AM’. The Significance of ‘Time’ For Food Among People Serving Custodial Sentences in England and Wales

In this article, I am thinking through the social life of time for food in prison from a practice theory perspective. I draw upon empirical data from in-depth qualitative interviews with people serving custodial sentences or recently released from prison in England and Wales who have been on placement at a prisoner resettlement charity (RC). These support findings from Her Majesty’s Inspectorate for Prisons report on Life Inside: Food from 2016, and I consider two aspects from the report, (i) an exploration of the standards and conditions in which food is consumed and (ii) the timings of mealtimes. For people in prison, disruptions to the usual rhythms of everyday life, or chrono-normative expectations, serve as stark reminders of a lack of agency and worth. People in prison are forced to adapt and work within temporal spaces that are subject to flux due to the systemic demands of an under-resourced prison system. These constitute a contravention of social and cultural norms and reinforce the notion of the prison as a place of punishment, and degradation. These temporal shifts contribute to the transformation of civilian to prisoner and form part of a process of de-synchronising with life outside.

Inequalities in physical and mental health among people in prison

Inequalities in physical and mental health among people in prison

The prevalence of substance use disorders among people in Norwegian, Danish and Swedish prisons: A multi-national cohort study, 2010-19.

We estimated the prevalence of substance use disorders (SUDs) in the Norwegian, Danish and Swedish prison populations and compared the prevalence of SUDs in the national prison populations with country-specific general population prevalence rates. A multi-national cohort study using data from the National Prison Registries linked to the National Patient Registries in Norway, Denmark and Sweden. We used data from the PriSUD-Nordic study, including national prison populations aged 19 years and older in Norway (2010-19), Denmark (2010-18) and Sweden (2010-13). A total of 119 507 Individuals (108 971 men and 10 536 women) contributing to 191 549 incarcerations were included in the study (Norway: 45432 men; 5429 women, Denmark: 42 162 men; 3370 women, Sweden: 21 377 men; 1737 women). We calculated a study prevalence and prevalence at entry to prison for all types of SUDs before imprisonment each consecutive year of observation in each prison population. We also extracted country-specific 1-year prevalence rates from the Global Burden of Diseases database to calculate comparative national prevalence ratios. The study prevalence of any SUD was approximately 40% [Norway: 44.0%, 95% confidence interval (CI) = 43.6-44.5%; Denmark: 39.9%, CI = 39.5-40.4%; Sweden: 39.1%, CI = 38.4-39.7%] in all three countries. Women had a significantly higher study prevalence of any SUD compared with men (Norway: 55.8 versus 42.6%, P < 0.001; Denmark 43.1 versus 39.7%, P = 0.004; Sweden: 51.7 versus 38.0%, P < 0.001). Prevalence estimates were higher for SUDs among people in prison than in the general population. We observed an increasing proportion of people with SUDs entering prison in Norway (P = 0.003), while the proportion was more stable in Denmark and Sweden. Substance use disorders (SUDs) appear to be highly prevalent among the Scandinavian prison populations compared with the general population, especially among women. In Norway, there was a relative increase in SUDs from 2010 to 2019.

Preparing correctional settings for the next pandemic: a modeling study of COVID-19 outbreaks in two high-income countries.

Correctional facilities are high-priority settings for coordinated public health responses to the COVID-19 pandemic. These facilities are at high risk of disease transmission due to close contacts between people in prison and with the wider community. People in prison are also vulnerable to severe disease given their high burden of co-morbidities. We developed a mathematical model to evaluate the effect of various public health interventions, including vaccination, on the mitigation of COVID-19 outbreaks, applying it to prisons in Australia and Canada. We found that, in the absence of any intervention, an outbreak would occur and infect almost 100% of people in prison within 20 days of the index case. However, the rapid rollout of vaccines with other non-pharmaceutical interventions would almost eliminate the risk of an outbreak. Our study highlights that high vaccination coverage is required for variants with high transmission probability to completely mitigate the outbreak risk in prisons.

Identifying structural risk factors for overdose following incarceration: a concept mapping study

BackgroundCurrently, there are more than two million people in prisons or jails, with nearly two-thirds meeting the criteria for a substance use disorder. Following these patterns, overdose is the leading cause of death following release from prison and the third leading cause of death during periods of incarceration in jails. Traditional quantitative methods analyzing the factors associated with overdose following incarceration may fail to capture structural and environmental factors present in specific communities. People with lived experiences in the criminal legal system and with substance use disorder hold unique perspectives and must be involved in the research process.ObjectiveTo identify perceived factors that impact overdose following release from incarceration among people with direct criminal legal involvement and experience with substance use.MethodsWithin a community-engaged approach to research, we used concept mapping to center the perspectives of people with personal experience with the carceral system. The following prompt guided our study: “What do you think are some of the main things that make people who have been in jail or prison more and less likely to overdose?” Individuals participated in three rounds of focus groups, which included brainstorming, sorting and rating, and community interpretation. We used the Concept Systems Inc. platform groupwisdom for our analyses and constructed cluster maps.ResultsEight individuals (ages 33 to 53) from four states participated. The brainstorming process resulted in 83 unique factors that impact overdose. The concept mapping process resulted in five clusters: (1) Community-Based Prevention, (2) Drug Use and Incarceration, (3) Resources for Treatment for Substance Use, (4) Carceral Factors, and (5) Stigma and Structural Barriers.ConclusionsOur study provides critical insight into community-identified factors associated with overdose following incarceration. These factors should be accounted for during resource planning and decision-making.

The Construction of Capital Among Family Members of People in Prison

Abstract Researchers have documented the harms of imprisonment on family life, but much less is known about how family members seek support to cope with the challenges of familial imprisonment. In this article, I draw on 8 months of ethnographic observations of a virtual family support group and in-depth interviews with 27 family members of people in prison to explore participants’ need for, and construction of, communities of support. Drawing on Bourdieu’s concepts of social and cultural capital, I reveal how family members cultivated and leveraged networks of support to develop the social connections, knowledge, skills and resources needed to cope with familial imprisonment. I argue, however, that the persistence of participants’ struggles underscores the intractable nature of the inequality produced by familial imprisonment.

Suicide following a conviction, solitary confinement, or transfer in people incarcerated: A comprehensive retrospective cohort study in France, 2017-2020.

Suicide rates are higher in prison than in the general population in most countries. The proximity of some suicides to prison events has only received little attention in comparative studies. The aim of this study was to assess the relationship between suicide and four prison events: conviction, disciplinary solitary confinement, nondisciplinary solitary confinement and inter-prison transfer, in a national retrospective cohort study of people in prison. All incarcerations in France that occurred during 2017-2020 were eligible. Data were collected from an administrative database of the National Prison Service. Survival bivariate and multivariate analyses were performed with a Cox regression model. Of 358,522 incarcerations were included, among which 469,348 events and 449 suicides occurred. In multivariate analysis, suicide risk was higher the first day of disciplinary solitary confinement (HR = 42.1 [21.5-82.7] and HR = 119.0 [71.5-197.9], before and after a government decree on the disciplinary system, respectively. It was higher within 2 weeks after a transfer (HR = 3.5 [2.3-5.2])) or entry in nondisciplinary solitary confinement (HR = 6.7 [3.4-13.3]) and lower within 2 weeks after a conviction (HR = 0.6 [0.4-1.0]). Solitary confinement and transfer were found to be precipitating factors of suicide in people who are incarcerated. These results offer interesting perspectives on prevention.

LGBT people in prison in Australia and human rights: A critical reflection

This article examines the human rights protections relevant to lesbian, gay, bisexual and/or transgender (‘LGBT’) people in Australian prisons. We commence by addressing some of the inequalities experienced by incarcerated LGBT people, before outlining the relevant international human rights frameworks and their implementation in Australia. We focus on Victoria as a case study, demonstrating that there are limited provisions for LGBT people in prisons, and these provisions are generally not legally enforceable. We conclude by recommending legislative reforms that would increase protections for a particularly vulnerable cohort in the prison environment and promote compliance with Australia’s obligations under international human rights law.

The prevalence and comorbidity of mental health and substance use disorders in Scandinavian prisons 2010-2019: a multi-national register study.

Mental health disorders are common among people in prison, but their prevalence in the Scandinavian prison population remain unclear. In this multinational register study, we examined the prevalence of mental health disorders and the comorbidity of substance use disorders (SUDs) with other mental health disorders in this population. Further, we investigated how the prevalence of mental disorders at prison entry had changed in Norway, Denmark, and Sweden over the study period. The three study cohorts included all individuals, aged 19 or older, whom had been imprisoned in Norway (2010-2019), Denmark (2011-2018), and Sweden (2010-2013). Mental disorders were defined as ICD-10 diagnoses (F-codes) registered in the national patient registers. The study prevalence was estimated based on recorded diagnoses during the entire study follow-up period in each respective country. The one-year prevalence of mental disorders was estimated for each calendar year for individuals entering prison during that year. The Scandinavian prison cohorts included 119 507 individuals released 191 549 times during the study period. Across all three countries a high proportion of both women (61.3%-74.4%) and men (49.6%-57.9%) had at least one mental health disorder during the observation period. The most prevalent disorders were SUDs (39.1%-44.0%), depressive disorder (8.1%-17.5%), and stress related disorder (8.8%-17.1%). Women (31.8%-41.1%) had higher levels of mental health and substance use comorbidities compared to men (20.8%-27.6%). The one-year prevalence of any mental health disorder increased over time with a 33% relative increase in Norway, 8% in Denmark, and 10% in Sweden. The proportion of individuals entering prison with a comorbid SUD and other mental disorder had also increased. While the incarceration rate has been decreasing during the past decade in the Scandinavian countries, an increasing proportion of people entering prison have a diagnosed mental health disorder. Our results suggest that prisons should provide adequate treatment and scale up services to accommodate the increasing proportion of people with complex health needs among incarcerated people.

Dementia care pathways in prisons – a comprehensive scoping review

BackgroundThe number of older people in prison is growing. As a result, there will also be more prisoners suffering from dementia. The support and management of this population is likely to present multiple challenges to the prison system.ObjectivesTo examine the published literature on the care and supervision of people living in prison with dementia and on transitioning into the community; to identify good practice and recommendations that might inform the development of prison dementia care pathways.MethodsA scoping review methodology was adopted with reporting guided by the PRISMA extension for scoping reviews checklist and explanation.ResultsSixty-seven papers were included. Most of these were from high income countries, with the majority from the United Kingdom (n = 34), followed by the United States (n = 15), and Australia (n = 12). One further paper was from India.DiscussionThe literature indicated that there were difficulties across the prison system for people with dementia along the pathway from reception to release and resettlement. These touched upon all aspects of prison life and its environment, including health and social care. A lack of resources and national and regional policies were identified as important barriers, although a number of solutions were also identified in the literature, including the development of locally tailored policies and increased collaboration with the voluntary sector.ConclusionTo our knowledge, this is the most comprehensive and inclusive review of the literature on dementia care pathways in prison to date. It has identified a number of important areas of concern and opportunities for future research across the prison system, and its operations. This will hopefully lead to the identification or adaptation of interventions to be implemented and evaluated, and facilitate the development of dementia care pathways in prisons.

Art therapy in a multidisciplinary team with young men in prison

ABSTRACT Background People in prison often present with histories of trauma that can be difficult to process in the volatile prison environment. This article seeks to advance our understanding of the benefits of art therapy within a multidisciplinary team, and how it can help young men in prison who have experienced trauma. Context A review of the art therapy-informed interventions offered for trauma stabilisation in a service for young adult men in prison with complex needs is presented. Approach This article discusses a trauma-informed service in the prison and the variety of ways in which art therapy can support people in prison with histories of complex trauma. It explores: the use of art therapy in a group focusing on improving the prison environment; the role of art therapy in supporting trauma stabilisation and the development of ‘safe place’ processing; and the use of art therapy tools to explore dissociation with service users prior to engaging in trauma therapy. Conclusions The article highlights the vital role of art therapy as a non-verbal therapy to support young men to heal their past trauma. Reflections are offered on the importance of embedding art therapy within a service’s trauma therapy pathway. Implications for research It is recommended that research into the use of art therapy within prison settings is undertaken which could explore its utility in supporting people to process their trauma. This would provide further evidence for the role that non-verbal therapies may play in healing trauma.

Transfer to community and prison mental health care from Ireland's main remand prison over three years: 2015-2017.

The post-release period is associated with an increased risk of morbidity and mortality. Previous studies have identified deficits in pre-release planning for mentally ill people in prison, particularly in remand settings. We aimed to determine the proportion of mentally ill people in Ireland's main remand prison who were referred for mental health follow up in community and prison settings, who achieved face to face contact with the receiving service. This retrospective observational cohort study was based in Ireland's main male remand prison, Cloverhill. Participants included all those individuals on the caseload of the prison inreach mental health team who were referred for mental health follow up in community and prison settings at the time of discharge, prison transfer or release from custody over a three-year period, 2015 - 2017. Successful transfer of care (TOC) was defined as face-to-face contact with the receiving service, confirmed by written correspondence or by follow up telephone call. Clinical, demographic and offence related variables were recorded for all participants. There were 911 discharges from the prison inreach mental health team within the three-year study period. Of these, 121 were admitted to hospital, 166 were transferred to other prison inreach mental health services and 237 were discharged to community based mental health follow up in psychiatric outpatient or primary care settings. One third (304/911) had an ICD-10 diagnosis of schizophreniform or bipolar disorder (F20-31) and 37.5% (161/911) were homeless. Over 90% (152/166) of those referred to mental health teams in other prisons achieved successful TOC, with a median of six days to first face-to face assessment. Overall, 59% (140/237) of those referred to community psychiatric outpatient or primary care services achieved TOC following referral on release from custody, with a median of nine days from release to assessment. Clinical and demographic variables did not differ between those achieving and not achieving successful TOC, other than having had input from the PICLS Housing Support Service. Successful transfer of care can be achieved in remand settings using a systematic approach with an emphasis on early and sustained interagency liaison and clear mapping of patient pathways. For incarcerated individuals experiencing homelessness and mental health disorders, provision of a housing support service was associated with increased likelihood of successful transfer of care to community mental health supports.

Mental health, chronic and infectious conditions among pregnant persons in US state prisons and local jails 2016-2017.

Pregnant individuals in incarcerated settings have unique healthcare needs. Rates of mental health, infectious diseases, and chronic disease are higher among nonpregnant incarcerated women compared with those who are not, but the prevalence of these conditions among pregnant people in custody has not been documented. The objective of this study is to describe the prevalence of metabolic, infectious, and mental health conditions in pregnant people to identify the medical needs of high-risk pregnancies in US state prisons and local jails. This was a prospective epidemiologic surveillance of a convenience sample of state prisons (n = 20) and local jails (n = 3). We used purposive and snowball sampling to recruit a national sample of prisons and jails of a range of sizes and geographies. Reporters submitted to our study database monthly data on selected pregnancy comorbidities for 6 months between 2016 and 2017. Screening, diagnosis, and tracking of these conditions are derived from each facility's medical record and health care delivery systems. Of the 445 newly admitted pregnant people in prisons and 243 in jails, the most prevalent conditions were mental health conditions and hepatitis C. Specifically, 34.1% (n = 152) in prison and 23.5% (n = 57) in jail had a substance use disorder, and 27.4% (n = 122) of those in prison and 17.7% (n = 43) in jail had a psychiatric diagnosis. Finally, 20.2% (n = 91) in prison and 6.6% (n = 16) in jail had hepatitis C. This study demonstrates that chronic medical and mental health conditions are prevalent among pregnant people in US prisons and jails. However, significant variability in the reported number of cases of these conditions from state to state and between facility types implies a lack of or inadequate screening practices. These data indicate the need for comprehensive screening and appropriate care for the complex needs of pregnant incarcerated people.

Exclusive breastfeeding among people in prison: an intersectional and abolitionist approach to analyzing scientific production in Brazil from 2000 to 2022

Resumo No Brasil, houve crescimento descontrolado do encarceramento feminino, sendo que não se interrompe essa situação em períodos de gravidez ou lactação. Foi realizada uma revisão de escopo com objetivo de mapear e sintetizar sistematicamente evidências, publicadas a partir do ano 2000, sobre a prática de aleitamento materno exclusivo (AME) entre pessoas em situação de cárcere no Brasil. A interseccionalidade e o abolicionismo penal foram as abordagens teórico-metodológicas utilizadas para análise dos artigos. Ao todo, 25 estudos foram selecionados, sendo 90% publicados entre 2010 e 2020. No âmbito de saúde materno-infantil, eles expuseram principalmente as dificuldades de manter o AME no cárcere, incluindo a indefinição de um período mínimo de estadia do bebê, a falta de orientação profissional à prática de AME e a estrutura inadequada das unidades prisionais. Na área do direito, os estudos relataram tensões entre a ordem disciplinar e o irredutível direito humano das crianças à alimentação. Os estudos focalizaram a investigação na vivência das mães, porém não questionaram as formas práticas e históricas do aprisionamento, em especial sobre corpos negros, femininos e pobres. Abordagens críticas e propositivas são necessárias à produção de evidências para a garantia de direitos à saúde e à alimentação.

Fatores associados ao óbito pela coinfecção tuberculose/HIV no sistema prisional

Abstract Objective to analyze the factors associated with deaths due to tuberculosis/HIV co-infection in people deprived of their freedom. Methods Retrospective cohort study, carried out in the state of São Paulo from 2008 to 2017. The study population was made up of people with tuberculosis/HIV co-infection in deprivation of their freedom. Data were collected from the TB-WEB Tuberculosis Patient Control System in linkage with the Mortality Information System. The risk of death according to sociodemographic, clinical and treatment variables was established by relative risk and respective 95% confidence intervals. Results 100 deaths from tuberculosis and/or HIV were identified in the period, which were associated with: individuals belonging to the Regional Coordination of Vale do Paraíba/in the coast (relative risk 2.59; 95% confidence interval 1.35-4, 94); age groups 30 to 39 years old (relative risk 2.49; 95% confidence interval 1.04-5.96), 40 to 49 years old (relative risk 7.09; 95% confidence interval 3.06-19, 06) and 50 to 59 years old (relative risk 14.11; 95% confidence interval 5.91-33.69); self-administered treatment (relative risk 1.94; 95% confidence interval 1.16-3.27); and occurrence of hospitalization (relative risk 2.62; 95% confidence interval 1.69-4.07). Conclusion Such factors must be considered when dealing with tuberculosis/HIV co-infection, considering the age of people in prison, the conditions of incarceration and the intensification of directly observed treatment, aiming to avoid conditions that will require hospitalization.

Accessing opioid agonist treatment in prison in England and Scotland remains problematic – the views of people with lived experience

PurposeThe purpose of this paper is to examine lived experiences of opioid agonist treatment (OAT) during and immediately following release from detention in prisons in England and Scotland.Design/methodology/approachSurveys were completed by serving prisoners in both countries and by those recently released from prison (England only). The survey findings were discussed in focus groups of people with lived experience. The combined findings from the surveys and focus groups were shared with an expert group of prison OAT providers and people with lived experience with the purpose of making recommendations for more accessible and effective OAT in custodial environments and continuity of OAT on releaseFindingsThe quality and accessibility of OAT varied considerably between establishments. It was reported to be harder to access OAT in Scottish prisons. It was often hard for people in prison to get the dosage of OAT they felt they needed and it was generally harder to access buprenorphine than methadone in English prisons. Only Scottish people in prison were aware of long-lasting forms of buprenorphine. People in English prisons had mixed experiences of the help available in prison, with no improvement recorded since a 2016 study. People in Scottish prisons were more likely to rate the help available as poor.Research limitations/implicationsThe number of people accessed while actually in prison (73) was reduced by the impact of the pandemic, making it more difficult to access people in prison and because some were resistant to participating on the basis that they had already been consulted for a wide variety of research projects focused on the impact of COVID. The Scottish cohort (a total of 19 individuals comprising 14 survey respondents and five focus group members) is clearly too small a number on which to base robust claims about differences in OAT provision between the English and Scottish prison systems..Practical implicationsThe study identifies key barriers to accessing OAT in prisons and suggests key components of more user-friendly approaches.Social implicationsThis study provides an overview of the recent lived experiences of people accessing OAT in prison and on release and offers valuable recommendations on how to make service provision more effective and consistent.Originality/valueThis study provides an overview of the recent lived experiences of people accessing OAT in prison and on release in England and Scotland and offers valuable recommendations on how to make service provision more effective and consistent.

COVID-related disruptions and adaptations to prison-based mental health and substance use services: a narrative review

PurposePublic health experts and advocates have long raised concerns about the pandemic preparedness of prison systems worldwide – an issue that became increasingly salient at the start of the COVID-19 pandemic. People in prison experience poorer health outcomes compared to the general population, making timely access to adequate health services in prison critical for their health and wellbeing. This study aims to identify the extent of the literature on initial changes in mental health and substance use services for people in prison during the COVID-19 pandemic, summarize and synthesize the findings and identify areas in need of further study.Design/methodology/approachThe authors conducted a review of the academic literature published internationally in English between 2019 and December 1, 2020 to describe the disruptions and adaptations to mental health and substance use services in prisons during the onset of the COVID-19 pandemic.FindingsThe authors found that mental health and substance use services in prisons around the world were widely disrupted due to the COVID-19 pandemic – predominantly consisting of the complete suspension of services, discontinuation of transfers to off-site treatment sites and limitations on service capacity. Adaptations ranged from virtual service delivery and changes to treatment dispensation processes to information sessions on overdose prevention.Originality/valueTo the best of the authors’ knowledge, this is the first review to examine the nature and extent of the literature on delivery of mental health and substance use services in prisons during the COVID-19 pandemic.

How punitive is pretrial? Measuring the relative pains of pretrial detention

The purpose of pretrial incarceration is not punishment. Yet, research demonstrates that pretrial detention elicits similar consequences as punishment. The goal of this study is to advance theory and policy discussions by enumerating the experiences and harms that emerge during pretrial detention and how closely they align with punishment. The analyses use the National Inmate Survey, 2011–2012 to compare the experiences of those held in pretrial detention to those incarcerated in jail or prison after a conviction. Individuals in pretrial detention report more disorderly environments than people in prisons, but also report more access to external social support and better views of staff legitimacy. The self-reported experiences of people in pretrial detention and those in jail as punishment are generally indistinguishable. The results provide considerable support for the argument that pretrial detention is inextricably punitive and, especially at its current scale, likely undermines system objectives of justice and public safety.

Unlocking empathy and preparedness

Developments in virtual reality (VR) technology and the increased availability of high-speed internet, have increased the affordability and accessibility of VR. This paper investigates the potential of VR to supplement the theoretical coursework of a large criminal justice course in Aotearoa New Zealand. By simulating interactions with people in prison, VR could offer a unique training platform where students develop essential skills, including communication, conflict resolution, and empathy, within a controlled environment. This ensures that trauma-sensitive issues can be addressed safely and effectively, providing students with invaluable experiential learning opportunities. Using VR, students could engage in simulated scenarios that mirror real-life. This immersive environment would allow them to gain firsthand experience and explore their emotional responses in a safe setting. Students could develop a deeper understanding of their triggers, manage their trauma, and acquire the necessary coping mechanisms to handle the challenging situations they may face in their future careers.

Reactive attachment disorder, disinhibited social engagement disorder, adverse childhood experiences, and mental health in an imprisoned young offender population

BackgroundA high proportion of young people in prison have a history of abuse and neglect, and/or of neurodevelopmental or psychiatric conditions. Despite this, the only two conditions specifically associated with abuse and neglect, Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED), have never been included as part of a comprehensive prevalence study. MethodsA cross sectional study, in 110 male inmates aged 16 to 23, examined the prevalence of, and associations between, adverse childhood experiences (ACEs), neurodevelopmental and mental health conditions, including RAD and DSED. OutcomesVirtually all of the young men (96 %) had one or more lifetime neurodevelopmental or mental health conditions, 85.5 % had a current condition, yet less than 3 % reported having received a mental health assessment in prison. High rates of RAD and/or DSED symptoms were found (53.6 %) and 74.5 % had experienced some form of abuse or neglect. InterpretationThere is a high prevalence of ACEs, RAD/DSED, neurodevelopmental and other mental health conditions within this population. Comprehensive clinical assessments are required to ensure appropriate support and staff training is needed to ensure that the full implications of the high prevalence of neurodevelopmental and mental health conditions are understood as part of trauma informed care.