Prison Units Research Articles

Spatial analysis of avoidable hospitalizations due to tuberculosis in Ribeirao Preto, SP, Brazil (2006-2012).

ABSTRACTOBJECTIVE To describe the spatial distribution of avoidable hospitalizations due to tuberculosis in the municipality of Ribeirao Preto, SP, Brazil, and to identify spatial and space-time clusters for the risk of occurrence of these events.METHODS This is a descriptive, ecological study that considered the hospitalizations records of the Hospital Information System of residents of Ribeirao Preto, SP, Southeastern Brazil, from 2006 to 2012. Only the cases with recorded addresses were considered for the spatial analyses, and they were also geocoded. We resorted to Kernel density estimation to identify the densest areas, local empirical Bayes rate as the method for smoothing the incidence rates of hospital admissions, and scan statistic for identifying clusters of risk. Softwares ArcGis 10.2, TerraView 4.2.2, and SaTScanTM were used in the analysis.RESULTS We identified 169 hospitalizations due to tuberculosis. Most were of men (n = 134; 79.2%), averagely aged 48 years (SD = 16.2). The predominant clinical form was the pulmonary one, which was confirmed through a microscopic examination of expectorated sputum (n = 66; 39.0%). We geocoded 159 cases (94.0%). We observed a non-random spatial distribution of avoidable hospitalizations due to tuberculosis concentrated in the northern and western regions of the municipality. Through the scan statistic, three spatial clusters for risk of hospitalizations due to tuberculosis were identified, one of them in the northern region of the municipality (relative risk [RR] = 3.4; 95%CI 2.7–4,4); the second in the central region, where there is a prison unit (RR = 28.6; 95%CI 22.4–36.6); and the last one in the southern region, and area of protection for hospitalizations (RR = 0.2; 95%CI 0.2–0.3). We did not identify any space-time clusters.CONCLUSIONS The investigation showed priority areas for the control and surveillance of tuberculosis, as well as the profile of the affected population, which shows important aspects to be considered in terms of management and organization of health care services targeting effectiveness in primary health care.

Prevalence of adult ADHD in an all-female prison unit.

There is increasing evidence suggesting a link between ADHD and criminality, including a strong association between ADHD symptoms and the likelihood of being on probation or in prison. Most studies investigating the prevalence of ADHD in prison populations have focused on adult male offenders. In the current study, 69 female prisoners were screened for both childhood and adult ADHD symptoms using the Barkley Adult ADHD Rating Scale-IV. The results indicate that 41% of the prisoners met the diagnostic criteria for ADHD in childhood and continued to meet criteria for ADHD as adults. More importantly, young female prisoners (aged 18-25) were significantly more likely to report symptoms of ADHD than older prisoners. Prisoners who reported symptoms of ADHD also reported high levels of impairment associated with these symptoms. A better understanding of the prevalence of ADHD in female prison units can highlight specific areas for intervention during rehabilitation, as well as the management of serious incidents within prison.

Intensive psychological treatment of high-risk violent offenders: Outcomes and pre-release mechanisms

ABSTRACTResearch on correlates of intervention programmes that reduce expected reconviction rates (‘what works’ literature, Risk–Need–Responsivity model) has been highly influential in criminal justice systems throughout much of the western world. But while this psychological research has been acquiring widespread recognition, a deeper understanding of how programmes work and of mechanisms for desistance more generally, has still to develop. This research reports results of a quasi-experimental recidivism outcome study for a series of prison units that provide intensive psychological treatment to high-risk, persistently violent prisoners. Four outcomes were examined over the first 12 months following release on parole: parole violations, new convictions, new convictions for violence, and imprisonment sentences resulting from new convictions. Alongside these results, we conducted preliminary analyses of two potential pre-release mechanisms for surviving the first 12 months on parole without reconviction: lower dynamic risk for violence, and greater release readiness. We found that dynamic violence risk fully accounted for differences between treatment completers and comparison prisoners in proportions reconvicted for violence. However, in all other cases, the proposed mechanisms did not significantly explain treatment-related differences. We close by considering possible explanations for these unexpected results, and reiterating the importance to our field of more sophisticated treatment outcome research.

Rusmestringsenheter i norske fengsler – humane og eksepsjonelle?

Substance treatment units in Norwegian prisons - humane and exceptional? Background The treatment of prison inmates in the Nordic countries has been described as humane and welfare-oriented – often referred to as ‘Nordic exceptionalism’ Aim This study explores how key actors working in 13 substance treatment units in Norwegian prisons assess the responsibilities, working methods and goal attainment of these units, and how their descriptions fit the idea of a Nordic exceptionalism. Data and Method The data consists of qualitative interviews with 23 strategically selected informants of the specialist health care services and the correctional services. The interviews were analysed with the aid of systematic text condensation (STC). Results The results show that ‘rehabilitation’, ‘substance use treatment’ and ‘dynamic control’ are key topics for those who work in the substance treatment units. Overall, the informants describe the rehabilitation programmes in the units as intensive and as aiming to improve the inmates' living conditions and social and cognitive skills, and to promote their reintegration into society. Moreover, informants state that inmates in the substance treatment units receive treatment from specialist health care services, and that the idea of therapy permeates many aspects of these units' activities. Informants also state that they prioritise less repressive forms of control in the relationship to the inmates, and that these forms of control are favourable to rehabilitation. Conclusions The main pattern that emerges from this study supports that welfare orientation and ideas about therapy and rehabilitation are priorities in work with imprisoned substance users in substance treatment units. The control of inmates in these units is described as less repressive and favourable to rehabilitation. This pattern is not unambiguous, however, and the findings in this study may therefore help add nuances to the notion of Nordic exceptionalism.

THE OFFENDER PERSONALITY DISORDER PATHWAY: RISKING REHABILITATION?

Following over a decade of treatment refusal by 'risky' offenders preventively detained in Dangerous and Severe Personality Disorder hospital and prison units, the coalition government now aims to improve treatment engagement in high secure prisons by clarifying pathways out of detention. This article asks whether the reconfiguration will end reliance upon preventive detention for public protection. Drawing on original empirical data collected by the author, it is argued that the government is unaware that offenders with 'severe personality disorder' appear to engage with treatment only if it increases their chances of achieving expedited parole. Hitherto, this incentive was provided by the Indeterminate Sentence for Public Protection; its replacement with determinate sentences under the Legal Aid, Sentencing and Punishment of Offenders Act 2012 will worsen treatment engagement, because they provide offenders with a prison release date. The troubling result may be increased reliance by the Secretary of State for Justice on his inherent jurisdiction under the Mental Health Act 1983 to transfer offenders due for prison release to secure psychiatric hospitals. To counter this limitation of risk-focused decision-making, it is proposed that judges be able to impose a new hybrid order combining a custodial term with a subsequent community mental health treatment requirement.

A eficácia sociopedagógica da pena de privação da liberdade

Este artigo recupera parte da pesquisa de doutoramento intitulada A eficácia sociopedagógica da pena de privação da liberdadeII, realizada no período de 1997 a 2001, junto ao Programa de Pós-Graduação em Educação da Universidade de São Paulo e defendida em 21 de agosto de 2001. A pertinência de voltar a refletir sobre o tema decorre da aprovação das Diretrizes Nacionais para a Oferta da Educação em Estabelecimentos Penais, conforme Resolução no 3, de 11 de março de 2009, do Conselho Nacional de Política Criminal e Penitenciária (CNPCP) e homologada pelo Ministério da Educação, por meio da Resolução nº 2 do Conselho Nacional de Educação (CNE) em 19 de maio de 2010. Uma consequência prática dessa normativa é a elaboração do Plano Nacional de Educação no Sistema Prisional e a obrigatoriedade de que cada estado da federação tenha o seu Plano Estadual de Educação nas Prisões, de onde emerge, implícita ou explicitamente, a ideia de um projeto político pedagógico para a educação em prisões. A pesquisa foi desenvolvida em quatro unidades de privação da liberdade, no estado de São Paulo, com uma amostra que envolve adolescentes, mulheres, homens adultos no interior do estado e homens cumprindo mais de doze anos de sentença. Trata-se de uma pesquisa longitudinal, documentada da infância à fase adulta e que diagnostica o estado em que os indivíduos entraram na prisão, as transformações que sofreram e as condições objetivas que teriam ao saírem em liberdade. As conclusões da pesquisa constituem importante subsídio para o atual debate sobre a educação em prisões no Brasil.

Exploring the Effect of Exposure to Short-Term Solitary Confinement Among Violent Prison Inmates

This study tracked the behavior of male inmates housed in the general inmate populations of 70 different prison units from a large southern state. Each of the inmates studied engaged in violent misconduct at least once during the first 2 years of incarceration (n = 3,808). The goal of the study was to isolate the effect of exposure to short-term solitary confinement (SC) as a punishment for their initial act of violent behavior on the occurrence and timing of subsequent misconduct. This study relied upon archival longitudinal data and employed a multilevel counterfactual research design (propensity score matching) that involved tests for group differences, event history analyses, and trajectory analyses. The results suggest that exposure to short-term solitary confinement as a punishment for an initial violence does not appear to play a role in increasing or decreasing the probability, timing, or development future misconduct for this particular group on inmates. Upon validation, these findings call for continued research and perhaps a dialog regarding the utility of solitary confinement policies under certain contexts. This unique study sets the stage for further research to more fully understand how solitary impacts post-exposure behavior.

A Faith-based Prison Unit as a Community of Change

A Faith-based Prison Unit as a Community of Change

An Analysis of a New Zealand Faith-based Prison Unit as a Place of Retreat

An Analysis of a New Zealand Faith-based Prison Unit as a Place of Retreat

One Road to Prison Reform Runs Through Europe

Following the U.S. Supreme Court’s landmark decision in Plata v. Brown, the author toured prison systems in Western Europe with a University of Maryland study abroad program and then again with corrections and public officials from three states. The goal of the first trip was to compare and contrast competing correctional systems. The second trip was designed to expose relevant public officials to different penological values and practices. Both groups quickly appreciated the profound differences in conditions and philosophies. Even though imprisonment in these European countries is a last resort, prisons are designed to be as “normal” as possible. The State’s responsibility goes past the constitutional minimum under the Eighth Amendment to provide food, clothing, shelter and personal safety. Reintegration into the community—not punishment—is the primary objective. These values translated to conditions and programs that are more humane and effective than those typically found in the United States. Correctional leaders used this experience to put into place programs limiting the housing of the mentally ill prisoners in segregation, improving reentry programs, and “normalizing” some prison units. Direct and personal exposure to European prison and criminal justice systems promoted humane and effective prisons at home.

Drogadição no cárcere: questões acerca de um projeto de desintoxicação de drogas para pessoas privadas de liberdade

In this theoretical study the aim was to analyze a specific project of drug detoxification exclusively directed to incarcerated people. This referred project is based on the logic of total abstinence. Although literature emphasizes harm reduction as a privileged strategy to deal with drug use in prisons, what we recognize are actions that emphasize abstinence, both in criminal proceedings and in prison units. One example of this type of action is the project mentioned above, sustained by a model that prohibits drug use and relapse. We understand the complexities involved in carrying out actions of harm reduction in prisons, given the specificities of this place. However, the use of drugs is part of prisons' routines. As such, it needs to be approached as a problem that goes beyond any individual prisoner; it is a part of the social node, both outside and inside prisons.

Portuguese

DOI: http://dx.doi.org/10.14244/19827199668 This study aims to analyze how two extension projects - Legal Adoption of Inmates (ASCES) and Teacher Training for Penitentiary System (UFPE) - enable coordinated actions of citizenship and human rights in a prison facility located in the ‘agreste’ region of Pernambuco state, Brazil, since 2001 (ASCES) and 2009 (UFPE). The work was articulated based on the participation of ASCES teachers in the Research Group of UFPE-CNPq, and on the perception of how the integration of institutional activities could improve results and include a larger number of teachers, students, and beneficiaries - prisoners and educators of the penitentiary system. The actions involving broad participation of civil society were carried out fortnightly at the prison unit; the works are presented in the form of training meetings with teachers, lectures, and discussions with inmates, as well as in activities mediated by playful elements such as images, photographs, films, documentaries, music, and poetry. Students from the two institutions are integrated without competition; teachers receive continuing education; and recreational activities with the inmates break their prison routine and encourage them to remain in the classroom, reducing evasion. The activity is used as internship workload for the ASCES students and as supplementary activities for students of Pedagogy. These activities also allow the two institutions to contribute for improving the quality of education in prison; motivate the interaction of students from different institutions, including students form institutions that do not belong to the projects, attracting the participation of many volunteers and alumni from the ASCES and the Faculty of Philosophy, Sciences and Languages of Caruaru - FAFICA. Political fraternity appears as the theoretical framework in the work with teachers and in encouraging relations between the subjects involved in the concern with the formation of civilizing values based on the dignity of inmates or free citizens. The theoretical framework that subsidizes this study has Paulo Freire, Hannah Arendt and Barros as main authors. Keywords: University extension, Human rights, Political fraternity.

No place to run, no place to hide: Socio-organizational processes and patterns of inmate victimization

This paper discusses the victimization patterns of inmates of the largest prison unit of Bahia. It uses data from a screening survey with 591 participants, which culminated in 107 semistructured interviews and direct observation. The study demonstrates that 54.3% of inmates report some type of material, physical, and psychological victimization. It asserts that those patterns are structured by institutional violence, jail arrangements, and criminal gangs in the prison. It also demonstrates the influence of the availability of economic, cultural, and social capital in the levels of vulnerability. It concludes that the drama of inmate victimization is a key to understand the dynamics of a prison system that is more dystopian than we can imagine.

Clinical Characteristics and Service Use of Incarcerated Males with Severe Mental Disorders: A Comparative Case-Control Study with Patients Found Not Criminally Responsible

Since the drop in the bed capacity of civil psychiatric hospitals, an increase in the bed capacity of forensic psychiatric care and prison units has been reported in the United States and Europe. However, in Canada, a decrease in the number of people with severe mental illness (SMI) during the last two decades in penitentiaries has been reported. At the same time, an increase in individuals found not criminally responsible on account of mental disorder (NCRMD) was observed in forensic hospitals. The aim of this study is to compare incarcerated severely mentally ill (I-SMI) individuals with forensic-hospitalized SMI individuals in terms of their clinical profiles and service use in the province of Quebec (Canada). A case-control study design was selected using a sample of 44 I-SMI individuals and 59 forensic-hospitalized SMI individuals. Important findings include the following: I-SMI persons had less schooling; they more often reported suicide attempts and violent and non-violent crimes; and they had a higher level of comorbidity involving Cluster B personality disorders and substance-use disorders. Forensic-hospitalized SMI persons were more likely to have been receiving psychiatric follow-up before hospitalization. The final logistic regression model showed that lifetime suicide attempts, non-violent crimes, and psychopathic traits were higher among I-SMI individuals than among forensic-hospitalized SMI individuals. In contrast, receiving regular psychiatric follow-up was associated with forensic-hospitalized SMI individuals. Differences in psychopathological characteristics and the use of mental health services were found for I-SMI persons. More research is needed to determine which new initiatives might be efficacious in addressing the mental health needs of I-SMI individuals.

Insights into the population structure of Mycobacterium tuberculosis using spoligotyping and RDRio in a southeastern Brazilian prison unit

Tuberculosis (TB) is still a serious public health problem, continuing to be an important threat for confined populations. We used spoligotyping to estimate the genotypic clades of Mycobacterium tuberculosis isolates from inmates in two blocks in a southeastern Brazilian prison unit, with TB incidence rate of 8185/100.000. The Latin American Mediterranean (LAM) clade is well represented in the country, and the LAM specific molecular markers, RDRio large sequence polymorphism and the SNP on the Rv3062 [ligB1212], were used to characterize spoligotype signatures from prison isolates. Typing of RDRio and ligB increase LAM clade from 66.7% (n=72/108) to 69.4% (n=75). The LAM2 SIT17 (n=23) and SIT179 (n=12) signatures comprised one third of all isolates, followed by Haarlem (11.5%, n=12), T (8.7%, n=9) and X (5.7%, n=6) clades. Strains with unknown signatures represented 5.5% (n=6), and four (3.7%) did not match any lineage. We observed RDRio among 64 (59.2%) isolates, and 54 (50%) were of the LAM clade. In particular, the LAM2/RDRio sub-lineage was significantly associated with clustering (p=0.02) and its frequency was higher (32%) when compared to that of the previous general TB cases in RJ (4.29%). Overall cluster frequency defined by spoligotyping/IS6110-RFLP was 62%. The two evolutionary markers helped to evaluate some LAM signature misconceptions and demonstrate that LAM2/RDRio was found with high frequency, hitherto being unnoticed. All these data, allied to high clustering, imply that public health measures to minimize the escalation of TB in prison is essential, and both spoligotyping as well as RDRio would be useful tools to monitor the effects of the measures with respect to M. tuberculosis lineage variation.

The need to improve health care in prisons.

OBJECTIVETo analyze physical structure, working conditions of health professionals and outline of the procedures established in prisons.METHODSWe analyzed 34 provisional detention centers and 69 male and six female prison units in the state of Sao Paulo, Southeastern Brazil, in 2009. A self-applied instrument was developed to collect quantitative data on the characteristics of health care structure, equipment and personnel in prisons. Analysis of variance (ANOVA) or equivalent non-parametric tests and Chi-square or Fisher’s tests were used to compare categorical and continuous variables, respectively, between the groups.RESULTSThe main problems were delays in the results of laboratory tests and imaging. With respect to the teams, it was observed that a large majority were in conditions close to those proposed by the Bipartite Commission 2013 but without improvement being reflected in the indicators. With respect to the process, more than 60.0% of prisons located in small towns do not have the structural conditions to ensure secondary or tertiary health care for the continuity of treatment.CONCLUSIONSThis profile of prisons in the country can be used for planning and monitoring future actions for the continuous improvement of healthcare processes.

Vulnerable Places: Prison Locations, Socioeconomic Status, and HIV Infection in Texas

U.S. prisons have higher rates of HIV infection and tend to locate in poor areas. Because the geographic concentration of vulnerable peoples creates an environment of heightened vulnerability to disease, and vulnerable places attract vulnerable people (Oppong and Harold 2009), we should expect higher HIV infection rates in areas immediately adjacent to prison facilities. Using deidentified HIV surveillance data, we explore this hypothesis. The results suggest that areas in close proximity to prison units have lower socioeconomic status and higher HIV rates, with clear distance decay, and should be prioritized for increased intervention to reduce HIV incidence.

"Quem mantém a ordem, quem cria desordem": gangues prisionais na Bahia

Em diversas democracias ocidentais onde diretrizes políticas de encarceramento foram adotadas, é possível observar a existência cada vez mais forte e recorrente de coletivos organizados de presos, a saber, as gangues prisionais. No Brasil, esse fenômeno também é observado em boa parte de suas unidades federativas. Procuramos aqui identificar alguns dos fatores e das nuanças que compuseram a relação entre Estado, administração prisional e as duas principais gangues prisionais que atuaram na Bahia durante a primeira década dos anos 2000. Ao utilizarmos a metodologia de estudo de caso e da triangulação de informações, encontramos elementos que ajudam a compreender como seu deu o processo de instauração e manutenção dessas gangues dentro e fora das unidades prisionais no período analisado.

Short-Run Prosocial Behavior in Response to Receiving Corrections and Affirmations in Three Therapeutic Communities

Therapeutic communities (TCs) have a strong record of maintaining high quality social climates in prison units. One possible reason for this is the system of mutual monitoring among TC residents, based on the assumption that peer affirmation of behavior in accord with TC norms, and peer correction of behavior contrary to TC norms, will lead to increased resident prosocial behavior. Laboratory experiments have demonstrated that such peer monitoring can lead to cooperation, but there has been no quantitative test of this hypothesis in an actual TC. In this article we test this assumption by using the affirmations that residents of three different TCs send as a measure of prosocial behavior following the reception of peer affirmations and corrections. At all three facilities residents send more affirmations following the reception of both affirmations and corrections, with this relationship being stronger and longer lasting after receiving affirmations. No other variable consistently predicts the number of affirmations that residents send to peers. These findings imply that mutual monitoring among TC residents can lead to increased levels of prosocial behavior within the facility, and that prosocial behavior in response to peer affirmations plays a key role.

Gender Relations and Division of Labour among Prison Officers in Swedish Male Prisons

In Sweden, female prison officers are a long-established fact. Today women make up about 38% of the prison officer work-force. However, the distribution of sexes in the organization is quite uneven between different types of prison wings and units, and at the in-group level there is an informal gendered division of labour going on. The article deals with how a gendered division of labour comes about as a result of socially established motives and notions among prison officers, as well as prisoners, about men's and women's different qualities in performing different types of work tasks. It is based on data from a minor interview study (from 2006), and a 3-year multi-strategic research project containing qualitative case-studies and a nationwide survey (from 2007–2009). The article concludes that a great number of female officers contribute to a more prominent position for the rehabilitative side of prison work. However, the on-going gendered division of labour in and between wings and units is also one important factor behind sub-cultural differentiation and variations in work practices in the prison organization. A more balanced distribution of the sexes would stimulate rehabilitative work and a more unified view of the occupational role throughout the whole organization.