State Prison System Research Articles

Conducting research as a visiting scientist in a women's prison.

Incarcerated populations have disparities in health risks and illness conditions meriting study, but the history of prison research is marred by unethical conduct. Ethical participation strategies are discussed in the context of studies implemented by the author in a state prison system. This study used ethnographic approaches, observed adherence to federal and institutional review board regulations and corrections department directives, and maintained continuous communication with vested interests to provide entry and long-term access for studies on female prisoners and their civilian infants. A culture clash between the punitive restrictive environment that serves the custody-control-care mission of corrections systems and the open inquiry environment needed for conduct of health research exists. Federal regulations protect prisoners as human subjects but additional vigilance and communication by researchers are required. Gaining and maintaining access to prison inmates for nursing research are leadership challenges that can be met within the caring and collaborative paradigm of nursing.

"There Is No Treatment Here:" Disability and Health Needs In A State Prison System

To understand the disability and health needs of prisoners, the Vermont Prisoner's Health Coalition sent out a survey to every adult prisoner within the Vermont correctional system in the fall of 2002. Open-ended questions centered on disability, health care, and treatment received by inmates within the Vermont correctional system. 190 surveys were returned, and narrative responses were analyzed using qualitative research methods. Most respondents reported having some kind of disability, including learning, developmental, or psychiatric disabilities. Treatment and accommodations were described as inadequate or non-existent, and long wait times for services were typical. The importance of listening to the voices of prisoners regarding accommodations and supports for their disabilities, and perceptions of the quality of their health care, is emphasized.

Health Status in US and Russian Prisons: More in Common, Less in Contrast

It has been 17 years since I began working in correctional health care. During that time, I managed the health services at Rikers Island (New York City's jail), supervised the health services for New York State's prison system, and, for the past io years, had a consulting practice focused on public policy, public health, and quality of health services in US jails, prisons, and juvenile facilities. I have examined the conditions of confinement and health services in more than ioo correctional facilities in 27 states. My work is about assuring access to high-quality health care for the 2.2 million people in US prisons and jails (i), protecting public health through prevention and early intervention, and assuring vital health services linkages for the 95% of inmates who return home to their communities. Reading the Bobrik et al. paper about the health status and health care for inmates in Russian prisons (2), it is easy to imagine the conditions: cells packed tightly with 30 sweaty bodies, milling aimlessly; hungry folks; rank odors and clamor; and air that is still and dank, all the more disagreeable with airborne droplets so likely to be carrying Mycobacterium tuberculosis. Not pleasant thoughts. Tuberculosis in Russian prisons is redolent of conditions in prisons in the United States a century ago. In 1894, Dr. Julius Ransom, a prison physician, reported that 25% of the 1,ooo inmates at the prison in Dannemora, NY, had active tuberculosis (3). In his report to Congress in 1907, the rates were unchanged, with high mortality, more than half of which was attributed to tuberculosis (4). One

The Impact of Administrative Support on Prison Treatment Staff Burnout: An exploratory Study

This exploratory study examined the relationship between upper-level administrative support and the burnout of 83 mental health and substance abuse staff working within a state prison system in the Midwest. After conducting univariate analyses, The author found that the burnout of the treatment staff seemed quite low, whereas their opinions about the supportiveness of high-ranking treatment managers varied considerably. Stepwise regression procedures indicated that danger, administrative support, and inmate contact, in descending order of strength, were the best predictors of exhaustion (burnout). Weaker perceptions of support from the deputy warden of special services were linked to higher exhaustion scores. A basic content analysis also revealed that the exhaustion of treatment staff could emerge from a range of sources. Suggestions on how to improve managerial support to prevent burnout and recommendations for further research are discussed.

Report on the Prison Litigation Reform Act: What Have the Courts Decided so Far?

The Prison Litigation Reform Act was passed by Congress in 1996. It had a two-fold purpose: reduce the amount of prisoner litigation and curtail the involvement of the federal courts in the operations of state prison systems. Since its passage, the U.S. Supreme Court and numerous lower federal courts have had the opportunity to interpret several of its complicated and controversial provisions. This article looks at what the courts have decided thus far and predicts future court opinions.

Health care delivery in the Texas prison system: the role of academic medicine.

Faced with explosive growth in its prison population and a legal mandate to improve medical care for incarcerated offenders, the state of Texas implemented a novel correctional managed health care program in 1994. The organizational structure of the program is based on a series of contractual relationships between the state prison system, 2 of the state's academic medical centers, and a separate governing body composed of 9 appointed members, which include 5 physicians. All medical, dental, and psychiatric care for more than 145,000 offenders, incarcerated under the jurisdiction of the Texas Department of Criminal Justice, is provided by the University of Texas Medical Branch and Texas Tech University Health Sciences Center. The health delivery system is composed of several levels of care, including primary ambulatory care clinics in each prison unit, 16 infirmaries at strategic locations throughout the state, several regional medical facilities, and a dedicated prison hospital with a full range of services. Specialized treatment programs have been established at various units for patients with chronic conditions, such as hypertension, diabetes mellitus, major psychiatric disorders, hepatitis, and human immunodeficiency virus infection. Significant improvements in health outcomes have occurred since the managed care program was established.

Psychiatric Disorders in Aging Prisoners

Objective:The purpose of this study is to describe and compare older individuals (over the age of 55) presently incarcerated in the Tennessee State Prison System who have diagnosed with mental illnesses with those older prisoners without diagnoses of mental illnesses. Method (Design, Setting, Participants):This study examined 671 Tennessee State Prison inmates 55 years of age and older. These prisoners were divided into two groups: those having a diagnosis of mental illness and those without such a diagnosis. Factors such as incidence of reincarceration, length of sentencing, mental illnesses and offenses committed were compared. Results (Interventions, Measurements):This study showed many characteristics of the mentally ill geriatric offender. Significance was found between gender and psychiatric illness, as well as between gender and the illnesses of depression and dementia. Women with a depressive disorder were more likely to have committed murder, and men with dementia were more like to have committed a sex crime. Conclusions:These findings indicate that there are a number of older individuals currently incarcerated in Tennessee prisons. Sixteen percent of these individuals had a diagnosis of a mental illness. This study's findings raise critical issues relative to the older incarcerated mentally ill population, which require additional research.

A RANDOMIZED EXPERIMENT TESTING INMATE CLASSIFICATION SYSTEMS*

Research Summary: In California, incarceration in the state prison system is in part organized by security level. The higher the security level, the more restrictive the setting. Upon arrival at a reception center, new inmates are scored within a classification system that is used to determine the appropriate level of security. In this paper, we report on the development and testing of a new inmate classification scoring system. Over 20,000 inmates took part in a randomized experiment in which half were assigned to their housing using the existing scoring system and half were assigned to their housing using the new scoring system. There were two key outcomes: (1) potential mismatches between the number of inmates assigned to different security levels and the available beds and (2) reports of inmate misconduct.Policy Implications: We conclude there to be some potential crowding problems, but that the new scoring system is much better than the old scoring system in sorting inmates by the likelihood of misconduct. We also conclude that some predictors popular in the past are no longer effective (e.g., marital status), while some new predictors are extremely powerful (e.g., gang activity), and that one can build in a number of mandatory housing placements (e.g., for sex offenders) and not degrade the overall effectiveness of the new classification system. Finally, the new classification system is shown to be more user‐friendly than the existing classification system and well received by the staff responsible for implementing it.

Alcatraz and Marion

The controversy over the behavioral and mental health consequences of confinement in high-security prisons has its origins in penal policies dating to the early 19th century. The rationale leading to the establishment of the first super-maximum custody prison at Alcatraz Island, California and the conversion in 1983 of the federal penitentiary at Marion, Illinois to a ‘supermax’ regime is briefly described. The subsequent application of the ‘Marion model’ by state prison systems is reviewed in terms of legal challenges and the criticisms of mental health professionals. Several measures of conduct after release from conditions of supermax confinement for Alcatraz and Marion inmates are presented. The need for systematic research and the difficulties in undertaking studies of this important new direction in penal policy are discussed.

Building an HIV continuum for inmates: New York State's criminal justice initiative.

The benefits of public health, corrections, and community-based organization (CBO) collaboration to meet HIV prevention needs of inmates are recognized. Each year over 100,000 inmates, most of whom have a history that put them at HIV risk, pass through the New York State (NYS) prison system. The NYS Department of Health AIDS Institute, the NYS Department of Correctional Services, the NYS Division of Parole, and a statewide network of CBOs collaborate to meet HIV prevention and support services needs of inmates and parolees through a continuum of interventions and services. This article describes the evolution of the prevention, supportive services, and transitional planning continuum within the NYS prison system. It identifies other agencies involved, obstacles to service delivery, describes approaches to overcome them, discusses ways to meet capacity building and technical assistance needs of CBOs, identifies challenges remaining, and provides practical advice from actual experience in NYS.

Health outcomes of incarcerated pregnant women and their infants in a community-based program

An experimental, community-based, residential program, focused on health promotion, was established in 1990 for incarcerated pregnant women with short-term sentences and histories of drug abuse in a large, midwestern metropolitan area in the United States. Infants resided with mothers after birth. Prenatal care, delivery, postpartum, and family-planning services were initiated and provided by a nurse-midwifery service. Community-based health care, job training, and drug rehabilitation were provided for women during pregnancy through the fourth postpartum month. Program participants’ prenatal, delivery, postpartum, and neonatal health outcomes are presented and compared with those of incarcerated women in the same state prison system who experienced usual correctional facility care and support. Program participants represented a group of obstetrically high-risk women. Health outcomes for both groups of incarcerated women and their infants were similar and more optimal than would have been expected given their preexisting health conditions and risk factors.

Central New York psychiatric center: an approach to the treatment of co‐occurring disorders in the New York State correctional mental health system

Central New York Psychiatric Center operates a maximum security inpatient treatment hospital and outpatient mental health services for all of the 72 New York State prisons. In this article prevalence data, patient characteristics, and interventions offered to inmates diagnosed with co-occurring mental illness and substance abuse disorders in the New York State prison system are reviewed and discussed. Available interventions have resulted from the close collaboration of the State Department of Correctional Services and State Office of Mental Health. Aspects of current programs and plans for future service developments are discussed along with implications for the treatment of an offender population diagnosed with a co-occurring disorder.

Availability of HIV Prevention Services Within New York State Correctional Facilities During 1999-2000: Results of a Survey

This survey examined the extent of HIV prevention interventions available to approximately 70,000 inmates housed in the 69 correctional facilities that comprise New York State's prison system and explored barriers to offering prevention services. Specific HIV prevention interventions were selected. A written survey was used to ascertain their availability within the previous 12-month period at each correctional facility. Correctional facilities reported a high level of availability of HIV prevention interventions and services. All 69 (100%) reported prevention education, and 59 (86%) said they met or exceeded inmate demand. More than 90% reported individual and group counseling and more than three-quarters offered both English and Spanish. Support groups were reported as being offered at 50 (73%) prisons. Significant progress in meeting HIV prevention needs of New York State inmates has been achieved. The Criminal Justice Initiative is a highly effective service delivery model. Efforts to better meet needs of Spanish-speaking inmates should continue.

Psychiatry Residents Threatened By Michigan’s Budget Crisis

Psychiatry Residents Threatened By Michigan’s Budget Crisis

Prisoner Reentry: Current Trends, Practices, and Issues

After three decades of passing laws and implementing policies designed to dramatically increase the nation's prison population and harden the conditions of confinement, there is a newfound interest among policy makers and criminologists in prisoner release. Using national data and a survey of eight states, this article examines the current “state of the art” of prisoner reentry. Not surprisingly, most state prison systems are ill equipped to ease the transition of inmates from prison to the community. A significant portion of released inmates pose minimal risk to public safety. Parole supervision increasingly results in ex-convicts' being reincarcerated for noncriminal behavior or misdemeanor crimes. For most inmates, reentry should be curtailed by either eliminating supervision or greatly shortening the period of supervision.

Current tobacco policies in U.S. adult male prisons☆

The current national trend in the restriction of smoking and use of tobacco products is extending to the prison system. At the same time that city, state and the federal governments are limiting smoking in public places and businesses, state and federal prison systems are limiting use in correctional facilities. The data for this paper was collected by mail from departments of correction in the fifty states, the District of Columbia and the federal Bureau of Prisons. The results show a continuing trend in tobacco limitation policies at male prisons within the U. S. Several states totally ban all tobacco and only a few still allow generally unlimited use. Limitation policies range from segregation into smoking and nonsmoking areas to the banishment of inmates and staff to smoking areas outside prison buildings. While many see a nonsmoking prison system as the wave of the future, use of tobacco in prisons is still common. This research examines the official reason given for changes in tobacco policy and the alterations in prison operations that developed after restrictions were implemented. Increased tensions developed among inmates, staff and administration as a result of the new policies. For those prison systems that banned tobacco, an active black market operation developed eclipsing other contraband problems.

Perceptions of the Juvenile Justice System Among Adult Prison Inmates

Although some studies have investigated the perceptions of various groups concerning the juvenile justice system, little research has examined the views of prison inmates regarding this system. Because many adult offenders had contact with the juvenile justice system, or personally know those who did, their experiences should influence their perceptions. Consequently, their views could shed some light on the direction that the juvenile justice system might take in the future. In order to investigate the perceptions of adult offenders, 116 inmates currently incarcerated in a state prison system completed a 20-item questionnaire addressing the following areas: (1) how helpful the juvenile justice system was to them personally; (2) the effectiveness of the juvenile justice system in deterring other juveniles; (3) what the juvenile justice system could have done to prevent them from committing further crimes; and (4) how the juvenile justice system could be improved to become more effective. The results indicated that the majority of the offenders reported that the juvenile justice system was not particularly helpful to them personally, and few felt that the juvenile justice system was very effective in deterring other juveniles. Their suggestions concerning improving the juvenile justice system were discussed in terms of their policy implications.

Reinventing the penitentiary: Punishment in Florida, 1868–1923

This study of the origins and development of Florida's state prison system, and the shift from the penitentiary to convict leasing in the 1880s, examines the relationship between penal practice in one Southern state and Foucault's conception of penal modernity, and the connections between race and gender and leasing. It argues that convict leasing which emerged from the failure of the penitentiary in Florida, reflects the continuity of an older model of punishment centering on punishing the body physically. Discipline and surveillance were essential features of Florida's convict lease system, but the absence of massive walls, individual cells and regimes of silence meant this Southern model conducted on private turpentine farms and phosphate mines was very different from the original Auburn and Pennsylvania penitentiaries.

Drugs and Prisoners: Treatment Needs on Entering Prison*

An interview study was conducted among a group of incoming prisoners in a county jail in Ohio during the summers of 1997 and 1998 to assess their current drug treatment needs. “Incoming prisoners” refers to individuals who were being transferred from this county jail to the state prison system. Marijuana and cocaine were the most commonly tried illegal drugs among the subjects as well as the drugs of choice during the month prior to imprisonment. The Diagnostic Interview Schedule, combined with questions employed in the Drug Use Forecasting (DUF) project, was used to construct the questionnaire for this study. Based on the criteria of DSM-IV diagnoses, 57.5% of those interviewed had exhibited drug dependency at some point in their lives, and 51% were currently dependent on some substance. Thus, more than half of the incoming prisoners were in need of treatment for use of at least one substance. Cocaine dependence was the greatest problem facing this group of inmates, with an especially notable problem among the older females. Younger males were more likely to have current marijuana dependence. The study found that individuals currently dependent on cocaine or opiates perceived that they had a need for drug treatment, while those currently dependent on marijuana did not share this perception.

Gauging the Effectiveness of a Preventive Dental Program in a Large State Prison System

Gauging the effectiveness of a preventive dental program that was implemented in a large state penal system over 10 years ago is the emphasis for this article. Results indicate the overall possible success of such a preventive program based on the low number of appointments required by the offender to achieve acceptable oral hygiene. Unfortunately, study results are not compared to reference groups as no previous survey gauging oral hygiene improvement has ever been done in a penal institution.