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Eck M, Da Costa J, Wathelet M, Beunas C, D'Ovidio K, Moncany AH, Thomas P, Fovet T. [Prevalence of mental disorders in French prisons: A systematic review]. L'ENCEPHALE 2024; 50:446-464. [PMID: 38378405 DOI: 10.1016/j.encep.2023.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION The prevalence of psychiatric disorders among prisoners remains a major public health issue worldwide. In France, despite the increasing number of persons who are incarcerated (+30% between 1992 and 2002 with a 120% prison overcrowding), and a historical concern about the mental health of persons in detention and its management, no systematic review has been published on this subject. The aim of this article is to present the results of a systematic review of the literature on the prevalence of psychiatric disorders in French prisons. METHOD The reporting of this systematic review conforms to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) checklist. We searched the PubMed and Web of Science databases. We used combinations of keywords relating to prison (prison*, jail*, inmate*), to psychiatry ("mental health", psychiatr*), and to France (France, French). This work was completed with a search through the digital libraries of the École des Hautes Études en Santé Publique (EHESP) and of the Système Universitaire de Documentation (Sudoc) to obtain data from academic works and the gray literature. References cited in studies included in this review were also examined. All references published up to September 2022, written in English or French, presenting the results of original quantitative studies on the prevalence of psychiatric disorders in correctional settings were included. Two researchers independently extracted data from included references according to a pre-established protocol. RESULTS Among 501 records identified, a total of 35 papers based on 24 epidemiological studies met the eligibility criteria for inclusion in this review: 16 were cross-sectional, 7 retrospective and 1 both cross-sectional and retrospective. All papers were published between 1999 and 2022. We found one European study, 5 international studies, 18 regional or local studies. Of these, 21 studies had all-male or mixed gender samples (but when the sample was mixed gender, it was always at least 92% male). Almost half of the studies (n=11) involved a small sample of fewer than 500 persons. Half of the studies involved a sample of recently incarcerated persons: 6 involved a random sample of persons in detention, and 1 involved a sample of people incarcerated for more than 5 years. The last 5 studies focused on persons aged over 50 years and incarcerated for more than one year (n=1), incarcerated for sexual offences (n=2), placed in disciplinary cells (n=1) or in a special wing for radicalized or suspected radicalized individuals (n=1). Nine studies used standardized and validated diagnostic tools. According to the 4 studies involving representative samples and using standardized and validated diagnostic tools, the prevalence of the following psychiatric disorders was: 29.4-44.4% for anxiety disorders, 5-14.2% for PTSD, 28-31.2% for mood disorders, 6.9-17% for psychotic disorders, 32% for personality disorders and 11% for ADHD. CONCLUSION This systematic review of the literature highlights the high prevalence of psychiatric disorders in French prisons. The data collected are in line with international studies. The great methodological heterogeneity of the papers included in this review calls for further rigorous research to better understand the rates of mental disorders in French prisons and to explore their determinants.
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Affiliation(s)
- Marion Eck
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France; Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France.
| | - Julien Da Costa
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Marielle Wathelet
- Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France; Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Clément Beunas
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Kevin D'Ovidio
- Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France (F2RSM Psy), Saint-André-lez-Lille, France
| | - Anne-Hélène Moncany
- Pôle de psychiatrie légale et de conduites addictives en milieu pénitentiaire, centre hospitalier Gérard Marchant, 31057 Toulouse, France
| | - Pierre Thomas
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
| | - Thomas Fovet
- Inserm, U1172 - Lille neuroscience & cognition, université de Lille, 59000 Lille, France; Pôle de psychiatrie, médecine légale et médecine en milieu pénitentiaire, CHU de Lille, 59000 Lille, France
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Fliss MD, Lao J, Behne F, Brinkley-Rubinstein L. Few Prison Systems Release Individual Death Data: Death in Custody Reporting Act Completeness, Speed, and Compliance. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:424-428. [PMID: 38603750 DOI: 10.1097/phh.0000000000001893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
The United States has one of the largest incarcerated populations per capita. Prisons are dangerous environments, with high in-prison and postrelease mortality. The Death in Custody Reporting Acts (DCRAs) of 2000 and 2013 require deaths of people in correctional custody or caused by law enforcement to be reported to the Bureau of Justice Assistance. These deaths must be reported within 3 months of the death and include 10 required fields (eg, age, cause of death). There is no public reporting requirement. Our Third City Mortality project tracks near-real-time data about individual deaths released publicly and prison system metadata, including data completeness and release speed, across (N = 54) US state, federal (N = 2; Bureau of Prisons, Immigration and Customs Enforcement), Washington, District of Columbia, and Puerto Rico prison systems. Twenty-one (38%) systems release no individual death data; 13 systems release incomplete data slower than 1 year; 19 release timely, but incomplete, death data; and only one system (Iowa) releases complete and timely data. Incomplete, untimely, public prison mortality data limit protective community responses and epidemiology.
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Affiliation(s)
- Mike Dolan Fliss
- Author Affiliations: Population Health Department, Duke University, Durham, North Carolina (Drs Fliss and Brinkley-Rubinstein and Mr Behne); UNC Injury Prevention Research Center (Dr Fliss) and Gillings School of Global Public Health (Mr Behne), The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts (Ms Lao)
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Baskin-Sommers A, Williams A, Benson-Williams C, Ruiz S, Ricard JR, Camacho J. Shrinking the footprint of the criminal legal system through policies informed by psychology and neuroscience. COMMUNICATIONS PSYCHOLOGY 2024; 2:38. [PMID: 39242804 PMCID: PMC11332213 DOI: 10.1038/s44271-024-00090-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/17/2024] [Indexed: 09/09/2024]
Abstract
The footprint of the legal system in the United States is expansive. Applying psychological and neuroscience research to understand or predict individual criminal behavior is problematic. Nonetheless, psychology and neuroscience can contribute substantially to the betterment of the criminal legal system and the outcomes it produces. We argue that scientific findings should be applied to the legal system through systemwide policy changes. Specifically, we discuss how science can shape policies around pollution in prisons, the use of solitary confinement, and the law's conceptualization of insanity. Policies informed by psychology and neuroscience have the potential to affect meaningful-and much-needed-legal change.
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Affiliation(s)
- Arielle Baskin-Sommers
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA.
- Yale Law School, 127 Wall St, New Haven, CT, 06511, USA.
| | - Alex Williams
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA
| | | | - Sonia Ruiz
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA
| | - Jordyn R Ricard
- Department of Psychology, Yale University, 100 College St, New Haven, CT, 06510, USA
| | - Jorge Camacho
- Yale Law School, 127 Wall St, New Haven, CT, 06511, USA
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Rosenberg A, Puglisi LB, Thomas KA, Halberstam AA, Martin RA, Brinkley-Rubinstein L, Wang EA. "It's just us sitting there for 23 hours like we done something wrong": Isolation, incarceration, and the COVID-19 pandemic. PLoS One 2024; 19:e0297518. [PMID: 38354166 PMCID: PMC10866499 DOI: 10.1371/journal.pone.0297518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/05/2024] [Indexed: 02/16/2024] Open
Abstract
For the millions of people incarcerated in United States' prisons and jails during the COVID-19 pandemic, isolation took many forms, including medical isolation for those sick with COVID-19, quarantine for those potentially exposed, and prolonged facility-wide lockdowns. Incarcerated people's lived experience of isolation during the pandemic has largely gone undocumented. Through interviews with 48 incarcerated people and 27 staff at two jails and one prison in geographically diverse locations in the United States, we document the implementation of COVID-19 isolation policies from the perspective of those that live and work in carceral settings. Incarcerated people were isolated from social contact, educational programs, employment, and recreation, and lacked clear communication about COVID-19-related protocols. Being isolated, no matter the reason, felt like punishment and was compared to solitary confinement-with resultant long-term, negative impacts on health. Participants detailed isolation policies as disruptive, detrimental to mental health, and dehumanizing for incarcerated people. Findings point to several recommendations for isolation policy in carceral settings. These include integrating healthcare delivery into isolation protocols, preserving social relationships during isolation, promoting bidirectional communication about protocols and their effect between facility leadership and incarcerated people. Most importantly, there is an urgent need to re-evaluate the current approach to the use of isolation in carceral settings and to establish external oversight procedures for its use during pandemics.
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Affiliation(s)
- Alana Rosenberg
- SEICHE Center for Health and Justice, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Lisa B Puglisi
- SEICHE Center for Health and Justice, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Kathryn A Thomas
- SEICHE Center for Health and Justice, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Alexandra A Halberstam
- SEICHE Center for Health and Justice, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Rosemarie A Martin
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, School of Public Health, Brown University, Providence, Rhode Island, United States of America
| | - Lauren Brinkley-Rubinstein
- Department of Population Health Sciences and the Samuel Dubois Cook Center on Social Equity, Duke University, Durham, North Carolina, United States of America
| | - Emily A Wang
- SEICHE Center for Health and Justice, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
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Fitch KV, Pence BW, Rosen DL, Miller VE, Gaynes BN, Swilley-Martinez ME, Kavee AL, Carey TS, Proescholdbell SK, Ranapurwala SI. Suicide Mortality Among Formerly Incarcerated People Compared With the General Population in North Carolina, 2000-2020. Am J Epidemiol 2024; 193:489-499. [PMID: 37939151 DOI: 10.1093/aje/kwad214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/11/2023] [Accepted: 10/27/2023] [Indexed: 11/10/2023] Open
Abstract
We aimed to compare rates and characteristics of suicide mortality in formerly incarcerated people with those of the general population in North Carolina. We conducted a retrospective cohort study of 266,400 people released from North Carolina state prisons between January 1, 2000, and March 1, 2020. Using direct and indirect standardization by age, sex, and calendar year, we calculated standardized suicide mortality rates and standardized mortality ratios comparing formerly incarcerated people with the North Carolina general population. We evaluated effect modification by race/ethnicity, sex, age, and firearm involvement. Formerly incarcerated people had approximately twice the overall suicide mortality of the general population for 3 years after release, with the highest rate of suicide mortality being observed in the 2-week period after release. In contrast to patterns in the general population, formerly incarcerated people had higher rates of non-firearm-involved suicide mortality than firearm-involved suicide mortality. Formerly incarcerated female, White and Hispanic/Latino, and emerging adult people had a greater elevation of suicide mortality than their general-population peers compared with other groups. These findings suggest a need for long-term support for formerly incarcerated people as they return to community living and a need to identify opportunities for interventions that reduce the harms of incarceration for especially vulnerable groups. This article is part of a Special Collection on Mental Health.
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Narita Z, Oh H, Koyanagi A, Wilcox HC, DeVylder J. Association of a History of Incarceration and Solitary Confinement with Suicide-Related Outcomes in a General Population Sample from Two U.S. Cities. Arch Suicide Res 2023:1-12. [PMID: 37937913 DOI: 10.1080/13811118.2023.2279523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
OBJECTIVES To evaluate whether a history of incarceration was associated with increased odds of suicidal ideation and suicide attempts, and to determine if this association was further strengthened when combined with a history of solitary confinement. METHODS We collected cross-sectional data from a general population sample in New York City and Baltimore in March 2017. Participants were categorized based on their history of incarceration and solitary confinement: (1) no incarceration, (2) incarceration-only, and (3) incarceration plus solitary confinement. We compared these three groups, utilizing hierarchical adjustments for sociodemographic factors and adverse childhood experiences. Missing data were accounted for utilizing multiple imputation via chained equation. RESULTS A total of 1221 individuals were analyzed. Those who experienced both incarceration and solitary confinement consistently had higher odds of suicidal ideation (OR, 2.80; 95% CI, 1.43 to 5.48) and suicide attempts (OR, 6.98; 95% CI, 2.77 to 17.61) than never incarcerated individuals. Those who experienced incarceration without solitary confinement had higher odds of suicide attempts (OR, 3.77; 95% CI, 1.35 to 10.56) than never incarcerated individuals, whereas this association was not evident for suicidal ideation. Solitary confinement increased the odds of suicidal ideation even compared to incarceration without solitary confinement (OR, 2.71; 95% CI, 1.09 to 6.74). CONCLUSIONS Our findings support the need to address the higher likelihood of suicide-related outcomes among those in contact with the criminal justice system, and to consider alternatives to solitary confinement.
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Abstract
A growing body of literature has engaged with mass incarceration as a public health problem. This article reviews some of that literature, illustrating why and how bioethicists can and should engage with the problem of mass incarceration as a remediable cause of health inequities. "Mass incarceration" refers to a phenomenon that emerged in the United States fifty years ago: imprisoning a vastly larger proportion of the population than peer countries do, with a greatly disproportionate number of incarcerated people being members of marginalized racial and ethnic groups. Bioethicists have long engaged with questions of health justice for incarcerated people, including consent issues for those participating in research and access to health care. This article provides an overview of the individual and public health impacts of mass incarceration. The article argues that mass incarceration is a bioethics issue that should be addressed in medical education, identifies opportunities for bioethicists to guide hospitals' interactions with law enforcement officials, and calls on bioethicists to be in conversation with medical and nursing students and health care professionals about these groups' advocacy efforts concerning structural racism, police violence, and mass incarceration.
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Raghunathan S. Returning research results to individuals who are incarcerated in the USA. JOURNAL OF MEDICAL ETHICS 2023:jme-2023-109493. [PMID: 37857508 DOI: 10.1136/jme-2023-109493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/28/2023] [Indexed: 10/21/2023]
Abstract
The return of research results to populations and individuals is increasingly recognised as both important but ethically complicated. In the USA, there are few studies or detailed evidence-based practices on the return of research results to individuals who are incarcerated. In general, return of research results is not required with some exceptions; however, there are reasons to believe that in many cases returning results is most consistent with the ethical conduct of research. With individuals who are incarcerated, specific considerations for this historically disadvantaged population should be addressed. These are privacy, therapeutic misconception, paternalism, actionability and communication. If research results are returned, the initial consent process should consider thoroughness regarding privacy rights, the researchers' role, clarity around next steps and communication methods. Prison leadership should be key stakeholders in the process to streamline communication. Returning research results can be a method to counter historical and current paternalism in the carceral setting, while shifting the culture on how research is understood and conducted in carceral settings. The decision to return results should balance benefits, risks and research ethics. Further research is needed to identify and implement optimal approaches for returning results in this population.
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Affiliation(s)
- Sahana Raghunathan
- The University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Cloud DH, Haney C, Augustine D, Ahalt C, Williams B. The resource team: A case study of a solitary confinement reform in Oregon. PLoS One 2023; 18:e0288187. [PMID: 37494407 PMCID: PMC10370690 DOI: 10.1371/journal.pone.0288187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
The continued use of solitary confinement has sparked international public health and human rights criticisms and concerns. This carceral practice has been linked repeatedly to a range of serious psychological harms among incarcerated persons. Vulnerabilities to harm are especially dire for persons with preexisting serious mental illness ("SMI"), a group that is overrepresented in solitary confinement units. Although there have been numerous calls for the practice to be significantly reformed, curtailed, and ended altogether, few strategies exist to minimize its use for people with SMI and histories of violence against themselves or others. This case study describes the "Oregon Resource Team" (ORT), a pilot project adapted from a Norwegian officer-led, interdisciplinary team-based approach to reduce isolation and improve outcomes for incarcerated persons with SMI and histories of trauma, self-injury, and violence against others. We describe the ORT's innovative approach, the characteristics and experiences of incarcerated people who participated in it, its reported impact on the behavior, health, and well-being of incarcerated persons and correctional staff, and ways to optimize its effectiveness and expand its use.
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Affiliation(s)
- David H Cloud
- Center for Vulnerable Populations, School of Medicine, University of California San Francisco, San Francisco, CA, United States of America
| | - Craig Haney
- Department of Psychology, University of California, Santa Cruz, Santa Cruz, CA, United States of America
| | - Dallas Augustine
- Center for Vulnerable Populations, School of Medicine, University of California San Francisco, San Francisco, CA, United States of America
| | - Cyrus Ahalt
- Center for Vulnerable Populations, School of Medicine, University of California San Francisco, San Francisco, CA, United States of America
| | - Brie Williams
- Center for Vulnerable Populations, School of Medicine, University of California San Francisco, San Francisco, CA, United States of America
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Cloud DH, Williams B, Haardöerfer R, Hosbey JT, Cooper HL. Self-injury and the embodiment of solitary confinement among adult men in Louisiana prisons. SSM Popul Health 2023; 22:101354. [PMID: 36865676 PMCID: PMC9971521 DOI: 10.1016/j.ssmph.2023.101354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/17/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Solitary confinement is a harrowing human rights and public health problem that is currently inflicted as a routine punishment for a litany of prison rule violations, a reactionary tactic to quell resistance to prison conditions, and as a destination of last resort for people serious mental illnesses (SMI) who are especially vulnerable to its harms. An extensive body of research has documented clusters of psychiatric symptoms-emotional distress, cognitive deficits, social withdrawal, anxiety, paranoia, sleeplessness, and hallucinations-linked to solitary confinement that often manifest in decompensating behaviors, which include self-injury and suicide. This study summarizes the historical evolution of solitary confinement, recaps its linkages to self-injury and suicidality, and offers a theoretical framework grounded in ecosocial theory, and supplemented with concepts from theories of dehumanization and carceral geography. Findings bolster extant evidence on the harms of solitary confinement by focusing on whether and how exertions of power by prison staff to deploy mechanisms of dehumanization-as a pathway between SMI and self-injury among a cross section of adult men (n = 517) exposed to solitary confinement in Louisiana prisons in 2017. Findings reinforce the need for structural interventions that diffuse forms of carceral power and practices that continue to subject people to isolation, dehumanization, and violence.
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Affiliation(s)
- David H. Cloud
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
- Amend, Center for Vulnerable Populations, University of California San Francisco, School of Medicine, USA
| | - Brie Williams
- Amend, Center for Vulnerable Populations, University of California San Francisco, School of Medicine, USA
| | - Regine Haardöerfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
| | - Justin T. Hosbey
- College of Environmental Design, University of California, Berkeley, USA
| | - Hannah L.F. Cooper
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, USA
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Cooper JA, Onyeka I, Cardwell C, Paterson E, Kirk R, O'Reilly D, Donnelly M. Record linkage studies of drug-related deaths among adults who were released from prison to the community: a scoping review. BMC Public Health 2023; 23:826. [PMID: 37147595 PMCID: PMC10161544 DOI: 10.1186/s12889-023-15673-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/13/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND There are public health concerns about an increased risk of mortality after release from prison. The objectives of this scoping review were to investigate, map and summarise evidence from record linkage studies about drug-related deaths among former adult prisoners. METHODS MEDLINE, EMBASE, PsychINFO and Web of Science were searched for studies (January 2011- September 2021) using keywords/index headings. Two authors independently screened all titles and abstracts using inclusion and exclusion criteria and subsequently screened full publications. Discrepancies were discussed with a third author. One author extracted data from all included publications using a data charting form. A second author independently extracted data from approximately one-third of the publications. Data were entered into Microsoft Excel sheets and cleaned for analysis. Standardised mortality ratios (SMRs) were pooled (where possible) using a random-effects DerSimonian-Laird model in STATA. RESULTS A total of 3680 publications were screened by title and abstract, and 109 publications were fully screened; 45 publications were included. The pooled drug-related SMR was 27.07 (95%CI 13.32- 55.02; I 2 = 93.99%) for the first two weeks (4 studies), 10.17 (95%CI 3.74-27.66; I 2 = 83.83%) for the first 3-4 weeks (3 studies) and 15.58 (95%CI 7.05-34.40; I 2 = 97.99%) for the first 1 year after release (3 studies) and 6.99 (95%CI 4.13-11.83; I 2 = 99.14%) for any time after release (5 studies). However, the estimates varied markedly between studies. There was considerable heterogeneity in terms of study design, study size, location, methodology and findings. Only four studies reported the use of a quality assessment checklist/technique. CONCLUSIONS This scoping review found an increased risk of drug-related death after release from prison, particularly during the first two weeks after release, though drug-related mortality risk remained elevated for the first year among former prisoners. Evidence synthesis was limited as only a small number of studies were suitable for pooled analyses for SMRs due to inconsistencies in study design and methodology.
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Affiliation(s)
- Janine A Cooper
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK.
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK.
| | - Ifeoma Onyeka
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Present address: Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, UK
| | - Christopher Cardwell
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
| | - Euan Paterson
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
| | - Richard Kirk
- Healthcare in Prison, South Eastern Health and Social Care Trust, Dundonald, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
- Administrative Data Research Centre Northern Ireland (ADRC NI), Centre for Public Health, Queen's University Belfast, Royal Hospitals Site, Grosvenor Road, Belfast, UK
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Cassarino N, Dabbara H, Monteiro CB, Bembury A, Credle L, Grandhi U, Patil A, White S, Jiménez MC. Conditions of Confinement in U.S. Carceral Facilities During COVID-19: Individuals Speak-Incarcerated During the COVID-19 Epidemic. Health Equity 2023; 7:261-270. [PMID: 37139167 PMCID: PMC10150723 DOI: 10.1089/heq.2022.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 05/05/2023] Open
Abstract
Objectives We aimed to describe conditions of confinement among people incarcerated in the United States during the coronavirus disease 2019 (COVID-19) pandemic using a community-science data collection approach. Methods We developed a web-based survey with community partners to collect information on confinement conditions (COVID-19 safety, basic needs, support). Formerly incarcerated adults released after March 1, 2020, or nonincarcerated adults in communication with an incarcerated person (proxy) were recruited through social media from July 25, 2020 to March 27, 2021. Descriptive statistics were estimated in aggregate and separately by proxy or formerly incarcerated status. Responses between proxy and formerly incarcerated respondents were compared using Chi-square or Fisher's exact tests based on α=0.05. Results Of 378 responses, 94% were by proxy, and 76% reflected state prison conditions. Participants reported inability to physically distance (≥6 ft at all times; 92%), inadequate access to soap (89%), water (46%), toilet paper (49%), and showers (68%) for incarcerated people. Among those receiving prepandemic mental health care, 75% reported reduced care for incarcerated people. Responses were consistent between formerly incarcerated and proxy respondents, although responses by formerly incarcerated people were limited. Conclusions Our findings suggest that a web-based community-science data collection approach through nonincarcerated community members is feasible; however, recruitment of recently released individuals may require additional resources. Our data obtained primarily through individuals in communication with an incarcerated person suggest COVID-19 safety and basic needs were not sufficiently addressed within some carceral settings in 2020-2021. The perspectives of incarcerated individuals should be leveraged in assessing crisis-response strategies.
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Affiliation(s)
| | - Harika Dabbara
- Brigham & Women's Hospital, Department of Medicine, Division of Women's Health, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Carla B. Monteiro
- Brigham Health Bridge Clinic, Boston, Massachusetts, USA
- Cape Verdean Social Workers Association, Boston, Massachusetts, USA
| | - Arthur Bembury
- Partakers Organization—College Behind Bars, Auburndale, Massachusetts, USA
| | - Leslie Credle
- National Council for Incarcerated and Formerly Incarcerated Women and Girls, Roxbury, Massachusetts, USA
- Justice 4 Housing, Boston, Massachusetts, USA
- Families for Justice as Healing, Boston, Massachusetts, USA
| | - Uma Grandhi
- University of California Santa Cruz, Santa Cruz, California, USA
| | - Ankita Patil
- Brigham & Women's Hospital, Department of Medicine, Division of Women's Health, Boston, Massachusetts, USA
| | - Samantha White
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Monik C. Jiménez
- Brigham & Women's Hospital, Department of Medicine, Division of Women's Health, Boston, Massachusetts, USA
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13
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Tverborgvik T, Stavseth MR, Bukten A. The association between drug use and mortality in a norwegian prison cohort: a prospective cohort study. HEALTH & JUSTICE 2023; 11:22. [PMID: 37058181 PMCID: PMC10103423 DOI: 10.1186/s40352-023-00223-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/05/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Elevated mortality rates are found among people who have experienced incarceration, even long after release from prison. The mechanisms related to this excess mortality are complex products of both individual and situational factors. The aim of this study was to describe all-cause and cause-specific mortality among people with a history of imprisonment, and to examine both individual and situational factors associated with mortality. METHODS In this prospective cohort study we used baseline survey data from the Norwegian Offender Mental Health and Addiction (NorMA) study (N = 733) linked with data from the Norwegian Cause of Death Registry during eight years of follow-up (2013-2021). RESULTS At end of follow-up, 56 persons (8%) of the cohort were deceased; 55% (n = 31) due to external causes such as overdoses or suicides, and 29% (n = 16) to internal causes such as cancer or lung disease. Having a score > 24 on the Drug Use Disorders Identification Test (DUDIT), indicating likely drug dependence was highly associated with external causes of death (OR 3.31, 95% CI 1.34-8.16), while having a job before baseline imprisonment had a protective effect on all-cause mortality (OR 0.51, ,95% CI 0.28-0.95). CONCLUSIONS High DUDIT score at baseline were highly associated with external causes of death, even years after the DUDIT screening was done. Screening incarcerated people using validated clinical tools, such as the DUDIT, together with initiation of appropriate treatment, may contribute to reduced mortality in this marginalized population.
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Affiliation(s)
- Torill Tverborgvik
- Norwegian Centre for Addiction Research, University of Oslo, P.O. Box 1074, Blindern, Oslo, 0316, Norway.
| | - Marianne Riksheim Stavseth
- Norwegian Centre for Addiction Research, University of Oslo, P.O. Box 1074, Blindern, Oslo, 0316, Norway
- Section for Clinical Addiction Research, Oslo University Hospital, P.O. Box 4959, Nydalen, Oslo, 0424, Norway
| | - Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, P.O. Box 1074, Blindern, Oslo, 0316, Norway
- Section for Clinical Addiction Research, Oslo University Hospital, P.O. Box 4959, Nydalen, Oslo, 0424, Norway
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14
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Cloud DH, Garcia-Grossman IR, Armstrong A, Williams B. Public Health and Prisons: Priorities in the Age of Mass Incarceration. Annu Rev Public Health 2023; 44:407-428. [PMID: 36542770 PMCID: PMC10128126 DOI: 10.1146/annurev-publhealth-071521-034016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Mass incarceration is a sociostructural driver of profound health inequalities in the United States. The political and economic forces underpinning mass incarceration are deeply rooted in centuries of the enslavement of people of African descent and the genocide and displacement of Indigenous people and is inextricably connected to labor exploitation, racial discrimination, the criminalization of immigration, and behavioral health problems such as mental illness and substance use disorders. This article focuses on major public health crises and advances in state and federal prisons and discusses a range of practical strategies for health scholars, practitioners, and activists to promote the health and dignity of incarcerated people. It begins by summarizing the historical and sociostructural factors that have led to mass incarceration in the United States. It then describes the ways in which prison conditions create or worsen chronic, communicable, and behavioral health conditions, while highlighting priority areas for public health research and intervention to improve the health of incarcerated people, including decarceral solutions that can profoundly minimize-and perhaps one day help abolish-the use of prisons.
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Affiliation(s)
- David H Cloud
- Center for Vulnerable Populations, San Francisco School of Medicine, University of California, San Francisco, California, USA;
- Rollins School of Public Health, Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - Ilana R Garcia-Grossman
- Center for Vulnerable Populations, San Francisco School of Medicine, University of California, San Francisco, California, USA;
| | - Andrea Armstrong
- College of Law, Loyola University New Orleans, New Orleans, Louisiana, USA
| | - Brie Williams
- Center for Vulnerable Populations, San Francisco School of Medicine, University of California, San Francisco, California, USA;
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15
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Janca E, Keen C, Willoughby M, Borschmann R, Sutherland G, Kwon S, Kinner SA. Sex differences in suicide, suicidal ideation, and self-harm after release from incarceration: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:355-371. [PMID: 36462041 PMCID: PMC9971066 DOI: 10.1007/s00127-022-02390-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE People released from incarceration are at increased risk of suicide compared to the general population. We aimed to synthesise evidence on the incidence of and sex differences in suicide, suicidal ideation, and self-harm after release from incarceration. METHODS We searched MEDLINE, EMBASE, PsycINFO, Web of Science and PubMed between 1 January 1970 and 14 October 2021 for suicide, suicidal ideation, and self-harm after release from incarceration (PROSPERO registration: CRD42020208885). We calculated pooled crude mortality rates (CMRs) and standardised mortality ratios (SMRs) for suicide, overall and by sex, using random-effects models. We calculated a pooled incidence rate ratio (IRR) comparing rates of suicide by sex. RESULTS Twenty-nine studies were included. The pooled suicide CMR per 100,000 person years was 114.5 (95%CI 97.0, 132.0, I2 = 99.2%) for non-sex stratified samples, 139.5 (95% CI 91.3, 187.8, I2 = 88.6%) for women, and 121.8 (95% CI 82.4, 161.2, I2 = 99.1%) for men. The suicide SMR was 7.4 (95% CI 5.4, 9.4, I2 = 98.3%) for non-sex stratified samples, 14.9 for women (95% CI 6.7, 23.1, I2 = 88.3%), and 4.6 for men (95% CI 1.3, 7.8, I2 = 98.8%). The pooled suicide IRR comparing women to men was 1.1 (95% CI 0.9, 1.4, I2 = 82.2%). No studies reporting self-harm or suicidal ideation after incarceration reported sex differences. CONCLUSION People released from incarceration are greater than seven times more likely to die by suicide than the general population. The rate of suicide is higher after release than during incarceration, with the elevation in suicide risk (compared with the general population) three times higher for women than for men. Greater effort to prevent suicide after incarceration, particularly among women, is urgently needed.
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Affiliation(s)
- Emilia Janca
- Curtin School of Population Health, Curtin University, 410 Koorliny Way, Bentley, WA, 6102, Australia.
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Claire Keen
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Melissa Willoughby
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
| | - Rohan Borschmann
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
- Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, VIC, Australia
| | - Georgina Sutherland
- Disability and Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Sohee Kwon
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Stuart A Kinner
- Curtin School of Population Health, Curtin University, 410 Koorliny Way, Bentley, WA, 6102, Australia
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Mater Research Institute-UQ, University of Queensland, Mater Hospital, Raymond Terrace, South Brisbane, QLD, 4101, Australia
- Griffith Criminology Institute, Griffith University, 176 Messines Ridge Road, Mount Gravatt, QLD, 4122, Australia
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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16
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Affiliation(s)
- Eric Reinhart
- From the Department of Anthropology, Harvard University, Cambridge, MA; and the Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, and the Department of Psychiatry and Behavioral Sciences, Chicago Center for Psychoanalysis - both in Chicago
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17
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Clustering of health burdens in solitary confinement: A mixed-methods approach. SSM - QUALITATIVE RESEARCH IN HEALTH 2022; 2. [PMID: 37008193 PMCID: PMC10065473 DOI: 10.1016/j.ssmqr.2021.100036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Research on the mental health consequences of solitary confinement has contributed to restrictions on its use, particularly for people with serious mental illness. However, solitary confinement continues to isolate people with physical and mental health problems, even where its use has been restricted. This mixed-methods analysis seeks to evaluate the practice of solitary confinement on mental and physical health using data from a sample of 99 men in Pennsylvania. We first describe patterns of multimorbidity among men in solitary confinement using a latent class analysis to group individuals with shared demographic attributes and mental and physical health conditions. We then use thematic analysis to explore how men from each of these groups experienced and managed health concerns in solitary confinement. Our findings describe significant physical and mental health burdens and unmet healthcare needs. Over three-quarters of respondents reported a physical health diagnosis such as heart disease or diabetes, and over half reported a mental health diagnosis, including anxiety, depression, and schizophrenia. Those with pre-existing, often multiple, health issues struggled to maintain their health given restrictions to daily living, isolated idle time, and limited healthcare access in solitary confinement. These aspects of solitary confinement also challenged those who entered solitary in relatively good health. These findings demonstrate the struggle for self-advocacy in maintaining health and healthcare access under extreme conditions of confinement and point to the need to prevent the health harms of solitary confinement by further restricting its use.
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18
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Sustained impacts of North Carolina prison therapeutic diversion units on behavioral outcomes, mental health, self-injury, and restrictive housing readmission. Prev Med 2022; 164:107318. [PMID: 36283487 DOI: 10.1016/j.ypmed.2022.107318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/20/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
Therapeutic Diversion Units (TDUs) in North Carolina prisons are intended to reduce cycling of individuals with mental health conditions through restrictive housing (i.e., solitary confinement). This paper investigates if previously identified benefits of TDU are sustained when individuals return to the general prison population. Using administrative data on 3170 people, we compare individuals placed in TDUs to TDU-eligible individuals (i.e., individuals with mental health needs) placed in restrictive housing. We use survival analysis methods to estimate hazard ratios (HRs) with confidence intervals (CIs), controlling for confounders. Compared to restrictive housing placement, TDU placement reduced the hazard of infractions (HR: 0.66; 95% CI: 0.52, 0.84) and subsequent restrictive housing placement (HR: 0.64; 95% CI: 0.55, 0.73) but increased the hazard of self-harm (HR: 2.67; 95% CI: 1.66, 4.29) upon program release to the general prison population. These findings suggest a need for additional investments and research on restrictive housing diversion programming, including post-diversion program supports.
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19
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Zarzar TR, Rosen DL, Kane MT, Sheitman BB. The Natural History of Initial Antipsychotic Treatment Among Men Admitted to a State Prison. Psychiatr Serv 2022; 73:1169-1172. [PMID: 35473366 DOI: 10.1176/appi.ps.202100545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study examined the natural history of antipsychotic medication treatment for men with a psychotic disorder who entered the North Carolina prison system in 2016-2017. METHODS The authors used prison records to identify individuals with a psychotic illness who were prescribed an index antipsychotic medication on prison entry (N=245). Data were analyzed to determine persistence of antipsychotic therapy and potential associations with treatment discontinuation. RESULTS About 28% of the patients had stopped their antipsychotic medication by day 50; the median time until stopping was 248 days (95% confidence interval=147-355). Younger patients and those not continuing a preincarceration medication regimen discontinued treatment sooner than their respective counterparts. CONCLUSIONS The early weeks of incarceration are a period of increased risk for antipsychotic discontinuation, particularly among younger individuals and those prescribed a new medication. These findings may help guide prison systems in implementing interventions that reduce antipsychotic treatment interruptions.
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Affiliation(s)
- Theodore R Zarzar
- Department of Psychiatry (Zarzar, Kane) and Department of Medicine (Rosen), University of North Carolina School of Medicine, Chapel Hill; North Carolina Department of Public Safety-Prisons, Raleigh, North Carolina (Sheitman)
| | - David L Rosen
- Department of Psychiatry (Zarzar, Kane) and Department of Medicine (Rosen), University of North Carolina School of Medicine, Chapel Hill; North Carolina Department of Public Safety-Prisons, Raleigh, North Carolina (Sheitman)
| | - Michael T Kane
- Department of Psychiatry (Zarzar, Kane) and Department of Medicine (Rosen), University of North Carolina School of Medicine, Chapel Hill; North Carolina Department of Public Safety-Prisons, Raleigh, North Carolina (Sheitman)
| | - Brian B Sheitman
- Department of Psychiatry (Zarzar, Kane) and Department of Medicine (Rosen), University of North Carolina School of Medicine, Chapel Hill; North Carolina Department of Public Safety-Prisons, Raleigh, North Carolina (Sheitman)
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20
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Conner C, Mitchell C, Jahn J. Advancing Public Health Interventions to Address the Harms of the Carceral System: A Policy Statement Adopted by the American Public Health Association, October 2021. Med Care 2022; 60:645-647. [PMID: 35848739 DOI: 10.1097/mlr.0000000000001756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Cheryl Conner
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | | | - Jaquelyn Jahn
- The Ubuntu Center on Racism, Global Movements & Population Health Equity, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
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21
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Zielinski MJ, Cowell M, Bull CE, Veluvolu M, Behne MF, Nowotny K, Brinkley-Rubinstein L. Policy and public communication methods among U.S. state prisons during the first year of the COVID-19 pandemic. HEALTH & JUSTICE 2022; 10:27. [PMID: 36048251 PMCID: PMC9435413 DOI: 10.1186/s40352-022-00187-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Throughout the first year of the COVID-19 pandemic, our research team monitored and documented policy changes in United States (U.S.) prison systems. Data sources included prison websites and official prison social media accounts. Over 2500 data sources relevant to the COVID-19 pandemic in U.S. prisons were located and summarized in to five different categories: 1) prevention, 2) case identification and intervention, 3) movement, 4) social communication and connection, and 5) programming, recreation, and privileges. RESULTS All state prison systems reportedly enacted multiple policies intended to limit the spread of COVID-19 during the pandemic. Document analysis revealed that the most commonly released policies were restrictions on social contacts and privileges, basic preventive measures (e.g., distribution of masks), and basic case identification measures (e.g., verbal screening and temperature checks). Utilization of social media for policy communication varied significantly across states, though relevant data was more often released on Facebook than Twitter. CONCLUSIONS Together, our work provides foundational knowledge on the wide breadth of policies that were reportedly enacted in the first year of the pandemic that may be used as a base for quantitative work on policy effectiveness and examinations of implementation.
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Affiliation(s)
- Melissa J Zielinski
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA.
| | - Mariah Cowell
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chelsey E Bull
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Manasa Veluvolu
- Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - M Forrest Behne
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn Nowotny
- Department of Sociology, University of Miami, Coral Gables, FL, USA
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22
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King Z, Lyerly AD, Knittel AK. Safekeeping of Pregnant People Experiencing Incarceration. WOMEN & CRIMINAL JUSTICE 2022; 33:363-377. [PMID: 37789904 PMCID: PMC10545335 DOI: 10.1080/08974454.2022.2104986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Safekeeping involves transferring individuals from jails to prisons without the presence of a conviction. In North Carolina, safekeeping is used for pregnant people with the aim of providing better prenatal care. We interviewed 14 stakeholders in the safekeeping process including sheriffs, clinicians, advocates, and lawyers. Three key themes emerged: jails' inability to provide care for pregnant individuals; safekeeping as an additional punishment to incarceration; and differing attitudes on the necessity of safekeeping. Participants perceived that while there may be some benefits of safekeeping such as enhanced prenatal care, safekeeping can also lead to worsened conditions for pregnant people experiencing incarceration.
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Affiliation(s)
- Zoe King
- Duke University, Trinity College of Arts & Sciences; 117 Physics Building; 120 Science Dr.; Durham, NC 27708; United States
| | - Anne D. Lyerly
- University of North Carolina at Chapel Hill School of Medicine, Department of Social Medicine, 333 South Columbia St, 333 MacNider Hall, CB# 7240, Chapel Hill, NC 27599; United States
| | - Andrea K. Knittel
- University of North Carolina at Chapel Hill Department of Obstetrics and Gynecology; 3027 Old Clinic Building, CB#7570, Chapel Hill, NC 27599
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23
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Bukten A, Skjærvø I, Stavseth MR. The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16). THE LANCET PUBLIC HEALTH 2022; 7:e583-e592. [DOI: 10.1016/s2468-2667(22)00107-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 12/01/2022] Open
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Nowotny K, Metheny H, LeMasters K, Brinkley-Rubinstein L. Age and COVID-19 mortality in the United States: a comparison of the prison and general population. Int J Prison Health 2022; ahead-of-print:35-46. [PMID: 35727567 PMCID: PMC9377390 DOI: 10.1108/ijph-08-2021-0069] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The USA has a rapidly aging prison population that, combined with their poorer health and living conditions, is at extreme risk for COVID-19. The purpose of this paper is to compare COVID-19 mortality trends in the US prison population and the general population to see how mortality risk changed over the course of the pandemic. The authors first provide a national overview of trends in COVID-19 mortality; then, the authors assess COVID-19 deaths among older populations using more detailed data from one US state. DESIGN/METHODOLOGY/APPROACH The authors used multiple publicly available data sets (e.g. Centers for Disease Control and prevention, COVID Prison Project) and indirect and direct standardization to estimate standardized mortality rates covering the period from April 2020 to June 2021 for the US and for the State of Texas. FINDINGS While 921 COVID-19-related deaths among people in US prisons were expected as of June 5, 2021, 2,664 were observed, corresponding to a standardized mortality ratio of 2.89 (95%CI 2.78, 3.00). The observed number of COVID-19-related deaths exceeded the expected number of COVID-19-related deaths among people in prison for most of the pandemic, with a substantially widening gap leading to a plateau about four weeks after the COVID-19 vaccine was introduced in the USA. In the state population, the older population in prison is dying at younger ages compared with the general population, with the highest percentage of deaths among people aged 50-64 years. RESEARCH LIMITATIONS/IMPLICATIONS People who are incarcerated are dying of COVID-19 at a rate that far outpaces the general population and are dying at younger ages. ORIGINALITY/VALUE This descriptive analysis serves as a first step in understanding the dynamic trends in COVID-19 mortality and the association between age and COVID-19 death in US prisons.
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Affiliation(s)
- Kathryn Nowotny
- Department of Sociology, University of Miami, Coral Gables, Florida, USA
| | - Hannah Metheny
- Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Katherine LeMasters
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lauren Brinkley-Rubinstein
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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25
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Ranapurwala SI, Miller VE, Carey TS, Gaynes BN, Keil AP, Fitch CV, Swilley-Martinez ME, Kavee AL, Cooper T, Dorris S, Goldston DB, Peiper LJ, Pence BW. Innovations in suicide prevention research (INSPIRE): a protocol for a population-based case-control study. Inj Prev 2022; 28:injuryprev-2022-044609. [PMID: 35701110 PMCID: PMC10213808 DOI: 10.1136/injuryprev-2022-044609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Suicide deaths have been increasing for the past 20 years in the USA resulting in 45 979 deaths in 2020, a 29% increase since 1999. Lack of data linkage between entities with potential to implement large suicide prevention initiatives (health insurers, health institutions and corrections) is a barrier to developing an integrated framework for suicide prevention. OBJECTIVES Data linkage between death records and several large administrative datasets to (1) estimate associations between risk factors and suicide outcomes, (2) develop predictive algorithms and (3) establish long-term data linkage workflow to ensure ongoing suicide surveillance. METHODS We will combine six data sources from North Carolina, the 10th most populous state in the USA, from 2006 onward, including death certificate records, violent deaths reporting system, large private health insurance claims data, Medicaid claims data, University of North Carolina electronic health records and data on justice involved individuals released from incarceration. We will determine the incidence of death from suicide, suicide attempts and ideation in the four subpopulations to establish benchmarks. We will use a nested case-control design with incidence density-matched population-based controls to (1) identify short-term and long-term risk factors associated with suicide attempts and mortality and (2) develop machine learning-based predictive algorithms to identify individuals at risk of suicide deaths. DISCUSSION We will address gaps from prior studies by establishing an in-depth linked suicide surveillance system integrating multiple large, comprehensive databases that permit establishment of benchmarks, identification of predictors, evaluation of prevention efforts and establishment of long-term surveillance workflow protocols.
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Affiliation(s)
- Shabbar I Ranapurwala
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Vanessa E Miller
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Timothy S Carey
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alexander P Keil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Catherine Vinita Fitch
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Monica E Swilley-Martinez
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Andrew L Kavee
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Toska Cooper
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Samantha Dorris
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - David B Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lewis J Peiper
- Division of Adult Correction - Prisons, North Carolina Department of Public Safety, Raleigh, North Carolina, USA
| | - Brian W Pence
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, North Carolina, USA
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26
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Liu YE, LeBoa C, Rodriguez M, Sherif B, Trinidad C, Del Rosario M, Allen S, Clifford C, Redding J, Chen WT, Rosas LG, Morales C, Chyorny A, Andrews JR. COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms. Front Public Health 2022; 10:854343. [PMID: 35774562 PMCID: PMC9237366 DOI: 10.3389/fpubh.2022.854343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Carceral facilities are high-risk settings for COVID-19 transmission. Little is known about the hidden burden of infection or practical barriers to infection control in these settings, especially in jails. There is also limited research on the mental health impacts of the pandemic among people living and working in carceral facilities. Methods Between July 8, 2020 and April 30, 2021, we performed SARS-CoV-2 rapid antibody testing and administered a questionnaire among residents and staff of four Northern California jails. We utilized multivariable logistic regression, adjusting for demographic and carceral characteristics, to analyze factors associated with prior infection, including perceived likelihood of prior infection and access to new masks. We additionally assessed the implementation of, perceptions toward, and impacts of COVID-19 policies in practice. We engaged stakeholder representatives, including incarcerated individuals, to guide study design, procedures, and results interpretation. Results We enrolled 788 jail residents and 380 jail staff. Nearly half of residents and two-thirds of staff who were antibody-positive had not previously tested positive for COVID-19. Among residents without a prior COVID-19 diagnosis, antibody positivity was significantly associated with perceived likelihood of prior infection (adjusted OR = 8.9; 95% CI, 3.6-22.0). Residents who had flu-like illness in jail cited inadequate responses to reported illness and deterrents to symptom reporting, including fears of medical isolation and perceptions of medical neglect. Residents also disclosed deficient access to face masks, which was associated with antibody positivity (adjusted OR = 13.8, 95% CI, 1.8-107.0). Worsened mental health was pervasive among residents, attributed not only to fear of COVID-19 and unsanitary jail conditions but also to intensified isolation and deprivation due to pandemic restrictions on in-person visitation, programs, and recreation time. Conclusion Carceral settings present significant challenges to maintaining infection control and human rights. Custody officials should work diligently to transform the conditions of medical isolation, which could mitigate deterrents to symptom reporting. Furthermore, they should minimize use of restrictive measures like lockdowns and suspension of visitation that exacerbate the mental health harms of incarceration. Instead, custody officials should ensure comprehensive implementation of other preventive strategies like masking, testing, and vaccination, in conjunction with multisector efforts to advance decarceration.
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Affiliation(s)
- Yiran E Liu
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford, CA, United States
- Cancer Biology Graduate Program, Stanford University School of Medicine, Stanford, CA, United States
| | - Christopher LeBoa
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford, CA, United States
| | - Marcela Rodriguez
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Beruk Sherif
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Chrisele Trinidad
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Michael Del Rosario
- Division of Correctional Health Services, San Mateo County Health, Redwood City, CA, United States
| | - Sophie Allen
- Stanford Law School, Stanford, CA, United States
- Department of Sociology, Stanford School of Humanities and Sciences, Stanford, CA, United States
| | | | - Jennifer Redding
- Santa Clara County Office of the Public Defender, San Jose, CA, United States
| | - Wei-Ting Chen
- Office of Community Engagement, Stanford University School of Medicine, Stanford, CA, United States
| | - Lisa G Rosas
- Office of Community Engagement, Stanford University School of Medicine, Stanford, CA, United States
| | - Carlos Morales
- Division of Correctional Health Services, San Mateo County Health, Redwood City, CA, United States
| | - Alexander Chyorny
- Division of Custody Health, Department of Medicine, Santa Clara Valley Health and Hospital System, San Jose, CA, United States
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford, CA, United States
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Luigi M, Dellazizzo L, Giguère CÉ, Goulet MH, Potvin S, Dumais A. Solitary Confinement of Inmates Associated With Relapse Into Any Recidivism Including Violent Crime: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2022; 23:444-456. [PMID: 32935639 DOI: 10.1177/1524838020957983] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Recidivism among released inmates is associated with a substantial societal burden given the financial and medical consequences of victimization. Among incarcerated North Americans, approximately 7% are housed in solitary confinement (SC). Studies show SC can lead to psychological deterioration and dispute it can effectively reduce institutional misconduct or recidivism. This meta-analysis aims to clarify the impact of SC on postrelease recidivism, which we hypothesized would increase following SC. A meta-analysis was conducted using PubMed, PsycINFO, Web of Science, and Google Scholar databases from inception until December 2019. Studies on adult inmates in correctional settings were included if they met an operational definition of SC, measured recidivism, and included a comparison group in general inmate population. Random-effect models were used to assess the impact of SC on multiple types of recidivism. Of the 2,713 identified records, 12 met inclusion criteria (n = 194,078). A moderate association was found between SC and any recidivism (odds ratio [OR] = 1.67, 95% confidence interval [1.41, 1.97]), which persisted in controlled studies (OR = 1.41). This association was replicated across types of recidivism comprising violence (OR = 1.41), rearrests (OR = 1.37), and reincarceration (OR = 1.67). Moreover, a more recent exposure to SC increased recidivism risk (OR = 2.02), and a dose-response relationship was found between days in SC and recidivism. The overall database presented high heterogeneity but no publication bias. Findings show a small to moderate association between SC and future crime/violence. Considering the societal costs associated with antisocial behaviors following SC, mental health and psychosocial programming facilitating inmates' successful reentry into society should be implemented and rigorously evaluated in strong research design.
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Affiliation(s)
- Mimosa Luigi
- 26612Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Quebec, Canada
- Department of Psychiatry and Addictology, 12368University of Montreal, Quebec, Canada
| | - Laura Dellazizzo
- 26612Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Quebec, Canada
- Department of Psychiatry and Addictology, 12368University of Montreal, Quebec, Canada
| | - Charles-Édouard Giguère
- 26612Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Quebec, Canada
| | - Marie-Hélène Goulet
- 26612Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Quebec, Canada
- Faculty of Nursing, 12368University of Montreal, Quebec, Canada
| | - Stéphane Potvin
- 26612Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Quebec, Canada
- Department of Psychiatry and Addictology, 12368University of Montreal, Quebec, Canada
| | - Alexandre Dumais
- 26612Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Quebec, Canada
- Department of Psychiatry and Addictology, 12368University of Montreal, Quebec, Canada
- Institut national de psychiatrie légale Philippe-Pinel, Montreal, Quebec, Canada
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Barragan M, Gonzalez G, Strong JD, Augustine D, Chesnut K, Reiter K, Pifer NA. Triaged out of Care: How Carceral Logics Complicate a ‘Course of Care’ in Solitary Confinement. Healthcare (Basel) 2022; 10:healthcare10020289. [PMID: 35206903 PMCID: PMC8871968 DOI: 10.3390/healthcare10020289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023] Open
Abstract
Incarceration, along with its most restrictive iteration, solitary confinement, is an increasingly common experience in America. More than two million Americans are currently incarcerated, and at least one-fifth of incarcerated people will experience solitary confinement. Understanding the barriers to care people experience in prison, and especially in solitary confinement, is key to improving their access to care during and after incarceration. Drawing on in-depth qualitative interviews with a random sample of 106 people living in solitary confinement and a convenience sample of 77 people working in solitary confinement in Washington State, we identify two key barriers to care that people in solitary confinement face: cultural barriers (assumptions that incarcerated people do not need or do not deserve care) and structural barriers (physical spaces and policies that make contacting a healthcare provider difficult). While scholarship has documented both the negative health consequences of solitary confinement and correctional healthcare providers’ challenges navigating between the “dual loyalty” of patient care and security missions, especially within solitary confinement, few have documented the specific mechanisms by which people in solitary confinement are repeatedly triaged out of healthcare access. Understanding these barriers to care is critical not only to improving correctional healthcare delivery but also to improving healthcare access for millions of formerly incarcerated people who have likely had negative experiences seeking healthcare in prison, especially if they were in solitary confinement.
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Affiliation(s)
- Melissa Barragan
- Department of Sociology, California Polytechnic University, Pomona, CA 93407, USA
- Correspondence:
| | - Gabriela Gonzalez
- Department of Public Administration, California State University, Dominguez Hills, Carson, CA 90747, USA;
| | - Justin Donald Strong
- Department of Criminology, Law & Society, University of California, Irvine, CA 92697, USA; (J.D.S.); (K.R.)
| | - Dallas Augustine
- Benioff Homelessness and Housing Initiative, UCSF Center for Vulnerable Populations, University of California, San Francisco, CA 94110, USA;
| | | | - Keramet Reiter
- Department of Criminology, Law & Society, University of California, Irvine, CA 92697, USA; (J.D.S.); (K.R.)
| | - Natalie A. Pifer
- Department of Criminology and Criminal Justice, University of Rhode Island, Kingston, RI 02881, USA;
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Flam-Ross JM, Lown J, Patil P, White LF, Wang J, Perry A, Bailer D, McKenzie M, Thigpen A, Newman R, Lincoln M, Mckinney T, Bernson D, Barocas JA. Factors associated with opioid-involved overdose among previously incarcerated people in the U.S.: A community engaged narrative review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 100:103534. [PMID: 34896932 PMCID: PMC8810696 DOI: 10.1016/j.drugpo.2021.103534] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND People with a history of incarceration are at high risk for opioid overdose. A variety of factors contribute to this elevated risk though our understanding of these factors is deficient. Research to identify risk and protective factors for overdose is often conducted using administrative data or researcher-derived surveys and without explicit input from people with lived experience. We aimed to understand the scope of U.S. research on factors associated with opioid overdose among previously incarcerated people. We did this by conducting a narrative review of the literature and convening expert panels of people with lived experience. We then categorized these factors using a social determinants of health framework to help contextualize our findings. METHODS We first conducted a narrative review of the published literature. A search was performed using PubMed and APA PsycInfo. We then convened two expert panels consisting of people with lived experience and people who work with people who were previously incarcerated. Experts were asked to evaluate the literature derived factors for completeness and add factors that were not identified. Finally, we categorized factors as either intermediary or structural according to the World Health Organization's Social Determinants of Health (SDOH) Framework. RESULTS We identified 13 papers that met our inclusion criteria for the narrative review. Within these 13 papers, we identified 22 relevant factors for their role in the relationship between overdose and people with a history of incarceration, 16 were risk factors and six were protective factors. Five of these were structural factors (three risk and two protective) and 17 were intermediary factors (13 risk and four protective). The expert panels identified 21 additional factors, 10 of which were structural (six risk and four protective) and 11 of which were intermediary (eight risk and three protective). CONCLUSION This narrative review along with expert panels demonstrates a gap in the published literature regarding factors associated with overdose among people who were previously incarcerated. Additionally, this review highlights a substantial gap with regard to the types of factors that are typically identified. Incorporating voices of people with lived experience is crucial to our understanding of overdose in this at-risk population.
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Affiliation(s)
| | - Josh Lown
- Boston College School of Social Work (BCSSW)
| | - Prasad Patil
- Boston University School of Public Health, Department of Biostatistics
| | - Laura F. White
- Boston University School of Public Health, Department of Biostatistics
| | - Jianing Wang
- Boston University School of Public Health, Department of Biostatistics
| | | | | | | | | | | | - Meko Lincoln
- Rhode Island Hospital COBRE on Opioids and Overdose
| | | | | | - Joshua A. Barocas
- University of Colorado Anschutz Medical Campus, Divisions of General Internal Medicine and Infectious Diseases,Corresponding author: Joshua A. Barocas, MD, University of Colorado School of Medicine, 8th Floor, Academic Office 1, Mailstop B180, 12631 E 17th Ave, Aurora, CO 80045, +1-314-348-3278,
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Pullen-Blasnik H, Simes JT, Western B. The population prevalence of solitary confinement. SCIENCE ADVANCES 2021; 7:eabj1928. [PMID: 34826243 PMCID: PMC8626064 DOI: 10.1126/sciadv.abj1928] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Solitary confinement is a severe form of incarceration closely associated with long-lasting psychological harm and poor post-release outcomes. Estimating the population prevalence, we find that 11% of all black men in Pennsylvania, born 1986 to 1989, were incarcerated in solitary confinement by age 32. Reflecting large racial disparities, the population prevalence is only 3.4% for Latinos and 1.4% for white men. About 9% of black men in the state cohort were held in solitary for more than 15 consecutive days, violating the United Nations standards for minimum treatment of incarcerated people. Nearly 1 in 100 black men experienced solitary for a year or longer by age 32. Racial disparities are similar for women, but rates are lower. A decomposition shows that black men’s high risk of solitary confinement stems primarily from their high imprisonment rate. Findings suggest that harsh conditions of U.S. incarceration have population-level effects on black men’s well-being.
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Favril L. Epidemiology, Risk Factors, and Prevention of Suicidal Thoughts and Behaviour in Prisons: A Literature Review. Psychol Belg 2021; 61:341-355. [PMID: 34900324 PMCID: PMC8622377 DOI: 10.5334/pb.1072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 10/19/2021] [Indexed: 12/21/2022] Open
Abstract
Suicide is a global public health concern that affects all echelons of society, albeit not equally so. Compared with adults in the general population, incarcerated offenders are at increased risk to consider, attempt, and die by suicide, which represents a substantial burden of morbidity and mortality in prisons worldwide. This review synthesises recent literature pertaining to the epidemiology, risk factors, and prevention of suicidal thoughts and behaviour among prisoners, and outlines a framework which emphasises the interplay between individuals (importation) and their surroundings (deprivation). The available evidence suggests that prison-specific stressors may exacerbate risk of suicide in an already vulnerable population characterised by complex health and social care needs. Emerging data point to differential mechanisms through which prisoners come to think about suicide and subsequently progress to suicidal behaviour. As risk of suicide is determined by a complex web of synergistically interacting factors, its management and prevention demands a cross-sectoral policy and service response that includes targeted interventions aimed at high-risk prisoners in combination with population strategies that promote the health and wellbeing of all people in prison.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, BE
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Remch M, Mautz C, Burke EG, Junker G, Kaniuka A, Proescholdbell S, Marshall SW, Naumann RB. Impact of a Prison Therapeutic Diversion Unit on Mental and Behavioral Health Outcomes. Am J Prev Med 2021; 61:619-627. [PMID: 34686299 DOI: 10.1016/j.amepre.2021.05.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/21/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Incarcerated individuals with mental health disorders are disproportionally sent to restrictive housing (i.e., solitary confinement), which is known to have deleterious impacts on mental health. In response, North Carolina's prison system developed Therapeutic Diversion Units, treatment-oriented units for incarcerated individuals with high mental health needs who cycle in and out of restrictive housing. This analysis compares the impact of restrictive housing and Therapeutic Diversion Units on infractions, mental health, and self-harm among incarcerated individuals. METHODS Data were 2016-2019 incarceration records from North Carolina prisons. Outcomes were rates of infractions, inpatient mental health admissions, and self-harm in restrictive housing and Therapeutic Diversion Units. Inverse probability of treatment weights was used to adjust for confounding, and Poisson regression with generalized estimating equations was used to estimate adjusted rate ratios. Analyses were conducted between January and December 2020. RESULTS The analytic sample was 3,480 people, of whom 463 enrolled in a Therapeutic Diversion Unit. Compared with Therapeutic Diversion Unit rates, the rate of infractions was 3 times as high in restrictive housing (adjusted rate ratio=2.99, 95% CI=2.31, 3.87), the inpatient mental health admissions rate was 3.5 times as high (adjusted rate ratio=3.57, 95% CI=1.97, 6.46), and the self-injury incident rate was 3.5 times as high (adjusted rate ratio=3.46, 95% CI=2.11, 5.69). CONCLUSIONS Therapeutic Diversion Unit use had strong impacts on infractions, mental health, and self-harm. Therapeutic Diversion Units provide a promising alternative to restrictive housing for individuals with mental health disorders.
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Affiliation(s)
- Molly Remch
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Charles Mautz
- Division of Adult Correction and Juvenile Justice, North Carolina Department of Public Safety, Raleigh, North Carolina
| | - Emily G Burke
- Division of Adult Correction and Juvenile Justice, North Carolina Department of Public Safety, Raleigh, North Carolina
| | - Gary Junker
- Division of Adult Correction and Juvenile Justice, North Carolina Department of Public Safety, Raleigh, North Carolina
| | - Andrea Kaniuka
- Department of Public Health Sciences, College of Health and Human Services, The University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Scott Proescholdbell
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina
| | - Stephen W Marshall
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; UNC Injury Prevention Research Center (IPRC), The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rebecca B Naumann
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; UNC Injury Prevention Research Center (IPRC), The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Willoughby M, Young JT, Spittal MJ, Borschmann R, Janca E, Kinner PSA. Violence-related deaths among people released from incarceration: systematic review and meta-analysis of cohort studies. EClinicalMedicine 2021; 41:101162. [PMID: 34746721 PMCID: PMC8551597 DOI: 10.1016/j.eclinm.2021.101162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND People released from incarceration have an increased risk of violence-related death. As deaths from violence are a rare event, meta-analysis is needed to calculate reliable estimates of this risk. We examined the crude mortality rates (CMRs), standardised mortality ratios (SMRs), and predictive factors for violence-related deaths among people released from incarceration. METHODS In this systematic review and meta-analysis, we searched MEDLINE, PubMed, PsycINFO, Scopus, Web of Science, CINCH, and Criminal Justice Abstracts from inception to 14 September 2020 for cohort studies published in English that examined violence-related deaths occurring in the community following release from adult or youth incarceration. We used the Methodological Standard for Epidemiological Research (MASTER) scale to assess the quality of included studies. We conducted a random-effects meta-analysis to calculate pooled estimates of the CMRs and SMRs. Heterogeneity was assessed using univariable meta-regression. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020209422). FINDINGS Our search identified 2,489 records, from which 11 studies met the eligibility criteria. The pooled CMR for violence-related deaths after release from incarceration was 78·7 per 100,000 person-years (95%CI 58·0-99·5). The pooled SMR was 7·6 (95%CI 2·4-12·8). The estimate of heterogeneity was high (I2≥99%) and the Cochran's Q test was significant (p<0·001) for the pooled CMR and SMR. Study design (prospective vs. retrospective; p=0·001) and type of incarceration facility (youth detention vs. prison; p=0·006) were identified as possible sources of heterogeneity for CMRs. Risk factors for violence-related death after release were reported in only five studies. These included being male (n=3), Black or Hispanic in the United States (n=3), and younger age at release from incarceration (n=2). INTERPRETATION People released from incarceration are almost eight times more likely to die from violence than the general population. Violence-related deaths are preventable, and the high rate at which they occur after release from incarceration represents an important public health issue requiring targeted, evidence-based response. FUNDING None.
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Affiliation(s)
- Melissa Willoughby
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia
- Corresponding author: Melissa Willoughby, Justice Health Unit, Level 4, 207 Bouverie Street, Carlton, The University of Melbourne, Victoria, 3053, Australia. ORCID ID: 0000-0002-4360-2605
| | - Jesse T. Young
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia
- School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia
- National Drug Research Institute, Curtin University, 7 Parker Place, Bentley, Western Australia, 6102, Australia
| | - Matthew J. Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
| | - Rohan Borschmann
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, Camberwell, London SE5 8AF, United Kingdom
- Melbourne School of Psychological Sciences, The University of Melbourne, Grattan Street, Parkville, Victoria, Australia
| | - Emilia Janca
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
| | - Prof Stuart A. Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia
- Mater Research Institute-UQ, University of Queensland, Mater Hospital, Raymond Terrace, South Brisbane, Queensland, 4101, Australia
- Griffith Criminology Institute, Griffith University, 176 Messines Ridge Road, Mount Gravatt, Queensland, 4122, Australia
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
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Cloud DH, Augustine D, Ahalt C, Haney C, Peterson L, Braun C, Williams B. "We just needed to open the door": a case study of the quest to end solitary confinement in North Dakota. HEALTH & JUSTICE 2021; 9:28. [PMID: 34664150 PMCID: PMC8522549 DOI: 10.1186/s40352-021-00155-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED Solitary confinement is a widespread practice in US correctional facilities. Long-standing concerns about the physical and mental health effects of solitary confinement have led to litigation, legislation, and community activism resulting in many prison systems introducing policies or implementing legal mandates to reduce or eliminate its use. Yet little is known about the nature and effectiveness of policies that states have adopted to reduce their use of solitary confinement and exactly how various reforms have actually impacted the lives of people living and working in the prisons where these reforms have taken place. METHODS We conducted an embedded case study, analyzing changes in policies and procedures, administrative data, and focus groups and interviews with incarcerated persons and staff, to describe the circumstances that led to changes in solitary confinement policies and practices in the North Dakota Department of Corrections and Rehabilitation (ND DOCR) and the perceived impact of these changes on incarcerated persons and prison staff. . RESULTS North Dakota's correctional officials and staff members attributed the impetus to change their solitary confinement policies to their participation in a program that directly exposed them to the Norwegian Correctional Service's philosophy, policies, and practices in 2015. The ensuing policy changes made by North Dakota officials were swift and resulted in a 74.28% reduction in the use of solitary confinement between 2016 and 2020. Additionally, placements in any form of restrictive housing decreased markedly for incarcerated persons with serious mental illness. In the two prisons that had solitary confinement units, rule infractions involving violence decreased at one prison overall and it decreased within the units at both prisons that were previously used for solitary confinement. Although fights and assaults between incarcerated people increased in one of the prison's general population units, during the initial months of reforms, these events continued to decline compared to years before reform. Moreover, incarcerated people and staff attributed the rise to a concomitant worsening of conditions in the general population due to overcrowding, idleness, and double bunking. Both incarcerated persons and staff members reported improvements in their health and well-being, enhanced interactions with one another, and less exposure to violence following the reforms. CONCLUSIONS Immersing correctional leaders in the Norwegian Correctional Service' public health and human rights principles motivated and guided the ND DOCR to pursue policy changes to decrease the use of solitary confinement in their prisons. Ensuing reductions in solitary confinement were experienced as beneficial to the health and wellness of incarcerated persons and staff alike. This case-study describes these policy changes and the perspectives of staff and incarcerated persons about the reforms that were undertaken. Findings have implications for stakeholders seeking to reduce their use of solitary confinement and limit its harmful consequences and underscore the need for research to describe and assess the impact of solitary confinement reforms.
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Affiliation(s)
- David H Cloud
- Amend, University of California, San Francisco, School of Medicine, 490 Illinois Street, Floor 8, UCSF Box 1265, San Francisco, CA, 94143, USA.
| | - Dallas Augustine
- Amend, University of California, San Francisco, School of Medicine, 490 Illinois Street, Floor 8, UCSF Box 1265, San Francisco, CA, 94143, USA
| | - Cyrus Ahalt
- Amend, University of California, San Francisco, School of Medicine, 490 Illinois Street, Floor 8, UCSF Box 1265, San Francisco, CA, 94143, USA
| | - Craig Haney
- Department of Psychology, University of California, Santa Cruz, 1156 High Street, Santa Cruz, CA, 95064, USA
| | - Lisa Peterson
- North Dakota Department of Corrections and Rehabilitation, 3100 Railroad Avenue, P.O. Box 1898, Bismarck, ND, 58502-1898, USA
| | - Colby Braun
- North Dakota Department of Corrections and Rehabilitation, 3100 Railroad Avenue, P.O. Box 1898, Bismarck, ND, 58502-1898, USA
| | - Brie Williams
- Amend, University of California, San Francisco, School of Medicine, 490 Illinois Street, Floor 8, UCSF Box 1265, San Francisco, CA, 94143, USA
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Maner M, LeMasters K, Lao J, Cowell M, Nowotny K, Cloud D, Brinkley-Rubinstein L. COVID-19 in corrections: Quarantine of incarcerated people. PLoS One 2021; 16:e0257842. [PMID: 34610015 PMCID: PMC8491943 DOI: 10.1371/journal.pone.0257842] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/12/2021] [Indexed: 01/21/2023] Open
Abstract
Carceral settings in the United States have been the source of many single site COVID-19 outbreaks. Quarantine is a strategy used to mitigate the spread of COVID-19 in correctional settings, and specific quarantine practices differ state to state. To better understand how states are using quarantine in prisons, we reviewed each state's definition of quarantine and compared each state's definition to the Centers for Disease Control's (CDC) definition and recommendations for quarantine in jails and prisons. Most prison systems, 45 of 53, define quarantine, but definitions vary widely. No state published definitions of quarantine that align with all CDC recommendations, and only 9 states provide quarantine data. In these states, the highest recorded quarantine rate occurred in Ohio in May 2020 at 843 per 1,000. It is necessary for prison systems to standardize their definitions of quarantine and to utilize quarantine practices in accordance with CDC recommendations. In addition, data transparency is needed to better understand the use of quarantine and its effectiveness at mitigating COVID-19 outbreaks in carceral settings.
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Affiliation(s)
- Morgan Maner
- Department of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Katherine LeMasters
- Department of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jennifer Lao
- Department of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Mariah Cowell
- College of Social Work, Utah Criminal Justice Center, University of North Carolina, Salt Lake City, Utah, United States of America
| | - Kathryn Nowotny
- Department of Sociology, University of Miami, Coral Gables, Florida, United States of America
| | - David Cloud
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, Georgia, United States of America
| | - Lauren Brinkley-Rubinstein
- Department of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Leibowitz AI, Siedner MJ, Tsai AC, Mohareb AM. Association Between Prison Crowding and COVID-19 Incidence Rates in Massachusetts Prisons, April 2020-January 2021. JAMA Intern Med 2021; 181:1315-1321. [PMID: 34369964 PMCID: PMC8353573 DOI: 10.1001/jamainternmed.2021.4392] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
IMPORTANCE COVID-19 incidence and mortality are higher among incarcerated persons than in the general US population, but the extent to which prison crowding contributes to their COVID-19 risk is unknown. OBJECTIVE To estimate the associations between prison crowding, community COVID-19 transmission, and prison incidence rates of COVID-19. DESIGN, SETTING, AND PARTICIPANTS This was a longitudinal ecological study among all incarcerated persons in 14 Massachusetts state prisons between April 21, 2020, and January 11, 2021. EXPOSURES The primary exposure of interest was prison crowding, measured by (1) the size of the incarcerated population as a percentage of the prison's design capacity and (2) the percentage of incarcerated persons housed in single-cell units. The analysis included the weekly COVID-19 incidence in the county where each prison is located as a covariate. MAIN OUTCOMES AND MEASURES The primary outcome was the weekly COVID-19 incidence rate as determined by positive SARS-CoV-2 tests among incarcerated persons at each prison over discrete 1-week increments. RESULTS There was on average 6876 people incarcerated in 14 prisons during the study period. The median level of crowding during the observation period ranged from 25% to 155% of design capacity. COVID-19 incidence was significantly higher in prisons where the incarcerated population was a larger percentage of the prison's design capacity (incidence rate ratio [IRR] per 10-percentage-point difference, 1.14; 95% CI, 1.03-1.27). COVID-19 incidence was lower in prisons where a higher proportion of incarcerated people were housed in single-cell units (IRR for each 10-percentage-point increase in single-cell units, 0.82; 95% CI, 0.73-0.93). COVID-19 transmission in the surrounding county was consistently associated with COVID-19 incidence in prisons (IRR [for each increase of 10 cases per 100 000 person-weeks in the community], 1.06; 95% CI, 1.05-1.08). CONCLUSIONS AND RELEVANCE This longitudinal ecological study found that within 14 Massachusetts state prisons, increased crowding was associated with increased incidence rates of COVID-19. Researchers and policy makers should explore strategies that reduce prison crowding, such as decarceration, as potential ways to mitigate COVID-19 morbidity and mortality among incarcerated persons.
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Affiliation(s)
- Abigail I Leibowitz
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,University of Colorado School of Medicine, Denver
| | - Mark J Siedner
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston.,Division of Infectious Diseases, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts.,Center for Global Health, Massachusetts General Hospital, Boston.,Mongan Institute, Massachusetts General Hospital, Boston
| | - Alexander C Tsai
- Harvard Medical School, Boston, Massachusetts.,Center for Global Health, Massachusetts General Hospital, Boston.,Mongan Institute, Massachusetts General Hospital, Boston
| | - Amir M Mohareb
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston.,Division of Infectious Diseases, Massachusetts General Hospital, Boston.,Harvard Medical School, Boston, Massachusetts.,Center for Global Health, Massachusetts General Hospital, Boston
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Willoughby M, Young JT, Spittal MJ, Borschmann R, Janca EK, Kinner SA. Violence-related deaths among people released from incarceration: protocol for a systematic review. BMJ Open 2021; 11:e045601. [PMID: 33472793 PMCID: PMC7818808 DOI: 10.1136/bmjopen-2020-045601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Young people and adults released from incarceration have a risk of dying from violence that far exceeds that in the general population. Despite this, evidence regarding the incidence, elevated risk and predictive factors for violence-related deaths after release have not yet been synthesised. This information is important to inform the development of evidence-based approaches to effectively prevent deaths from violence in this population. This systematic review will synthesise the literature examining the crude mortality rates (CMRs), standardised mortality ratios (SMRs) and predictive factors for violence-related deaths among people released from incarceration. METHODS AND ANALYSIS We searched key electronic health, social science and criminology databases (MEDLINE, PubMed, PsycINFO, Scopus, Web of Science, CINCH, Criminal Justice Abstracts) for peer-reviewed cohort studies published in English on 14th September 2020. Our primary outcome of interest is violence-related deaths occurring in the community following release from incarceration. We will not restrict study eligibility by year of publication or age of participants. The Methodological Standard for Epidemiological Research (MASTER) scale will be used to assess the quality of included studies. If there are sufficient studies and homogeneity between studies, we will conduct meta-analyses to calculate pooled estimates of CMRs, SMRs or predictive factors for violence-related deaths. If there is a sufficient number of included studies, meta-regression will be conducted to examine the influence of subgroups and methodological factors on the CMRs, SMRs or predictive factors. If the studies do not report sufficient data, or if there is substantial heterogeneity, findings will be presented in a narrative form. ETHICS AND DISSEMINATION This review is exempt from ethics approval as it will synthesise findings from published studies that have already obtained ethics approval. Our findings will be disseminated through a peer-reviewed journal article, and national and international conference and seminar presentations. TRIAL REGISTRATION DETAILS This study is registered with PROSPERO (CRD42020209422).
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Affiliation(s)
- Melissa Willoughby
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Rohan Borschmann
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England, UK
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Emilia K Janca
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Stuart A Kinner
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Mater Research Institute-UQ, University of Queensland, Brisbane, Queensland, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Strong JD, Reiter K, Gonzalez G, Tublitz R, Augustine D, Barragan M, Chesnut K, Dashtgard P, Pifer N, Blair TR. The body in isolation: The physical health impacts of incarceration in solitary confinement. PLoS One 2020; 15:e0238510. [PMID: 33035215 PMCID: PMC7546459 DOI: 10.1371/journal.pone.0238510] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 08/18/2020] [Indexed: 11/19/2022] Open
Abstract
We examine how solitary confinement correlates with self-reported adverse physical health outcomes, and how such outcomes extend the understanding of the health disparities associated with incarceration. Using a mixed methods approach, we find that solitary confinement is associated not just with mental, but also with physical health problems. Given the disproportionate use of solitary among incarcerated people of color, these symptoms are most likely to affect those populations. Drawing from a random sample of prisoners (n = 106) in long-term solitary confinement in the Washington State Department of Corrections in 2017, we conducted semi-structured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for these subjects. We also conducted a paper survey of the entire long-term solitary confinement population (n = 225 respondents) and analyzed administrative data for the entire population of prisoners in the state in 2017 (n = 17,943). Results reflect qualitative content and descriptive statistical analysis. BPRS scores reflect clinically significant somatic concerns in 15% of sample. Objective specification of medical conditions is generally elusive, but that, itself, is a highly informative finding. Using subjective reports, we specify and analyze a range of physical symptoms experienced in solitary confinement: (1) skin irritations and weight fluctuation associated with the restrictive conditions of solitary confinement; (2) un-treated and mis-treated chronic conditions associated with the restrictive policies of solitary confinement; (3) musculoskeletal pain exacerbated by both restrictive conditions and policies. Administrative data analyses reveal disproportionate rates of racial/ethnic minorities in solitary confinement. This analysis raises the stakes for future studies to evaluate comparative prevalence of objective medical diagnoses and potential causal mechanisms for the physical symptoms specified here, and for understanding differential use of solitary confinement and its medically harmful sequelae.
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Affiliation(s)
- Justin D. Strong
- Department of Criminology, Law and Society, University of California, Irvine, Irvine, California, United States of America
| | - Keramet Reiter
- Department of Criminology, Law and Society, University of California, Irvine, Irvine, California, United States of America
| | - Gabriela Gonzalez
- Department of Criminology, Law and Society, University of California, Irvine, Irvine, California, United States of America
| | - Rebecca Tublitz
- Department of Criminology, Law and Society, University of California, Irvine, Irvine, California, United States of America
| | - Dallas Augustine
- Department of Criminology, Law and Society, University of California, Irvine, Irvine, California, United States of America
| | - Melissa Barragan
- Department of Criminology, Law and Society, University of California, Irvine, Irvine, California, United States of America
| | - Kelsie Chesnut
- Department of Criminology, Law and Society, University of California, Irvine, Irvine, California, United States of America
| | - Pasha Dashtgard
- Department of Psychological Sciences, University of California, Irvine, Irvine, California, United States of America
| | - Natalie Pifer
- Department of Criminology and Criminal Justice, The University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Thomas R. Blair
- Department of Psychiatry, Southern California Permanente Medical Group, Downey, Los Angeles, California, United States of America
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Cloud DH, Ahalt C, Augustine D, Sears D, Williams B. Medical Isolation and Solitary Confinement: Balancing Health and Humanity in US Jails and Prisons During COVID-19. J Gen Intern Med 2020; 35:2738-2742. [PMID: 32632787 PMCID: PMC7338113 DOI: 10.1007/s11606-020-05968-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/05/2020] [Indexed: 11/09/2022]
Abstract
In the face of the continually worsening COVID-19 pandemic, jails and prisons have become the greatest vectors of community transmission and are a point of heightened crisis and fear within the global crisis. Critical public health tools to mitigate the spread of COVID-19 are medical isolation and quarantine, but use of these tools is complicated in prisons and jails where decades of overuse of punitive solitary confinement is the norm. This has resulted in advocates denouncing the use of any form of isolation and attorneys litigating to end its use. It is essential to clarify the critical differences between punitive solitary confinement and the ethical use of medical isolation and quarantine during a pandemic. By doing so, then all those invested in stopping the spread of COVID-19 in prisons can work together to integrate medically sound, humane forms of medical isolation and quarantine that follow community standards of care rather than punitive forms of solitary confinement to manage COVID-19.
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Affiliation(s)
- David H Cloud
- Division of Geriatrics, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - Cyrus Ahalt
- Division of Geriatrics, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Dallas Augustine
- Division of Geriatrics, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - David Sears
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Brie Williams
- Division of Geriatrics, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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40
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Luigi M, Dellazizzo L, Giguère CÉ, Goulet MH, Dumais A. Shedding Light on "the Hole": A Systematic Review and Meta-Analysis on Adverse Psychological Effects and Mortality Following Solitary Confinement in Correctional Settings. Front Psychiatry 2020; 11:840. [PMID: 32973582 PMCID: PMC7468496 DOI: 10.3389/fpsyt.2020.00840] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/03/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To systematically review and meta-analyze the psychological effects and mortality rate in inmates having been exposed to solitary confinement in correctional settings. METHODS PubMed, PsycINFO, Web of Science, and Google Scholar were searched using keywords describing solitary confinement in combination with keywords for psychological or mortality outcomes. Eligible case-control studies for the systematic review met an operational definition for solitary confinement and evaluated outcomes after exposure to such confinement. Studies presenting statistical data which allowed to compute standardized mean differences for symptom scales or odds ratio for mortality were further meta-analyzed using random-effects models. RESULTS Systematic review identified 13 studies for inclusion, with a total sample of 382,440 inmates (23% having been exposed to solitary confinement). Higher quality evidence showed solitary confinement was associated with an increase in adverse psychological effects, self-harm, and mortality, especially by suicide. Meta-analysis of five studies (n = 4,517) showed a standardized mean difference of 0.45 for general psychological symptomatology, which increased to 0.51 upon outlier exclusion. Small to moderate significant effects were observed for mood, psychotic, and hostility symptoms specifically. In addition, meta-analysis of two mortality studies (n = 243,050) showed a trend for a moderate effect for mortality by any or unnatural causes (i.e., suicide, homicide, overdose, and accidents). CONCLUSIONS Analyses showed that solitary confinement is associated with the psychological deterioration of inmates. This effect appears to be beyond that of general incarceration or presence of prior mental illness. Thus, solitary confinement may pose significant harm for inmates. Still, further studies are required to show that exposure to SC can increase risk of post-release death. Finally, add-on treatments and alternatives to solitary confinement that could alleviate the associated psychological harm are discussed.
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Affiliation(s)
- Mimosa Luigi
- Research Center, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
- Departement of Psychiatry and Addictology, University of Montreal, Montreal, QC, Canada
| | - Laura Dellazizzo
- Research Center, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
- Departement of Psychiatry and Addictology, University of Montreal, Montreal, QC, Canada
| | | | | | - Alexandre Dumais
- Research Center, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
- Departement of Psychiatry and Addictology, University of Montreal, Montreal, QC, Canada
- Institut national de psychiatrie légale Philippe-Pinel, Montreal, QC, Canada
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McLeod KE, Martin RE. Solitary confinement, post-release health, and the urgent need for further research. LANCET PUBLIC HEALTH 2020; 5:e74-e75. [PMID: 32032558 DOI: 10.1016/s2468-2667(20)30009-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Katherine E McLeod
- The School of Population and Public Health University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Ruth Elwood Martin
- The School of Population and Public Health University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
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42
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Wolff H, Greifinger R. Incarceration Harms Health: Homer Venters’s Book on Rikers Island Jails. Am J Public Health 2020. [DOI: 10.2105/ajph.2019.305445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Hans Wolff
- Hans Wolff is with the Division of Prison Health, Geneva University Hospitals, Geneva, Switzerland, and the Committee for the Prevention of Torture, Council of Europe, Strasbourg, France. Robert Greifinger is a consultant on health care in detention, New York, NY
| | - Robert Greifinger
- Hans Wolff is with the Division of Prison Health, Geneva University Hospitals, Geneva, Switzerland, and the Committee for the Prevention of Torture, Council of Europe, Strasbourg, France. Robert Greifinger is a consultant on health care in detention, New York, NY
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