International Journal of Prisoner Health最新文献

Purpose: Aging and mental illness both represent significant public health challenges for incarcerated people in the USA. The COVID-19 pandemic has further highlighted the vulnerabilities of incarcerated people because of the risks of infectious disease transmission in correctional facilities. Focusing on older adults with mental illness, this paper aims to examine efforts to decarcerate US correctional facilities during the COVID-19 pandemic and whether these approaches may lead to sustainable reforms beyond the pandemic.

Design/methodology/approach: A narrative literature review was conducted using numerous online resources, including PubMed, Google Scholar and LexisNexis. Search terms used included "decarceration pandemic," "COVID-19 decarceration," "aging mental illness decarceration," "jails prisons decarceration," "early release COVID-19" and "correctional decarceration pandemic," among others. Given the rapidly changing nature of the COVID-19 pandemic, this narrative literature review included content from not only scholarly articles and federal and state government publications but also relevant media articles and policy-related reports. The authors reviewed these sources collaboratively to synthesize a review of existing evidence and opinions on these topics and generate conclusions and policy recommendations moving forward.

Findings: To mitigate the risks of COVID-19, policymakers have pursued various decarceration strategies across the USA. Some efforts have focused on reducing inflow into correctional systems, including advising police to reduce numbers of arrests and limiting use of pretrial detention. Other policies have sought to increase outflow from correctional systems, such as facilitating early release of people convicted of nonviolent offenses or those nearing the end of their sentences. Given the well-known risks of COVID-19 among older individuals, age was commonly cited as a reason for diverting or expediting release of people from incarceration. In contrast, despite their vulnerability to complications from COVID-19, people with serious mental illness (SMI), particularly those with acute treatment needs, may have been less likely in some instances to be diverted or released early from incarceration.

Originality/value: Although much has been written about decarceration during the COVID-19 pandemic, little attention has been paid to the relevance of these efforts for older adults with mental illness. This paper synthesizes existing proposals and evidence while drawing attention to the public health implications of aging and SMI in US correctional settings and explores opportunities for decarceration of older adults with SMI beyond the COVID-19 pandemic.

Purpose: The purpose of this paper aims to examine differences in measures of and relationships between visitation and quality of life (QOL) among older and younger jailed adults. The authors also explored the contribution of visitation to QOL among adults in this setting. The authors anticipated fewer visits and lower QOL among older adults. Framed by psychosocial developmental theory, the authors also anticipated a larger effect in the relationship between visitation and QOL among older rather than younger adults and that visitation would contribute most readily to psychological QOL.

Design/methodology/approach: Cross-sectional data from a large US jail were used (n = 264). The authors described the sample regarding visitation and QOL measures among older (≥45) and younger adults (≤44) and examined differences in measures of and relationships between visitation and QOL using independent sample t-tests and bivariate analyses. The authors explored the contribution of visitation to psychological, social relationships, physical and environmental QOL among jailed adults using hierarchical multiple linear regression.

Findings: Older adults had fewer family visits and lower physical QOL than younger adults, disparities were moderate in effect (d range = 0.33-0.35). A significant difference also emerged between groups regarding the visitation and environmental QOL relationship (z = 1.66, p <0.05). Visitation contributed to variation in physical and social relationships QOL among jailed adults (Beta range = 0.19-0.24).

Originality/value: Limited research exists among jailed older adults and scholars have yet to examine the relationship between visitation and QOL among persons in these settings.

Purpose: With a rapidly growing population of older adults with chronic illness in US prisons, the number of people who die while incarcerated is increasing. Support for patients' medical decision-making is a cornerstone of quality care for people at the end of life (EOL). This study aims to identify, describe, and analyze existing policies regarding EOL decision-making in U.S. Departments of Corrections.

Design/methodology/approach: This study performed an iterative content analysis on all available EOL decision-making policies in US state departments of corrections and the Federal Bureau of Prisons.

Findings: This study collected and reviewed available policies from 37 of 51 prison systems (73%). Some areas of commonality included the importance of establishing health-care proxies and how to transfer EOL decision documents, although policies differed in terms of which patients can complete advance care planning documents, and who can serve as their surrogate decision-makers.

Practical implications: Many prison systems have an opportunity to enhance their patient medical decision-making policies to bring them in line with community standard quality of care. In addition, this study was unable to locate policies regarding patient decision-making at the EOL in one quarter of US prison systems, suggesting there may be quality-of-care challenges around formalized approaches to documenting patient medical wishes in some of those prison systems.

Originality/value: To the best of the authors' knowledge, this is the first content analysis of EOL decision-making policies in US prison systems.

Purpose: The purpose of this study is to continue research and development of the ECAD-P learning system with an emphasis on developing a scalable unit for testing in a larger number of more diverse correctional settings. There are almost 2.3 million US persons incarcerated. Geriatric and end-of-life (EOL) care in corrections is not as equitable as care in the free world. Technological delivery of geriatric training to staff through computer-based learning (CBL) offers a novel approach to improve care and reduce disparities among those who are most vulnerable during confinement.

Design/methodology/approach: This mixed methods study built an interactive CBL for multidisciplinary staff to address EOL and geriatric issues in prisons. The CBL was iteratively built and tested prior to launching a full-scale evaluation using a pre/post-intervention design.

Findings: Evaluation of the CBL occurred at 7 sites (i.e. 6 state prisons and 1 prison health-care vendor). A total of 241 staff were recruited with 173 completing post-tests. Outcomes were knowledge acquisition regarding care for aging and dying incarcerated persons (i.e. cognitive measure) and attitudes, motivations and values for providing care (i.e. affective measure). Cognitive and affective post-tests were significantly better than at pre-test (all ps < 0.01). ANCOVAs revealed no significant differences for sex or ethnicity.

Originality/value: Outcomes reveal that the CBL is acceptable, feasible and usable in corrections. Staff improved their knowledge after receiving the training. Correctional settings face increasing pressures to better address the health care and management needs of aged, chronically ill and dying incarcerated persons. This e-learning holds promise to contribute to better preparation of corrections staff to effectively care for these populations.

Aims: This study aimed to examine potential heterogeneity in longitudinal changes in home-based arts engagement during the first national lockdown and following gradual easing of restrictions in the UK. Furthermore, it sought to explore factors that were associated with patterns of longitudinal changes in home-based arts engagement.

Method: Data were from the UCL COVID-19 Social Study. The analytical sample consisted of 29,147 adults in the UK who were followed up for 22 weeks from 21 March to 21 August 2020. Data were analysed using growth mixture models.

Results: Our analyses identified five classes of growth trajectories. There were two stable classes showing little change in arts engagement over time (64.4% in total), two classes showing initial increases in arts engagement followed by declines as restrictions were eased (29.8%), and one class showing slight declines during strict lockdown followed by an increase in arts engagement after the easing of restrictions (5.9%). A range of factors were found to be associated with class membership of these arts engagement trajectories, such as age, gender, education, income, employment status, and health.

Conclusion: There is substantial heterogeneity in longitudinal changes in home-based arts engagement. For participants whose engagement changed over time, growth trajectories of arts engagement were related to changes in lockdown measures. These findings suggest that some individuals may have drawn on the arts when they needed them the most, such as during the strict lockdown period, even if they usually had lower levels of arts engagement before the pandemic. Overall, our results indicate the importance of promoting arts engagement during pandemics and periods of lockdown as part of public health campaigns.

Purpose: The purpose of this paper is to investigate the presence of bladder and bowel symptoms in women recently imprisoned in Western Australian prisons, specifically; stress, urge and mixed urinary incontinence, faecal incontinence, nocturia, nocturnal enuresis and constipation and the impact on the quality of life (QOL).

Design/methodology/approach: Over a 12-month period 29 women, recently released from Western Australia's female prisons, were surveyed using a questionnaire previously validated for the prison population. The Short Form King's Health Questionnaire and a modified version of the Manchester Health Questionnaire were used to assess the effects of these symptoms on QOL.

Findings: Of those surveyed only one respondent reported having no bladder or bowel symptoms following release from prison. Trends assessed by Chi-square analysis suggest women imprisoned for any period of time are more likely to develop both bladder and bowel symptoms which persist after release back into the community. A history of substance or alcohol abuse is often concurrent with the presence of symptoms. QOL scores are also lower for those reporting either bladder or bowel symptoms affecting total scores and the domains of both activities of daily living and mental health.

Originality/value: Women imprisoned for any length of time developed bladder and bowel symptoms which had a negative impact on their QOL. Larger studies need to be conducted to investigate these trends and whether small changes in conservative measures can influence outcomes.

Purpose: The purpose of this study is to assess the intensity of perceived stress and measure the subjective control of anxiety, anger and depression in a group of women and men staying in Polish penitentiary institutions.

Design/methodology/approach: The research was carried out in two penitentiary institutions located in the Lesser Poland Voivodeship at the turn of 2019/2020. The study group consisted of 152 prisoners. In the cross-sectional study, two standardised research tools - the Perceived Stress Scale and the Emotional Control Scale - were used.

Findings: Over half of the prisoners (57.24%) presented a high level of stress. The intensity of the perceived stress did not depend on the gender and age of the convicted persons. The general indicator of emotional control among the respondents averaged 51.82 points (standard deviation = 14.52) and ranged from 22 to 83 points, which means that people detained in penitentiary institutions suppressed their negative emotions at an average level. The prisoners had the best control over fear (M = 18.68), less over anger (M = 16.86) and the least over depression (M = 16.27). Statistical analysis showed a correlation between the level of emotional control and the intensity of perceived stress.

Research limitations/implications: The small sample size of the group participating in the study and narrowing of the research area means that results can not be generalised across all isolated prison population.

Practical implications: The results obtained from the study can be used by a multidisciplinary team to develop therapeutic programmes for convicted persons, the aim of which is to evaluate strategies for coping with stress and controlling emotions.

Social implications: Popularising reliable information related to the issue of experiencing stress and varied emotions in those staying in penitentiary institutions may lead to the elimination of harmful stereotypes functioning in society, as well as reduce the phenomenon of marginalisation of prisoners, and thus contribute to the success of the social rehabilitation process.

Originality/value: Research on the level of stress intensity in prisoners is important because the rates of mental health disorders among prisoners consistently exceed the rates of such disorders in the general population.

Purpose: This study aims to describe knowledge of Canada's Good Samaritan Drug Overdose Act (GSDOA) and take home naloxone (THN) training and kit possession among people being released from provincial correctional facilities in British Columbia.

Design/methodology/approach: The authors conducted surveys with clients of the Unlocking the Gates Peer Health Mentoring program on their release. The authors compared the characteristics of people who had and had not heard of the GSDOA and who were in possession of a THN kit.

Findings: In this study, 71% people had heard of the GSDOA, and 55.6% were in possession of a THN kit. This study found that 99% of people who had heard of the GSDOA indicated that they would call 911 if they saw an overdose. Among people who perceived themselves to be at risk of overdose, 28.3% did not have a THN kit. Only half (52%) of participants had a mobile phone, but 100% of those with a phone said they would call 911 if they witnessed an overdose.

Originality/value: The authors found that people with knowledge of the GSDOA were likely to report that they would call 911 for help with an overdose. Education about the GSDOA should be a standard component of naloxone training in correctional facilities. More than one in four people at risk of overdose were released without a naloxone kit, highlighting opportunities for training and distribution. Access to a cellphone is important in enabling calls to 911 and should be included in discharge planning.

Purpose: The purpose of this paper was to conduct a legal realist assessment of women's situation in European immigration detention which focuses on relevant international and European human rights instruments applicable to conditions and health rights in detention settings, academic literature and relevant European Court of Human Rights (ECtHR) jurisprudence since 2010.

Design/methodology/approach: In spite of the United Nations human rights frameworks and European Union (EU) standards, conditions in European immigration detention settings continue to pose a health risk to those detained. Migrant health rights when detained are intertwined with the right not to be subjected to arbitrary detention, detention in conditions compatible for respect for human dignity and right to medical assistance. Migrant women are particularly vulnerable requiring special consideration (pregnant and lactating women; single women travelling alone or with children; adolescent girls; early-married children, including with newborn infants) in immigration detention settings.

Findings: The situation of women in immigration detention is patchy in EU policy, academic literature and ECtHR jurisprudence. Where referred to, they are at best confined to their positionality as pregnant women or as mothers, with their unique gendered health needs ill-resourced. ECtHR jurisprudence is largely from male applicants. Where women are applicants, cases centre on dire conditions of detention, extreme vulnerability of children accompanying their mother and arbitrary or unlawful detention of these women (with child).

Originality/value: Concerns have been raised by the European Parliament around immigration detention of women including those travelling with their children. There is a continued failure to maintain minimum and equivalent standards of care for women in European immigration detention settings.