Journal of correctional health care : the official journal of the National Commission on Correctional Health Care最新文献

There are many reasons why people experiencing incarceration may be predisposed to developing dementia. Dementia assessment in prisons is challenging. This study assessed the Addenbrooke's Cognitive Examination 3rd Edition (ACE-III) and the Mini Addenbrooke's Cognitive Examination (M-ACE) as potential tools for use in incarcerated populations, with a view to detecting suspected dementia. The ACE-III was administered to 114 males more than 50 years of age without a diagnosis of dementia across three prison sites in Victoria, Australia, in 2022. A psychogeriatrician reviewed data for atypical response patterns to determine whether individuals' profiles were suggestive of dementia. The M-ACE was scored retrospectively from the ACE-III. Scores were compared with the psychogeriatrician's review to determine concordance rates. Both tools acceptably discriminated males who indicated dementia from those without (area under the curve [AUC] = 0.77, [0.65, 0.98]; AUC = 0.77, [0.60, 0.93], respectively). Both tools produced high negative predictive values (0.96 and 0.97). Both the ACE-III and M-ACE demonstrated utility for use in this cohort. The M-ACE may be an useful tool for screening out individuals who do not have dementia, while the ACE-III provides a comprehensive cognitive profile as a basis to assess for dementia.

The prison population is aging and health care costs are rising. Compassionate release for the terminally ill and disabled is underutilized, especially in Louisiana, which is the state with the highest incarceration rate. This article evaluates the utilization of community physicians to improve compassionate release rates. Health care providers at a contract hospital for the Louisiana Department of Public Safety and Corrections collaborated with attorneys, the Louisiana Department of Health, and the Louisiana Department of Public Safety and Corrections to facilitate compassionate release for eligible individuals. A retrospective analysis of patients referred for compassionate release between August 01, 2022 and December 31, 2023 was completed. Outcomes included release rates and underlying conditions. During this time, 18 patients were eligible; most were 56 to 75 years of age, consistent with national trends. Of the 18 eligible patients, four were released, eight died while incarcerated, and six remained incarcerated. This retrospective review shows that a coordinated, multidisciplinary approach can have a significant impact.

People involved in the criminal justice system have higher rates of opioid use disorder (OUD) and are less likely to receive recovery services. Medications to treat OUD, such as extended-release naltrexone, have been found to reduce relapse and recidivism. We hope to provide practical lessons learned from the evaluation process of the Department of Corrections' Extended-Release Naltrexone Program and considerations for incorporating medications to treat OUD into a reentry program. The program evaluation followed participants for 1 year and conducted interviews and surveys on health, well-being, and community reintegration. The program experienced significant barriers to effective implementation; few participants received extended-release naltrexone after release, and no case management was provided after release. Despite barriers to implementation, participants reported the need for medications to support treatment of OUD. Results of this program evaluation reveal barriers and opportunities to inform longer-term strategies for similar programs, including considerations for programs pre- and postrelease, participant follow-up, and treatment options. In addition, the lack of reentry planning and coordination between the correctional system and the community introduced barriers. Opportunities exist for holistic supportive reentry starting with needs identification and coordination among correctional facilities, discharge planners, and community providers.

In South Africa, there is no provision of medication for opioid use disorder (MOUD) for people who are incarcerated or were recently incarcerated. This study aimed to describe MOUD uptake and barriers among people living with human immunodeficiency virus and using illicit opioids reentering the community from incarceration. A mixed-method exploratory study was conducted between September 2021 and September 2022 in South Africa, during which we offered low-barrier MOUD and harm reduction services. We followed 23 participants postrelease and observed a low uptake of MOUD after release (8 of 23, 35%). Reported barriers to MOUD included perceived ineffectiveness, a preference for residential withdrawal management, and delays in initiating MOUD. Innovation is needed in strategies to deliver MOUD and harm reduction in South Africa.

Adolescents in the juvenile legal system have unaddressed sexual health needs. Factors at multiple ecological levels-including caregivers or neighborhoods-may promote or hinder sexual health for this group. We aimed to identify targets for future intervention by determining the associations between sexual behaviors and multilevel risk and protective factors among adolescents involved in the juvenile legal system. To do this, we examined data from adolescent-caregiver dyads newly involved with the juvenile legal system and used an ecodevelopmental resilience framework and multinomial models to determine associations between higher sexual behavior score (representing higher sexually transmitted infection risk) and multilevel factors. Among 423 dyads, higher sexual behavior score was independently associated with lower-quality sexuality communication with caregivers and less neighborhood cohesion. Improving the quality of caregiver sexuality communication and prioritizing sexual health resources in neighborhoods with lower cohesion are promising intervention targets to improve sexual health for adolescents newly involved in the juvenile legal system.

The Federal Bureau of Prisons (BOP) has both formal policies and internal guidelines for commissary food items that aim to increase access and provide nutritional information for individuals who experience incarceration. The purpose of this research was to determine (a) the nutritional assessment of commissary offerings by the BOP Mid-Atlantic Region because little is known about the foods offered in commissaries, (b) if the BOP commissaries align with recommended packaged snack food and nutrition standards, and (c) if they follow their own policies and standards for healthy commissary food offerings. Commissary lists for 21 BOP commissaries in the Mid-Atlantic Region were collected. Food items were analyzed and categorized based on the BOP's list of healthy commissary food options. None of the commissaries met all the standards. The BOP does not align its current policy or healthy commissary food options with the U.S. Department of Health and Human Services' Food Service Guidelines for Federal Facilities. Furthermore, the BOP does not follow their own internal policies and standards for healthy commissary food options. The food availability is dominated by a few select items. The omission of adequate healthy options in commissaries increases preventable health risk exposure to individuals experiencing incarceration.

Recruitment and retention of clinical staff in correctional settings remain a significant challenge. Few physicians learn about the provision of care within carceral institutions, most notably during their initial training programs when career trajectories are typically determined. A rotation for senior family medicine residents was developed in a county jail with an experiential learning curriculum that centers the needs of individuals experiencing incarceration. We investigated whether residents who completed this rotation subsequently worked within correctional medicine or cared for individuals in the community who had been formerly incarcerated. Residents who concluded the rotation between 2014 and 2020 and had since graduated from their training programs (N = 20) were invited to participate in an anonymous survey. Approximately 88% of survey participants reported caring for patients with a history of incarceration since completing the rotation. Nearly 18% reported having worked in a jail or prison after graduation. All respondents reported that they would consider pursuing correctional medicine at some point in their career. Findings from this study suggest that providing a brief but structured clinical rotation for senior medical residents in a jail or prison may encourage graduates to consider working with people involved in the criminal legal system.

Unaddressed grief and trauma may precipitate and maintain problematic substance use, criminal behavior, and resultant incarceration. We detail the implementation and evaluation of an evidence-based grief support group model conducted in seven groups in the two substance-use disorder treatment programs within a state correctional facility. The three aims of this project were to (1) train Department of Corrections mental health clinicians in the grief support group model, (2) conduct seven grief support groups facilitated by trained clinical social workers in two substance-use disorder treatment programs within the prison, and (3) evaluate impact of the grief support group model on participant grief. This is a pragmatic intervention feasibility evaluation of 69 incarcerated people in seven grief support groups facilitated by prison mental health clinicians trained in the grief support group model. The investigation resulted in high satisfaction and self-efficacy among clinician trainees, research feasibility being established, the intervention being found acceptable and practical, and client participants reporting clinically significant reductions in grief severity and grief improvement. The grief support group model holds promise as a complementary modality within a well-designed therapeutic program at the proper time for clients with severe grief.

Incarcerated individuals face many health care challenges, including limited sanitation, limitations of formularies, and difficulty obtaining routine medical care. This study characterizes skin conditions in incarcerated individuals in the Harris Health System in Houston, Texas. We performed a retrospective health record review on incarcerated inpatients and outpatients between 2011 and 2022, collecting data on diagnostic workups, diagnoses, and interventions. Skin and soft tissue infections and drug reactions (42.9%) were the most common inpatient conditions, compared with papulosquamous and eczematous diseases (34.8%) and neoplasms (31.5%) in outpatients. Many patients demonstrated challenges in management directly related to their incarceration. Overall, the distribution of skin conditions in the incarcerated population shares similarities with that of the general population. Dermatologists should overcome resource limitations, educate patients and jails, and promote improved jail protocols for this vulnerable population.