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Community-based research has found racial differences in suicide attempts for Black and White men and in how men are treated after a suicide attempt; however, prison-based research has largely not explored such differences. This study examined racial differences in the circumstances of incarcerated men's suicide attempts and investigated health care disparities in staff responses to these suicide attempts. With administrative data from three state prisons over a 5-year period, we conducted a latent class analysis to explore patterns of suicide attempts for 207 incarcerated men. We examined race as a predictor of class membership. Black men were more likely than White men to use a method of hanging/suffocation for attempting suicide, and they were also commonly subjected to segregation when they attempted suicide. Black men were less likely to receive health care post-attempt than White men. Given the findings of this study, several key researches, practices, and policy directions are needed to prevent suicide and promote the health and well-being of incarcerated men, particularly incarcerated Black men., Competing Interests: Declarations Disclaimer The opinions or points of view expressed in this document are those of the authors and do not reflect the official position of CHAS. Competing Interests The authors declare no competing interest., (© 2023. W. Montague Cobb-NMA Health Institute.)

Background: Mental health problems are highly prevalent in prison populations. Incarcerated persons generally come from disadvantaged backgrounds and are living under extraordinary conditions while in prison. Their healthcare needs are complex compared to the general population. Studies have found that incarcerated individuals are reluctant to seek help and that they experience challenges in accessing mental healthcare services. To some extent, seeking treatment depends on the degree of fit between potential users and health services, and actual use might be a better indication of accessibility than the fact that services are available. This study aimed to explore individual and systemic facilitators and barriers to accessing mental healthcare in a prison context., Methods: An analytical approach drawing on elements of constructivist Grounded theory was the methodological basis of this study. Fifteen male participants were recruited from three prisons in Northern Norway. Data was collected through in-depth interviews on topics such as help-seeking experiences, perceived access to services and availability of health information., Results: We found that distrust in the system, challenges with the referral routines, worries about negative consequences, and perceived limited access to mental healthcare were barriers to help-seeking among incarcerated individuals. How prison officers, and healthcare personnel respond to incarcerated persons reporting mental distress could also be critical for their future willingness to seek help. Providing information about mental health and available services, initiating outreaching mental health services, and integrating mental health interventions into treatment programs are examples of efforts that might reduce barriers to accessing services., Conclusions: Facilitating access to mental health services is crucial to accommodate the mental health needs of those incarcerated. This study provides insights into the complex interplay of individual, social and systemic factors that may contribute to the utilization of mental health care among incarcerated persons. We suggest that correctional and healthcare systems review their practices to facilitate access to healthcare for people in prison., (© 2024. The Author(s).)

Reentry is a difficult juncture for young adults (ages 18-24 years), who simultaneously face challenges of emerging adulthood. Although their health-related needs may be substantial, little is reported on young adults' reentry health care and social service needs. Furthermore, empirical measurements of factors affecting their engagement in reentry services after jail are lacking. We sought to describe health needs and predictors of linkages to reentry services for the 2,525 young adult participants in the Whole Person Care-LA Reentry program (WPC Reentry). Descriptive statistics were calculated and chi-square tests, t tests, and logistic regression were performed to identify factors associated with linkage to WPC Reentry postrelease compared with only engaging with WPC Reentry prerelease. Most participants (72.6%) were male, 80.2% were Hispanic or Black, and 60.9% had been unhoused. Mental health (57.2%) and substance use disorders (45.8%) were common, physical health was overall good (mean Charlson Comorbidity Index score 0.53), and social needs, especially housing, were high (40.7%). Older age (i.e., closer to 25 years) and history of being unhoused were associated with higher postrelease engagement in WPC Reentry (age: odds ratio [OR] = 1.06, p  = .01; history of being unhoused: OR = 1.18, p  = .05). Attentiveness to younger clients and to addressing housing needs may be key for successful reentry care linkages.

Purpose: Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm., Design/methodology/approach: Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017-2019 was used. Annual rates per 1,000 were calculated by age and gender., Findings: The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18-29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner's environment and relationships., Practical Implications: There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts., Originality/value: To the best of the authors' knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population., (© Emerald Publishing Limited.)

Jails and prisons in the United States house people with elevated rates of mental health and substance use disorders. The goal of this cross-sectional study was to evaluate the frequency of racial/ethnic differences in the self-report of mental illness and psychiatric medication use at jail entry. Our sample included individuals who had been incarcerated between 2016 and 2020 at the Middlesex Jail & House of Correction, located in Billerica, MA. We used data from the "Offender Management System," the administrative database used by the jail containing data on people who are incarcerated, and COREMR, the electronic medical record (EMR) used in the Middlesex Jail & House of Correction. We evaluated two primary outcomes (1) self-reported mental illness history and (2) self-reported use of psychiatric medication, with the primary indicator of interest as race/ethnicity. At intake, over half (57%) of the sample self-reported history of mental illness and 20% reported the use of psychiatric medications. Among people who self-reported a history of mental illness, Hispanic (AOR: 0.73, 95% CI: 0.60-0.90), Black (AOR: 0.52, 95% CI: 0.43-0.64), Asian/Pacific Islander (Non-Hispanic) people (AOR: 0.31, 95% CI: 0.13-0.74), and people from other racial/ethnic groups (AOR: 0.33, 95% CI: 0.11-0.93) all had decreased odds of reporting psychiatric medications. Mental illness was reported in about one-half of people who entered jail, but only 20% reported receiving medications in the community prior to incarceration. Our findings build on the existing literature on jail-based mental illness and show racial disparities in self-report of psychiatric medications in people who self-reported mental illness. The timing, frequency, and equity of mental health services in both the community and the jail setting deserves further research, investment, and improvement., (© 2023. The Author(s).)

Background: The estimated number of people deprived of liberty is increasing, with 11.55 million incarcerated globally in 2021. Transmission of Mycobacterium tuberculosis strains is facilitated in over-crowded, poorly ventilated settings, such as jails and penitentiaries. Moreover, inmates may show individual risk factors for the development of tuberculosis disease. Treatment regimens for latent tuberculosis infection (LTBI) may require up to 9 months of drug exposure and are characterized by adverse events (AE) and low completion rates., Objectives: To describe current scientific evidence on feasibility, acceptability, and completion rate of LTBI treatment in prison or correctional institutes., Data Sources: Articles were retrieved from MEDLINE/PubMed, no time restriction was applied., Study Eligibility Criteria: Human retrospective and prospective studies published on LTBI treatment in incarcerated populations were included., Assessment of Risk of Bias: Bias assessment plots and Egger weighted regression test were used to determine the risk of bias., Methods of Data Synthesis: Absolute and relative frequencies were assessed for qualitative data. Pooled proportion of included study groups and 95% confidence interval estimates, weighted for sample sizes, were illustrated in forest plots. I 2 indicator association were used for true variability and overall variation. Fixed and random-effects models were chosen depending on the estimated between-study heterogeneity., Results: Of the 11 selected studies, only 1 was conducted in a high tuberculosis incidence country. Overall, completion rates ranged from 26% to 100% across the included studies. Reason for the discontinuation of treatment were transfer to other facilities, release, or loss to follow-up (range, 0-74%), incidence of AEs (range, 0-18%), and refusal or withdrawal from treatment (range, 0-16%)., Conclusions: Implementation of short-course regimens in prisons should be considered given the low incidence of AEs observed; however, inmates consistently refused to complete LTBI treatment, thus underlining the need for improvement in retention in care., Competing Interests: Transparency declaration All Authors have no conflict of interest to disclose for this manuscript. No external funding was received for this manuscript. Supervision: NR, GT, MF, and GS. TM and NR contributed equally to this research work., (Copyright © 2023 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Nonthumb metacarpal (NTMC) fractures are common in the incarcerated and the underinsured civilian populations. However, certain social challenges contribute to high rates of follow-up noncompliance and complications in these unique populations. We conducted a retrospective review of the treatments, outcomes, and complications in the incarcerated and civilian patient population who were treated at a tertiary public hospital for NTMC fractures. Even though incarcerated patients were more likely than their civilian counterparts to undergo operative interventions, both populations showed similar complication profiles as well as low rates of treatment compliance and follow-up. This article affirms that incarcerated individuals do not receive inferior care compared with civilians, and both the incarcerated and underinsured civilians would benefit from careful consideration of treatment algorithms and additional access to hand therapy.

Background: Incarcerated individuals have poor mental health compared to the general population. Social support has a beneficial effect on mental health. The buffering model proposes that social support facilitates coping under stressful conditions, while the main effects model suggests that belonging to social networks and having positive social interactions are beneficial for mental health. Prisons are a highly interesting context for studying social support, as imprisonment is perceived as stressful and disrupts social relationships and the availability of support. This study aims to explore incarcerated individuals' perceptions of social support from various sources in the transition from community to prison, its perceived significance for mental health, and the opportunities and barriers to accessing social support in a Norwegian prison context., Methods: The experiences of eight incarcerated individuals from a prison in Northern Norway were gathered through conducting individual in-depth interviews. The data analysis was inspired by Charmaz's version of Grounded Theory., Results: Social support from peers was perceived to be important for the well-being and preserving of mental health in prison. Support from informal sources outside prison and prison officers were not granted the same significance by the participants. Although prison life was perceived as stressful, social support in the form of companionship, the feeling of belonging, shared activities, and everyday conversations were more important for the participants than support focusing on coping with the stress of incarceration., Conclusions: Peers are perceived to be the most important source of social support, and vital for well-being and mental health in prison. Barriers to support from family, friends and prison officers may amplify the significance of support from peers., (© 2022. The Author(s).)

Introduction and Hypothesis: Our objective is to demonstrate a surgical approach to the treatment of incarcerated procidentia with obstructed ureters due to a pelvic mass., Methods: A 61-year-old woman presented with constipation, vaginal swelling, and difficulty voiding. On examination she had complete procidentia, which could not be reduced with gentle pressure. On imaging the prolapse appeared to contain a large pelvic mass measuring 11.5 cm in its greatest diameter, with features consistent with a mature teratoma. She was also noted to have bilateral ureteral obstruction and prominent hydronephrosis. After unsuccessful prolapse reduction under anesthesia, Bovie electrocautery was used to perform a posterior colpotomy. The obstructing mass was dissected away from the uterus and its connecting pedicle transected. The prolapse could then be reduced and a robotic hysterectomy performed., Results: Pathology showed multiple pelvic masses including an 8-cm necrotic cystic nodule most consistent with uterine fibroids and a 4.5-cm mature cystic teratoma with associated seromucinous cystadenoma of the left ovary. Bilateral nephrostomy tubes were placed postoperatively., Conclusion: Incarcerated procidentia is an uncommon occurrence, which in rare cases may be due to a pelvic mass. Surgical management may be required with colpotomy for removal of the pelvic mass in order to reduce the prolapse and resolve the case., (© 2022. The International Urogynecological Association.)

Background: Antisocial Personality Disorder (ASPD) describes individuals who engage in repetitive aggressiveness, deceitfulness, impulsivity, and unlawful behavior. It has a broad impact on families, relationships, and social functioning, and also people with ASPD make heavy demands on the judicial system, social and mental health services. Even though ASPD is a common problem among incarcerated in prisons, it is not well studied in developing countries including Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of ASPD among incarcerated in prison in Dessie city correctional center., Method: A cross-sectional study design was conducted among 320 incarcerated in prison at Dessie correctional center, Ethiopia. The study subjects were selected by using a simple random sampling technique and the Diagnostic and Statistical Manual 5th text revision (DSM-5) was used to measure ASPD using face-to-face interviews. Social support was assessed using the Oslo social support scale (Oslo-3). The collected data were checked for completeness and entered into Epi-data Version 3.1 and then exported to SPSS version 26 for analysis. Bivariate and multivariable logistic regressions were done to identify factors related to antisocial personality disorder. In multivariable logistic regression variables with a p-value, less than 0.05 were considered significant and, adjusted OR (AOR) with 95% CI was used to present the strength of the association., Results: The current study showed that the prevalence of ASPD was found to be 30.6% (95% CI:25.6,35.9). In a multivariable analysis, being single [AOR = 2.33; 95%CI (1.39,3.89)], monthly income of 1000-2000 ETB (Ethiopian Birr) [AOR = 2.12; 95%CI (1.163,3.45)], reconviction [AOR = 2.37; 95%CI (1.08,5.19)], and alcohol use [AOR = 2.00; 95% CI (1.16,3.45)] were discovered to be predictors of antisocial personality disorder., Conclusion: This study revealed that nearly one-third of incarcerated in prison were found to have an anti-social personality disorder. Being single, 1000-2000 ETB income, reconviction, and alcohol users were variables that are independent predictors of ASPD. A screening and intervention program is required and further research should be needed., (© 2022. The Author(s).)

Objective: Suicidal behavior in adolescents is an important public health problem, and it ranks first among the causes of prison deaths in incarcerated adolescents(IAs). The aim of this study is to determine the probability of suicide and associated risk factors in IAs., Method: Seventy-one male adolescents in a reformatory center were contrasted with a matched group of 71 male adolescent with no psychiatric disorder and no criminal record. Suicidal probability and psychiatric symptomatology were assessed with the Suicide Probability Scale, SA-45 Questionnaire, respectively., Results: It was determined that the probability of suicide was higher in IAs, and depression and hostility symptoms, the presence of another individual involved in delinquency in family had predictive effects. It was also found that there was a positive correlation between the probability of suicide and the number of delinquencies, the number of incarceration, and a negative correlation between attending to school or work while in reformatory and being visited by relatives while in reformatory., Conclusions: The results suggest that when assessing suicide risk for IAS, it may be useful to pay attention to those with symptoms of depression or hostility, those with multiple delinquencies or entrance to reformatory, and those who have family members involved in delinquency., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Current literature expounds on community and personal factors contributing to the rapidly growing number of women involved in the criminal justice system. Contributing factors are complex and interwoven, leaving women with life patterns of trauma exposure, mental illness, and substance use disorders. Consequences of these life patterns and incarceration have a significant impact on maternal role attainment. The conceptual model Mothering and Incarceration organizes the multifaceted life patterns of incarcerated women and the influences on a woman's ability to mother her children during and following incarceration. The model has the potential to provide direction to program developers, researchers, and correctional systems to tailor programs for women. The most significant implication of the conceptual model is ending the intergenerational influences of incarceration on children.

Background: Interventions to better manage aggressive behaviour and reduce recidivism are a primary concern for corrective services. Nutritional interventions to correct prisoner behaviour have been largely overlooked in the literature. Emerging evidence suggests that dietary intake influences aggressive behaviours and that nutritional supplementation with omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) could attenuate both the severity and frequency of aggressive behaviour., Methods: Adult male prisoners who have a history of aggressive behaviour (n = 600) will be recruited from at least 6 Correctional Centres and randomised to receive either n-3 LCPUFA or placebo supplementation for a 16-week duration. Treatment will be with either 1 g/day of n-3 LCPUFA (694 mg DHA and 397 mg EPA) or placebo capsules, which are a corn/soy oil blend and are identical in size and colour. The primary outcome measure is the Inmate Behavioural Observation Scale (IBOS): an objective measure of aggressive behaviour. Secondary outcome measures include questionnaires (including aggression, attention deficit disorder, impulsivity, depression/anxiety/stress scales), engagement in programmes, recidivism and quality of life. Baseline and post-intervention assessments include the IBOS, questionnaires and blood to measure the levels of n-3 LCPUFA., Discussion: To conclusively test the potential that increasing n-3 LCPUFA intakes can improve rates of prisoner aggression and associated mental health and violence-related social system management costs, we propose an adequately powered multi-centre, double-blind, randomised controlled trial, examining the effects of n-3 LCPUFA supplementation on aggressive behaviour in adult male prisoners. If successful, this study will inform prisoner policy with respect to nutrition and by inference contribute to a broader community approach to preventative mental health practices., Trial Registration: Australian New Zealand Clinical Trial Registry (ANZCTR) ACTRN12618001665224 . Registered on 10 October 2018.

Introduction: Incarcerated patients have been documented to have higher rates of mental illness, substance abuse disorders, trauma, and chronic illnesses compared to non-incarcerated populations. In this study, we evaluated the incidence of subdural hematoma (SDH) in incarcerated patients and compared the outcomes of these patients to those of non-incarcerated patients., Methods: We conducted a retrospective cohort study of incarcerated patients admitted to a hospital with acute SDH using the Nationwide Readmissions Database between 2016-2017. Nearest-neighbor propensity score matching for demographics was implemented to identify non-incarcerated control patients admitted with SDH. Analysis used chi-squared testing, Mann-Whitney U testing, and generalized binomial regression modeling., Results: A total of 962 incarcerated and non-incarcerated patients were identified at primary admission. No significant difference was found between the two cohorts with regards to rates of neurosurgical complications or readmissions. Incarcerated patients were found to receive a significantly lower number of procedures, including respiratory ventilation, intubation, central venous line placement, and imaging, during their primary admission (NPR = 2.7 ± 4.0) compared to non-incarcerated patients (NPR = 3.9 ± 4.9) (p = 0.00050), reduced length of stay (p = 0.0052), and reduced hospital costs (p = 0.00026) compared to non-incarcerated patients. Furthermore, female incarcerated patients with SDH had significantly worse outcomes compared to male patients with SDH, including higher rates of mortality (p = 0.0017) and 30-day readmission rates (p = 0.041)., Discussion: Our study suggests that incarcerated patients may receive significantly fewer diagnostic and supportive procedures while admitted for SDH and may be discharged sooner than non-incarcerated patients with SDH. In addition, outcomes following SDH within incarcerated patients may be significantly worse for females., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Motivational Interviewing plus Cognitive Behavior Therapy (MI/CBT) has been used to reduce adolescent substance use, but has rarely been applied in youth correctional settings. This trial compared MI/CBT against Relaxation Training plus Substance-Education/12-Steps (RT/SET) to reduce substance use and crime among incarcerated youth., Methods: Participants (N = 199) were incarcerated juveniles (64.8 % non-White, 10.1 % girls, mean age of 17.1 years). Two individual sessions of MI (or RT) were followed by 10 group sessions of CBT (or SET). Youth were randomized to condition with follow-ups at 3- and 6-months after release. Major outcomes included alcohol, marijuana and crimes involving aggression., Results: A marginal treatment by time interaction was found for percent heavy drinking days, with follow-up tests indicating less alcohol use in RT/SET than MI/CBT at 6 months, and increased use within MI/CBT from 3 to 6 months. A significant treatment by time interaction was found for alcohol-related predatory aggression, with follow-up tests indicating fewer youth engaged in this behavior from 3 to 6 months within RT/SET, and weak evidence favoring MI/CBT over RT/SET at 3 months. General predatory aggression decreased from 3 to 6-months for both treatments., Conclusions: Although weak evidence was found favoring MI/CBT with respect to alcohol-related predatory aggression, results generally support RT/SET in reducing percent heavy drinking days., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Pregnant women in prisons are recognised as a marginalised group. However, there is a limited understanding of the women's unique maternity needs and how correctional institutions and maternity service providers respond to these needs., Aim: The aims of the review are threefold., Method: An integrative literature review was undertaken. A comprehensive search strategy using seven electronic databases resulted in the retrieval of 363 articles. Of them, 32 peer-reviewed studies met the final selection criteria and were included in this review which utilised the Critical Appraisal Skills Program tools and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. Thematic analysis identified universal themes., Findings: Three dominant themes emerged related to the experience of pregnant women in prison: (1) risks and vulnerability factors; (2) prison enablers and supports; and (3) prison barriers. Extant research on risks and vulnerability factors is disproportionate to research examining how prisons can enable or obstruct responding to the women's perinatal needs. Limited research on the midwifery support available to the women in prison is available. Significantly, only two out of 32 reviewed papers include research directly conducted with the pregnant women in prison., Conclusion: Pregnant women in prisons have complex needs. More research is required to understand how prisons can enhance the pregnancy experience by engaging pregnant women in prisons as research participants., (Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Despite California's declining teen pregnancy rate, teens in the juvenile justice system have higher rates than their nonincarcerated counterparts. This study explored domains that may shape decision-making for pregnancy prevention in this group. Twenty purposively selected female teens with a recent incarceration participated in hour-long semistructured interviews about their future plans, social networks, access to reproductive health services, and sexual behavior. Transcripts revealed that, contrary to literature, desire for unconditional love and lack of access to family planning services did not mediate decision-making. Lack of future planning, poor social support, and limited social mobility shaped youths' decisions to use contraceptives. Understanding this group's social location and the domains that inform decision-making for pregnancy intentions and prevention provides clues to help programs predict and serve this population's needs.

Background: The country of Georgia has a high burden of chronic hepatitis C virus (HCV) infection, and prisoners are disproportionately affected. During 2013, a novel program offering no cost screening and treatment of HCV infection for eligible prisoners was launched., Methods: The HCV treatment program implemented a voluntary opt-in anti-HCV testing policy to all prisoners. Anti-HCV positive persons received HCV RNA and genotype testing. Transient elastography was also performed on prisoners with positive HCV RNA results. Prisoners with chronic HCV infection who had ≥F2 Metavir stage for liver fibrosis and a prison sentence ≥ 6 months were eligible for interferon-based treatment, which was the standard treatment prior to 2015. We conducted an evaluation of the HCV treatment program among prisoners from the program's inception in December 2013 through April 2015 by combining data from personal interviews with corrections staff, prisoner data in the corrections database, and HCV-specific laboratory information., Results: Of an estimated 30,000 prisoners who were incarcerated at some time during the evaluation period, an estimated 13,500 (45%) received anti-HCV screening, of whom 5175 (38%) tested positive. Of these, 3840 (74%) received HCV RNA testing, 2730 (71%) tested positive, and 880 (32%) met treatment eligibility. Of these, 585 (66%) enrolled; 405 (69%) completed treatment, and 202 (50%) achieved a sustained virologic response at least 12 weeks after treatment completion., Conclusions: HCV infection prevalence among Georgian prisoners was high. Despite challenges, we determined HCV treatment within Georgian Ministry of Correction facilities was feasible. Efforts to address HCV infection among prison population is one important component of HCV elimination in Georgia.

Background: Incarcerated individuals represent a significant proportion of the US population and face unique healthcare challenges. Scarce articles have been published about emergency department (ED) care of these patients. We studied the ED visits from one urban jail to better describe this population., Methods: A cohort study design was used, identifying patients who were sent to the ED from a city jail in 2015. Demographics, triage information, length of stay, number of studies, billing codes, diagnoses, and disposition data were collected. These were compared to the overall ED patient population in the same year., Results: 868 ED visits by jail patients occurred, representing 1.3% of the ED census. Compared to the general population, incarcerated patients were younger (32.1 years vs. 44.0 years, p < .01), healthier based on Elixhauser comorbidity scores (0.71 vs. 0.98, p < .01), and had lower admission rates (11.29% vs. 21.54%, p < .01). An abnormal vital sign was noted in 25% of incarcerated patients. Laboratory (61% vs. 57%, p < .02) and radiologic (63% vs 45%, p < .001) testing was more frequent for inmates and length of stay was longer (271 vs. 225 min, p < .01)., Conclusion: ED visits from jail were common, involving a relatively young and healthy population with a low incidence of abnormal vital signs and admission. Given the high costs associated with ED care and the medical resources available at some jails, further study should evaluate if increased jail medical capabilities could improve care and decrease costs by decreasing ED visits., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Health literacy is increasingly understood to be a mediator of chronic disease self-management and health care utilization. However, there has been very little research examining health literacy among incarcerated persons. This study aimed to describe the health literacy and relevant patient characteristics in a recently incarcerated primary care patient population in 12 communities in 6 states and Puerto Rico. Baseline data were collected from 751 individuals through the national Transitions Clinic Network (TCN), a model which utilizes a community health worker (CHW) with a previous history of incarceration to engage previously incarcerated people with chronic medical diseases in medical care upon release. Participants in this study completed study measures during or shortly after their first medical visit in the TCN. Data included demographics, health-related survey responses, and a measure of health literacy, The Newest Vital Sign (NVS). Bivariate and linear regression models were fit to explore associations among health literacy and the time from release to first clinic appointment, number of emergency room visits before first clinic appointment and confidence in adhering to medication. Our study found that almost 60% of the sample had inadequate health literacy. Inadequate health literacy was associated with decreased confidence in taking medications following release and an increased likelihood of visiting the emergency department prior to primary care. Early engagement may improve health risks for this population of individuals that is at high risk of death, acute care utilization, and hospitalization following release.

Background: Across the literature, impairment and disability among the older people have been associated with a decline in meeting their special needs. Failure in meeting such needs may cause deterioration of function and threaten successful aging. Accordingly, successful aging studies were carried out among males, in health care institutions, and in communities. In spite of these, the process by which successful aging is experienced by incarcerated older women remains to be a blank spot in research., Aim: This study purports to describe the process by which incarcerated older Filipino women experience successful aging., Methods: Strauss and Corbin's grounded theory design was employed. Semistructured interviews were conducted among 15 purposively selected incarcerated older Filipino from a Philippine penal institution exclusive for women. Further, data gathered was reduced to field text and was analyzed through open, axial and selective coding. Finally, truthfulness and trustworthiness of the findings were established through member checking., Findings: The study generated "The Road to Success Model". Interestingly, five phases relative to successful aging emerged, namely: Struggling, Remotivating, Reforming, Reintegrating and Sustaining. These phases describe how select incarcerated older Filipino women undergo transformation towards successful aging. Similar to a road, each phase is considered a station where one must pass through in order to get to the destination., Conclusion: Findings of the study serve as an impetus for structural and procedural changes in prison, with a view to providing an environment conducive to successful aging and appropriate recognition to the older prisoner's efforts to achieve successful aging., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Previous studies provide insight into the mental health of jail and prison inmates, but this research does not compare the two groups of inmates. Using data from the Fragile Families and Child Wellbeing Study, this article examines how the association between incarceration and self-reported mental health varies by facility type, net of an array of demographic and socioeconomic characteristics. Both jail and prison inmates report high rates of depression, life dissatisfaction, heavy drinking, and illicit drug use. In adjusted logistic regression models, those incarcerated in jails, compared with those not incarcerated, have higher odds of depression (odds ratio [ OR] = 5.06, 90% confidence interval [CI; 1.96, 13.11]), life dissatisfaction ( OR = 3.59, 90% CI [1.40, 9.24]), and recent illicit drug use ( OR = 4.03, 90% CI [1.49, 10.58]). Those incarcerated in prisons have higher odds of life dissatisfaction ( OR = 3.88, 90% CI [2.16, 6.94]) and lower odds of recent heavy drinking ( OR = 0.32, 90% CI [0.13, 0.81]) compared with those not incarcerated. Furthermore, jail inmates report significantly more depression, heavy drinking, and illicit drug use than prison inmates. These results suggest the association between incarceration and mental health may vary substantially across facilities and highlight the importance of expanding research in this area beyond studies of prisons. The results also indicate that public health professionals in the correctional system should be especially attuned to the disproportionately high levels of poor mental health outcomes among jail inmates.

Over 2 million adults in the United States are incarcerated and over 650,000 return to the community each year. This disparate population is known to have an elevated burden of chronic disease and lower socioeconomic status. Medical residency training about care for incarcerated or previously incarcerated patients is significantly lacking in the United States. Curriculum can be developed and implemented in residency programs to help physicians learn how to work with this population, be sensitive to their unique needs, and achieve positive health outcomes. This article describes a method for "educating the educators" based on a workshop presented at a peer-reviewed national conference during the fall of 2016. Attendees participated in exercises addressing assumptions, expectations, bias, and worldview and increased their ability for self-reflection when interacting with patients who are or have experienced incarceration. In this session, strategies were identified that engaged the patient with the goal to aid in patient retention and compliance. Future steps include development of a formal curriculum for training in this area, incorporation into existing community medicine rotations or electives, and establishment of structured transition clinics where residents can be exposed to this population on a more regular basis and improve their overall health outcomes.

Incarcerated black women in the southern USA are understudied despite the high prevalence of sexually transmitted infections (STI) and human immunodeficiency virus (HIV). These incarceration and health disparities are rooted in centuries of historically inequitable treatment. Amidst the current dialogue on mass incarceration in the south and its relationship to the health of the black community, individual and environmental risk factors for STI/HIV transmission are seldom paired with discussions of evidence-based solutions. A narrative review of the literature from January 1995 to May 2015 was conducted. This sample of the literature (n = 18) revealed that partner concurrency, inconsistent condom use, sex work, previous STI, and drug abuse augmented individual STI/HIV risk. Recommended interventions include those which promote healthier relationships, cultural competence, and gender specificity, as well as those that enhance prevention skills. Policy recommendations include improving cultural sensitivity, cultural competence, and cultural humility training for clinicians, as well as substantially increasing funding for prevention, treatment, and rehabilitative services. These recommendations are timely given the recent national attention to incarceration, STI, and HIV disparities, particularly in the southern USA.

About one in nine Canadians who are infected with hepatitis C spend time in a correctional facility each year. With high rates of current injection drug use and needle sharing, this population may account for a large proportion of new infections. Any national strategy to address hepatitis C should include a focus on persons in correctional facilities, and should build on existing evidence regarding primary, secondary and tertiary prevention.

Objective: The aim of this study was to examine the prevalence of ADHD and psychiatric comorbidity, including substance use in incarcerated women., Method: This was a cross-sectional study, consisting of two parts: (a) screening using the ADHD Self-Rating Scale (ASRS) and (b) diagnostic assessment using a structured interview., Results: A sample of 96 incarcerated women was screened and 56 underwent the diagnostic assessment. Twenty-nine percent of the women met the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnostic criteria for adult ADHD in the diagnostic assessment. Forty-four of the women had misuse of alcohol, and 83% had misuse of narcotics the year prior to the incarceration. The ASRS showed sensitivity of 1.0 and specificity of 0.66., Conclusion: The prevalence rate of ADHD in incarcerated women was high and comparable to that in male offenders. Illicit stimulant use and antisocial personality disorder were significantly more common in women with ADHD. ASRS is useful as a screener in this population., (© 2012 SAGE Publications.)

Background: Studies report the variable prevalence of attention deficit hyperactivity disorder (ADHD) in incarcerated populations. The aim of this meta-analysis was to determine the prevalence of ADHD in these populations., Method: Primary research studies reporting the prevalence (lifetime/current) of ADHD in incarcerated populations were identified. The meta-analysis used a mixed log-binomial model, including fixed effects for each covariate and a random study effect, to estimate the significance of various risk factors., Results: Forty-two studies were included in the analysis. ADHD prevalence was higher with screening diagnoses versus diagnostic interview (and with retrospective youth diagnoses versus current diagnoses). Using diagnostic interview data, the estimated prevalence was 25.5% and there were no significant differences for gender and age. Significant country differences were noted., Conclusions: Compared with published general population prevalence, there is a fivefold increase in prevalence of ADHD in youth prison populations (30.1%) and a 10-fold increase in adult prison populations (26.2%).

The relationship between childhood adversity and adult depression is well-established but less is known about the association between childhood adversity and adult depression among the incarcerated. In this paper, we examine differential exposure and vulnerability to childhood adversity by race/ethnicity and gender on adult depression among the incarcerated in the United States. We address three research questions: does exposure to childhood adverse experiences vary by race/ethnicity and gender? Is there an association between these childhood adverse events and depression and does the strength of the association vary by the specific adverse experiences? And does vulnerability to childhood adversity vary by gender and race/ethnicity? Using the 2004 Survey of Inmates in State and Federal Correctional Facilities (SI-SFCF), we measure four key childhood adverse events - parental/caretaker substance abuse, physical assault, having been placed in foster care, and sexual assault. We use ordinary least squares regression and a series of interaction effect analyses to examine differential exposure and vulnerability to the four childhood adverse experiences by race/ethnicity and gender. Incarcerated women are more likely to report parental substance abuse, but all inmates/prisoners are similarly vulnerable to this experience. For the other three adverse experiences measured, we find that there are important racial/ethnic and gender differences in both exposure and vulnerability. African American men and women are more vulnerable to the effects of physical and sexual victimization than White and Hispanic men and women. Women are much more likely to be exposed to sexual victimization, but men who report this experience are significantly more depressed. Hispanic women and White men and women are more likely to report foster care, but all inmates/prisoners who report foster care experiences are significantly more depressed than other inmates/prisoners, with the exception of white men. The findings indicate that there are significant differences in exposure and vulnerability to childhood adversity by race/ethnicity and gender. We conclude that in order to effectively design and implement programs to decrease the probability that childhood adversity is a risk factor for adult depression interventions must be targeted toward specific, vulnerable groups according to race/ethnicity and gender., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

This study examined the factor structure, reliability, and validity of the Antisocial Process Screening Device-Self-Report (APSD-SR), the Youth Psychopathic Traits Inventory (YPI), and the YPI-Short Version (YPI-SV) in detained female adolescents aged 12 to 17 years. The proposed three-factor structure of the YPI and YPI-SV was replicated, whereas the proposed three-factor structure of the APSD-SR or alternate models did not yield adequate fit. Overall, reliability indices for the YPI and YPI-SV were higher than those reported for the APSD-SR. APSD-SR and YPI scales were positively related with each other, except the affective dimensions of the instruments. All questionnaires showed good criterion validity but the YPI's factor structure and reliability was superior to the APSD-SR. This superiority is not because of the larger number of items in the YPI, because we also demonstrated that the factor structure and reliability of the YPI-SV was better than that of the APSD-SR., (© The Author(s) 2013.)

Incarcerated women, in comparison to nonincarcerated women, are at high risk for sexually transmitted infections (STIs) and many have experienced interpersonal violence. The psychological construct of emotional dysregulation-which includes heightened intensity of emotions, poor understanding of emotions, negative reactivity to emotion state, inability to control behaviors when experiencing emotional distress, and maladaptive emotion management responses-is a possible pathway to explain the link between interpersonal violence exposure and STI risk. The present study examined maladaptive emotion management responses for emotional dysregulation (i.e., avoidance and numbing, and dissociation) occurring in the context of risky sexual behavior. We collected qualitative data from 4 focus groups with a sample of n = 21 incarcerated women (aged 18+ years) from urban facilities in New England. Qualitative data were analyzed using a thematic analysis approach. Findings indicated that incarcerated women reported engaging in a variety of maladaptive responses for emotion management during sexual encounters. These maladaptive responses for emotion management appear to increase sexual risk behaviors and alter women's ability to implement STI protective behaviors, such as sexual negotiation and condom use. Preventive interventions to reduce sexual risk behaviors should incorporate strategies to promote emotional regulation among incarcerated women with histories of interpersonal violence.

This project sought to understand the present-day experiences of individuals housed in prisons by utilizing Participatory Action Research (PAR) methods that partnered a university research team with individuals incarcerated in an urban correctional facility. The team assessed perceptions of the current environment by surveying people incarcerated in an urban prison. This article discusses the role of PAR methodologies from project initiation to finalization, explicitly focusing on coordination with prison and Department of Correction (DOC) administrative leadership and the value of including incarcerated individuals on the research team for successful change. Throughout the process, the team identified areas for improvement and innovations to improve the prison environment. This article provides a road map, lessons learned from conducting PAR in prison environments, and the power of partnering researchers and members of the researched population on one collaborative research team. [ABSTRACT FROM AUTHOR]

Literature reveals that forgiveness can bring advantages to those who experience it, increasing quality of life. This study explores the relevance of forgiveness in a prison context and aims to understand how incarcerated individuals perceive forgiveness, focusing on their rehabilitation processes. The sample comprised N = 11 participants (males) who were serving a prison sentence in the Porto Prison Establishment. Qualitative data were collected through a sociodemographic questionnaire and a semi-structured interview and analyzed based on thematic analysis. The findings offer further evidence on the importance of all types of rehabilitation programs and, specifically the ones focused on forgiveness. These findings show that forgiveness can be a facilitator for behavioral changes in incarcerated individuals and highlights the importance of psychological interventions during rehabilitation. We discuss the implications of these results, suggesting the need to increase knowledge with future studies about forgiveness and rehabilitation processes with this public. [ABSTRACT FROM AUTHOR]

There are limited data about the tattoo removal process in formerly gang-involved and incarcerated people of color. This single center retrospective study was conducted on patients treated at Homeboy Industries' Ya'Stuvo Tattoo Removal Clinic between January 2016–December 2018. It reviewed data on 2,118 tattoos, and a representative sample of 502 patients was used to conduct our analysis. Treatment on 118 of the tattoos (5.57%) resulted in at least one complication (hypo-or hyper-pigmentation, keloids, or scarring). Patients who experienced tattoo removal complications (7.3%) were less likely to return to complete the removal process. More complications were experienced with higher fluences of energy, on tattoos placed by professional artists, on colored tattoos, and tattoos on clients who had a greater number of treatments. The study highlights complications and best practices in tattoo removal in people of color, a process critical to the reintegration and gang disengagement of this vulnerable population. [ABSTRACT FROM AUTHOR]

Aims: We sought to gather experts' perspectives on Medicaid coverage gaps during reentry to identify high-yield policy solutions to improve the health of justice-involved individuals in the United States. Subject and methods: We interviewed 28 experts at the intersection of Medicaid and criminal justice via telephone between November 2018 and April 2019. Interviewees included Medicaid administrators, health and justice officials, policy makers, and health policy researchers. We performed thematic analysis of semi-structured interview transcripts to identify emergent themes and distill policy recommendations. Results: Three themes emerged: 1) Medicaid coverage gaps during reentry contribute to poor health outcomes and recidivism, 2) excessive burden on justice-involved people to re-activate Medicaid leads to coverage gaps, and 3) scalable policy solutions exist to eliminate Medicaid coverage gaps during reentry. Policy recommendations centered on ending the federal "inmate exclusion," delaying Medicaid de-activation at intake, and promoting re-activation by reentry. Experts viewed coverage gaps as problematic, viewed current approaches as inefficient and burdensome, and recommended several policy solutions. Conclusion: By pursuing strategies to eliminate Medicaid gaps during reentry, policymakers can improve health outcomes and efficiency of government spending on healthcare, and may reduce cycles of incarceration. [ABSTRACT FROM AUTHOR]

The notion of socialization being a relevant and multidimensional construct has been demonstrated by the literature and reinforced in the present study. Socialization can be a difficult process, especially for certain types of people due to their personality and life experiences. Based on inmate research, being negatively labeled by others and internalizing such labels can result in feelings of dissonance in addition to socialization problems. The current study used the 24-item SOC scale to analyze differences in socialization difficulty among four specific groups of participants: the incarcerated, high school, college, and university students. The SOC scale was deemed reliable after yielding a Cronbach's Alpha of .831, while the multifaceted nature of socialization difficulty was made clear after conducting a factor analysis that yielded six factors accounting for 49.449% of the variance in the data. As hypothesized, it was found that the incarcerated group had significantly greater socialization difficulty than the three student groups. [ABSTRACT FROM AUTHOR]

This paper presents the concept of autogenous cultural practices as a political form that is neither a subject of state practices, nor a means of resistive anti-state force. Through a study of three participatory art projects carried out by the author, this paper examines how and if autogenous culture can be presented and more importantly effect societal change. These projects were carried out in a governmental disciplinary facility, a local non-governmental organization supporting sex workers and an independent art project with three young women who were graduates of the Normal Technical stream in Singapore respectively. [ABSTRACT FROM AUTHOR]

The present study investigated gender differences in the prevalence and incidence of violence-related traumatic brain injury (TBI) among justice-involved individuals, as well as potential associations between violence-related TBI and select biopsychosocial variables among women in the sample. Data from 409 justice-involved individuals were analyzed, and men and women were compared for rate of violence-related TBI. Women were grouped by violence-related TBI history and compared on eight biopsychosocial variables. Gender was significantly associated with multiple TBIs and multiple violence-related TBIs. History of violence-related TBI in women was associated with physical health problems and incarceration history. This research revealed a high rate of violence-related multiple TBIs among justice-involved women. Violence-related TBIs were associated with more prevalent physical illness and increased incarceration times. Identification of justice-involved women with these injuries may help clinicians better tailor services to improve inmate outcomes and reduce cost burdens to justice systems. [ABSTRACT FROM AUTHOR]

We obtained 180 pre- and post-test surveys to investigate how an established financial literacy program may have increased financial knowledge of residents in a work release program in Augusta, Georgia. Paired t tests analyzed changes in subjective and objective financial knowledge, understanding of banking and credit, and financial attitudes. OLS regressions of pre- and post-test financial knowledge were guided by human capital theory to learn which program participant characteristics were associated with greater increase in knowledge and infer why. Education, age, and use of financial tools were significant predictors in the pretest. Controlling for pretest knowledge, there were significant, positive differences from pre- to post-test, regardless of race. Implications for further research and specific suggestions for financial education content for the incarcerated are provided. [ABSTRACT FROM AUTHOR]

Rationale: Cancer is the second most common cause of death in incarcerated population and lung cancer is the most common cause of cancer death in this group. Inmates are excluded from most published surveys and research, thus the effectiveness of lung cancer palliation in this population is not known. Objective: To report the feasibility and safety of palliative interventional pulmonary procedures in inmates with cancer. Study Design: Retrospective review of registry data from a single center. Materials and Methods: Inmate data on prospectively enrolled data registry (2009-2012) from the interventional pulmonology procedural registry at Virginia Commonwealth University was extracted and analyzed for safety and efficacy. Inmates with lung cancer and advanced malignancies with pleural or airway metastasis requiring airway debulking (mechanical/thermal), airway stenting, and tunneled pleural catheter (TPC) placement were included in the analysis. Results: A total of 16 procedures were performed in 12 incarcerated patients. These included six TPC placements in six patients. Ten procedures were performed in seven patients with airway obstruction. These procedures included rigid and flexible bronchoscopy with mechanical (rigid and balloon dilation) and thermal (laser, argon plasma coagulation, and cautery) tumor debulking and dilation, airway stenting, and tracheostomy in one case. All six TPC patients had immediate symptomatic relief and improved lung aeration on chest radiograph. Three of six patients had successful auto-pleurodesis. In the seven patients with airway obstruction, three patients reported symptomatic relief and one had resolution of post-obstructive pneumonia. No immediate- or long-term procedure-related complications were reported. Conclusion: Incarcerated patients with advanced malignancy may benefit from interventional pulmonology procedures with low complications. Palliative interventional pulmonology procedures in inmates should not be withheld solely on their incarceration status. [ABSTRACT FROM AUTHOR]

Renal transplantation (Tx) improves mortality and morbidity but is limited by availability of suitable organs. Clinical and economic impact of a Tx program for end-stage renal disease (ESRD) prisoners was evaluated. Wait list time and patient and organ survival rates were assessed. Twelve of the 104 ESRD prisoners at a prison dialysis unit were activated; 9 transplanted, 2 released active on the United Network for Organ Sharing list, and 1 died after listing. Kidneys from antibody-positive hepatitis C (HepC) donors were given to consenting HepC antibody-positive recipients. The average waiting period was 6.6 months for HepC-positive kidney recipients and 49.6 months for others. Compared with costs of continuing dialysis, Tx resulted in substantial savings. Patients with HepC experienced good graft and survival rates when given grafts from HepC donors, suggesting that transplantation is a viable, cost-effective option for the incarcerated patient with ESRD including those who have chronic HepC infection. [ABSTRACT FROM AUTHOR]

Although the Static-99R has been found to be a robust measure of long-term risk to reoffend among adult male sex offenders, few studies have investigated the relationship between Static-99R scores and institutional (i.e., prison) behavior. The current study sought to address this gap in the research by testing the ability of the Static-99 and Static-99R to predict five types of institutional misconduct: (a) sexual, (b) violent (nonsexual), (c) nonviolent (nonsexual), (d) drug-related, and (e) any nonsexual. Results indicate that the Static-99/99R may be useful as predictors of institutional misconduct and, therefore, as a risk classification measure for prisons to protect both staff and inmates and improve institutional environments. [ABSTRACT FROM AUTHOR]

In a review of the literature on child gender and gender-specific effects for children of incarcerated parents, the present paper examines what we do and do not know about gender-specific protective and risk factors for children of incarcerated parents. The nuanced effects of parental separation based on child gender are offered, drawn from secondary level girls in an all-female support group operated at a secondary school in Little Rock, Arkansas for the past six years. Other programs are examined that evidence gender-specific effects for boys and girls in those programs. A few basic statistical indices suggest that the gender of an adolescent separated from his or her incarcerated parents has differential impacts to be better studied and possibly considered in service programming. The results may enhance the outcomes for the girls, and perhaps the boys. [ABSTRACT FROM AUTHOR]

Introduction: The current study evaluated effects of an adapted version of Mindfulness-Based Relapse Prevention (MBRP) on several psychosocial indices in a sample of incarcerated adult males with substance use disorders. Method: This study used a 2 (baseline vs post-session) × 2 (MBRP vs. treatment-as-usual (TAU) mixed design. Twenty-four incarcerated individuals with a history of substance abuse were randomly assigned to either MBRP or TAU. At pre- and post-session assessment points, participants completed the Drug Use Identification Disorders Test- Extended (DUDIT-E), the Drug Avoidance Self-Efficacy Scale (DASE) and positive//negative outcome expectancies (Ep//En). The Beck Depression Inventory-II (BDI-II) was completed in each weekly session of MBRP. MANOVA and repeated measures ANOVA examined changes between and within subjects, with the significant level set at 0.05. Results: No between-group differences were found on positive outcome expectancies or self-efficacy. Differences BDI-II scores among MBRP participants showed a downward trend over time. A Group × Time effect emerged for negative outcome expectancies, with significant differences between groups at post-course assessment. Conclusions: Results from this randomized trial suggest pre- to post-intervention trend-level effects of MBRP on depression, and significant group differences over time and at post-course on negative outcome expectancies, with the MBRP group reporting increases. [ABSTRACT FROM AUTHOR]

The article reports on a study which has evaluated the effectiveness of a Vipassana meditation (VM) course, the Buddhist mindfulness-based practice, on substance use and psychosocial outcomes in an incarcerated population. Vipassana meditation provides an alternative for individuals who have not succeeded with traditional addiction treatments. Results indicate that after release from jail, VM participants showed an increase in positive psychosocial outcomes.