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In 2019, the Israeli Ministry of Health joined the World Health Organization initiative to eliminate hepatitis C virus (HCV) (1). The national elimination program included HCV testing among 6 high-risk [...]

I. INTRODUCTION There are over two million people incarcerated around the country in local, state, and federal jails and prisons. (1) Although prisoners do not have the full slate of [...]

Summary This article, the fourth in a five-part series, explores the management of long-term conditions in the prison population, as well as patient-centred approaches to care and the challenges this [...]

Summary This article summarises the needs of people with learning disabilities in the police station, courts and prisons. The article describes national plans to address these needs, with particular information [...]

The confluence of the deinstitutionalization of people with mental illness and the massive incarceration of drug offenders has dramatically raised the number of substance abusers with mental illness in American jails. This study sought to identify correlates of comorbidity and service gaps among jail inmates using data from the 2002 Survey of Inmates in Local Jails. Results suggest that offenders with comorbidity can be satisfactorily identified according to their past exposure to certain risk factors. One third of the jail population met the comorbidity criteria and 64% of them did not receive any treatment or counseling service while incarcerated. Policy implications are discussed. KEYWORDS comorbidity, co-occurring disorders, jail inmates, treatment needs DOI: 10.1080/10509670903534811

In 2005, there were 20,888 prisoners in the U.S. prisons known to be HIV-positive, many substance-involved. The high reincarceration rate of substance-involved prisoners, coupled with the fact that substance-involved prisoners are more prone to HIV-risk behaviors in the community, necessitates attention to preventing substance use and HIV transmission risk behaviors of prisoners upon reentry to communities. We use a social support framework to explore the role of social support in HIV+ prisoners' expectations of release and postrelease plans. Interview data from 23 participants were collected from August 2005 to January 2006. Participants reported concerns about their ability to access needed formal and informal prosocial support upon release. Implications of these findings for release planning are discussed. KEYWORDS HIV-positive prisoners, reentry, release planning, social support, substance-involved prisoners, transitional programming

Objectives. We analyzed the prevalence of chronic illnesses, including mental illness, and access to health care among US inmates. Methods. We used the 2002 Survey of Inmates in Local Jails and the 2004 Survey of Inmates in State and Federal Correctional Facilities to analyze disease prevalence and clinical measures of access to health care for inmates. Results. Among inmates in federal prisons, state prisons, and local jails, 38.5% (SE=2.2%), 42.8% (SE=1.1%), and 38.7% (SE=0.7%), respectively, suffered a chronic medical condition. Among inmates with a mental condition ever treated with a psychiatric medication, only 25.5% (SE=7.5%) of federal, 29.6% (SE=2.8%) of state, and 38.5% (SE=1.5%) of local jail inmates were taking a psychiatric medication at the time of arrest, whereas 69.1% (SE=4.8%), 68.6% (SE=1.9%), and 45.5% (SE=1.6%) were on a psychiatric medication after admission. Conclusions. Many inmates with a serious chronic physical illness fail to receive care while incarcerated. Among inmates with mental illness, most were off their treatments at the time of arrest. Improvements are needed both in correctional health care and in community mental health services that might prevent crime and incarceration. (doi:10.2105/AJPH.2008.144279)

A study was conducted to investigate the proportion of inmates that prescribed for antiretroviral therapy (ART) within 60 days after release from prison as well as the demographic, clinical, and correctional predictors of this outcome. Results indicated that only a small percentage of prisoners continued with ART within 60 days after release from prison.

Prisoners, ex-offenders, and the communities they belong to constitute a distinct and highly vulnerable population, and research must be sensitive to their priorities. In light of recent suggestions that scientific experimentation involving prisoners be reconsidered, community-based participatory research can be a valuable tool for determining the immediate concerns of prisoners, such as the receipt of high-quality and dignified health care inside and outside prisons. In building research agendas, more must be done to ensure the participation of communities affected by the resulting policies. (Am J Public Health. 2009; 99:201-204. doi:10.2105/ AJPH.2008.125617)

In corrections, where staffing limitations tax an overburdened mental health system, telemental health is an increasingly common mode of mental health service delivery. Although telemental health presents an efficient treatment modality for a spectrum of mental health services, it is imperative to study how this modality influences key elements of the treatment experience. In this study, the authors compared inmates' perceptions of the working alliance, postsession mood, and satisfaction with psychiatric and psychological mental health services delivered through 2 different modalities: telemental health and face-to-face. Participants consisted of 186 inmates who received mental health services (36 via telepsychology, 50 via face-to-face psychology, 50 via telepsychiatry, and 50 via face-to-face psychiatry). Results indicate no significant differences in inmates' perceptions of the work alliance with the mental health professional, postsession mood, or overall satisfaction with services when telemental health and face-to-face modalities were compared within each type of mental health service. Implications of these findings are presented. Keywords: telemental health, offender, inmate and correctional mental health services

Largely the result of prison officials needing to safely and efficiently manage a volatile inmate population, administrative segregation or supermax facilities are criticized as violating basic human needs, particularly for mentally ill inmates. The present study compared Colorado offenders with mental illness (OMIs) to nonOMIs in segregated and non-segregated environments. OMIs committed a large portion of institutional misbehaviors, likely a symptomatic expression of their illness, causing them to be placed at a disproportionately high rate in segregation. Even when OMIs cannot be managed in a less restrictive setting, corrections officials must provide enhanced services to monitor their psychological well-being. doi:10.1300/J076v45n01_11 KEYWORDS Administrative segregation, offender characteristics, prevalence rates

Limited research has been conducted on the creation or impact of 'decent' prisons, institutions where prisoners are treated with care and respect. This study set out to explore organizational factors associated with locating hospice programs into prison settings. Yet, the research produced unexpected findings about the contribution of hospice to the creation of decent prisons. Findings suggest that prison hospice programs have a transformative influence on the prisoners who volunteer for the program as well as on the overall institutional climate. Hospice appears to enhance the capacity to build and communicate respect, dignity and compassion among prison staff and prisoners, doi: 10.13001J076v44n04_01 KEYWORDS Decent prisons, humanitarian treatment, organizational transformation, prison hospice

One of the current debates in the literature on aging inmates asks, what is the most efficient housing/health care model for this 'special needs' population? State and federal correctional systems place elderly inmates either in specialized segregated housing units away from the general inmate population, consolidate elderly inmates in housing units within the prison, or provide a combination of both models. In general, proponents of the segregated housing model argue that aging inmates will receive specialized medical services in geriatric units. However, proponents of consolidated housing model argue that aging inmates will have the benefit of both geriatric and non-geriatric health services. This paper examines the association between the type of housing management model for aging inmates and the availability of non-geriatric physical and mental health services. Data for the analysis come from the 2000 Bureau of Justice Statistics Census of State and Federal Adult Correctional Facilities. The results suggest that institutions offering consolidated geriatric care provide more mental health services and that these effects are independent of the characteristics of prison facility. doi: 10.1300/J031v19n04_03 KEYWORDS. Aging inmates, housing models, geriatric health care

Drug treatment aftercare is frequently cited as necessary for individuals served within the criminal justice system. The purposes of this article are to review how much is actually known about aftercare and to highlight issues in studying the role of aftercare. We begin with a review of the literature, looking at how aftercare is defined within the criminal justice system outcome literature and the findings on aftercare for offenders who received initial treatment from in-prison substance use treatment programs. We continue with a discussion of how substance use treatment provided within the federal system, drug use patterns, and responses to drug use create methodological difficulties in adequately assessing the effectiveness of aftercare services. Taking into account both the previous research on aftercare and the issues encountered in attempting to evaluate the federal aftercare services, we concluded that the claim of certainty about aftercare effectiveness is not well substantiated and that the precise nature of aftercare services needed is not well understood. We conclude with a discussion of the methodological and substantive issues that need to be addressed in future research. Issues identified include the need to address self-selection bias and to disentangle offender behavior from the effects of criminal justice system policies. Research is also needed to identify the most effective type and intensity of aftercare. Keywords: Drug treatment; Aftercare; Prison

Objective: To conduct a pilot study to determine the feasibility and effectiveness of a multi-component smoking cessation intervention among prison inmates. Methods: A prospective study conducted within a maximum-security prison located near Sydney, New South Wales, and housing around 330 men. Participants received a smoking cessation intervention with six-month follow-up to determine abstinence. The smoking cessation intervention consisted of two brief cognitive behavioural therapy sessions, nicotine replacement therapy, bupropion and self-help resources. Point prevalence and continuous abstinence at follow-up were verified with expired carbon monoxide measures. Results: Thirty male inmates participated in the intervention. At six months, the biochemically validated point prevalence and continuous abstinence rates were 26% and 22% respectively. Reasons for relapse to smoking included: transfers to other prisons without notice, boredom, prolonged periods locked in cells, and stress associated with family or legal concerns. Those inmates who relapsed, or continued to smoke following the intervention, smoked less tobacco than at baseline and 95% stated they were willing to try to quit again using our intervention. Conclusions: Prison inmates are able to quit or reduce tobacco consumption while in prison but any smoking cessation intervention in this setting needs to address prison-specific issues such as boredom, stress, transfers to other prisons, court appearances, and isolation from family and friends. Implications: The prevalence of smoking within Australian prisons is alarmingly high. Further work into how to encourage prisoners to quit smoking is required.

By the end of 2003, 3.2% of the U.S. adult population or 6.9 million adults were incarcerated, on probation or on parole. While non-whites constitute approximately 25% of the general U.S. population, they represent the majority of the prison (62%) and jail population (57%), a 33% increase since 1980. Approximately 15% of this prison and jail population has active symptoms of serious mental illness with two-thirds likely to have a co-occurring substance use disorder diagnosis. Meanwhile, the lack of adequate mental health and substance abuse treatment within all levels of the criminal justice system continues to exist. This is further exaggerated by the dearth of evidence showing appropriate cultural awareness and competence in delivery of these much needed services to a majority non-white population. This article will review the existing racial disparities present in the criminal justice system, the lack of appropriate psychiatric services, and the effect of cultural dissonance in service provision when services do exist. Policy implications and recommendations are included in the conclusion with a call for action to all agencies directly and indirectly affected by this multifaceted problem.

The purpose of the current study was to determine the extent to which an early prison release incentive impacted inmates' perceptions of substance abuse treatment helpfulness, overall satisfaction and focus on treatment issues. Three groups of inmates participating in their first, third or sixth month of residential drug abuse treatment were surveyed. Overall, findings indicated that the early release incentive served to encourage inmates' engagement in drug treatment and did not appear to distract inmates from perceiving their treatment as helpful or to hinder their pursuit of various treatment topics and skills. Statistically significant differences in what the inmates expected to learn or acquire, overall satisfaction and perceived helpfulness were found between those inmates who were provisionally eligible for the early release incentive versus those who were not. Emphasizing the importance of treatment engagement, an examination of qualitative data also revealed that those who had been in the program longer had higher rates of perceived helpfulness and suggests that at the six-month point in treatment inmates begin to experience and integrate their treatment gains. KEYWORDS Prison, treatment, helpfulness, substance abuse

High-risk drug use is prevalent among UK prison populations (Lipton, 1995) while recovery in prison is both complex and variable. Grounded theory methodology was employed to gain a greater understanding of the perceptions and conceptualisations of 'risk,' 'need' and 'motivation' in relation to prisoner drug abusing practices, criminal practices, abstinence initiating practices and the meaning of recovery for 11 Her Majesty's Prison (HMP) based drug rehabilitation clients. The analysis presented five themes with the main problem faced by the participants as 'staying clean.' KEYWORDS Drug rehabilitation, prison, grounded theory, risk, recovery

This study examined the effects of postrelease transitional therapeutic community treatment on the drug use and employment rates of drug involved prisoners in the Delaware correction system followed for up to 5 years after release. A comparison group received standard postrelease supervision. Abstinence rates were 32.2% in the treatment group and 9.9% in the no-treatment group, and the treatment group had a higher overall proportion of time free of drug use. Time to relapse was a mean of 28.8 months in the treatment group versus 13.2 months in the no-treatment group. Relapse was defined as any use of any drug and was confirmed by urinalysis. Positive effects were seen even for those who did not complete treatment. The treatment group had a significantly higher rate of employment after leaving work release (54.6%) than did the no-treatment group (45.4%). Treatment during the transitional period between prison and community showed substantial and persistent benefits even for a cohort marked with extensive criminal history, low rates of marital bonds, and substantial unemployment. Keywords. Treatment in corrections: Substance use; Treatment outcomes; Employment; Relapse

Correctional facilities are under increasing pressure to respond to the treatment needs of mentally disordered of lenders during their incarceration and to arrange for treatment post release through reentry planning. This paper constructs cost estimates for three different reentry investments using data on the population (n = 2715) of male mentally disordered inmates in New Jersey prisons. Different assumptions are used on the distribution of treatment needs and criminal characteristics within the population, ranging from equal treatment needs and placement difficulties to different treatment needs and difficulties accessing community-based resources as a consequence of their past criminal behaviors. The costs of these investments range from approximately $700,000 to $934,000 per year for roughly 500 released inmates. Reentry planning, as a social investment, protects the outcomes produced by correctional heath care during incarceration and protects the public from future crime associated with untreated mental illness. KEYWORDS Reentry planning, mentally disordered offenders, costs, social investment

Studies have demonstrated that treatment for drug-involved offenders can reduce relapse and recidivism. However, few institutions utilize validated assessments of drug dependence, limiting the ability to determine and prioritize services. Toward this goal, we explain an assessment method implemented statewide using a sample of 22,069 prisoners. Our purpose is to demonstrate best practice standards for screening and placement, and to disseminate information on the implementation process and data from the statewide screening, so that others may adapt similar procedures in their institutional environments. Six steps in the process are detailed with a brief summary of the efficacy of the new procedure. KEYWORDS Substance abuse, assessment, treatment, prisoners, continuum of care

A significant number of people living with HIV infection in the U.S. are incarcerated; at least 8% of all HIV-infected people are in prison or jail. (1,2) The prevalence of […]

Over the past two decades, the criminal justice population in the US has grown by over 200%, most of this due to an increase in drug-involved offenders. Although there is good evidence that prison-based substance abuse treatment programs can be effective in reducing rearrest, few cost-effectiveness studies have been conducted. Using data from the Connecticut Department of Correction and the Connecticut Department of Mental Health and Addiction Services (DMHAS), we compared the cost-effectiveness of four tiers (levels) of substance abuse treatment programs for a sample of 831 offenders who were released during FY1996-FY1997. Effectiveness, measured by reductions in the likelihood of rearrest within six months, one year and 18 months post-release, was compared for inmates who had received treatment while incarcerated (n = 358) and those who had not (n = 473). At all intervals, offenders who attended any of the higher tier programs (two, three and four) had significantly lower rates of rearrest when compared to offenders who attended Tier One only or who had attended no tier programs, even after controlling for background characteristics that may have differentiated the two groups. The benefits to the State of Connecticut correctional system alone, measured in terms of the costs of avoided re-incarcerations, were from 1.8 to 5.7 times the cost of implementing the programs, ranging from $20,098 (Tier Four) to $37,605 (Tier Two). Since society receives a favorable return on its investment in prison-based treatment programs, we should find ways to ensure that more drug-involved inmates receive treatment. [Article copies available for a fee from The Haworth Document Deliver), Service: 1-800-HAWORTH. E-mail address: Website: [c] 2004 by The Haworth Press, Inc. All rights reserved.] KEYWORDS Substance abuse treatment, state prisons, cost-effectiveness analysis, program evaluation