Journal of Correctional Health Care

There is little research on treatment for firesetting, especially for those who were incarcerated for their offenses. Of the treatment programs that do exist, there are limitations to feasibly implementing these in correctional settings. We propose a short-term (eight-session) program, Intervention for Firesetting Offenses (INFO), based on techniques that have been empirically supported for this population, including psychoeducation, motivational interviewing, cognitive behavioral therapy-based strategies, and relapse prevention. We provide a description of INFO using the case study of Mr. A, a man who was incarcerated for an arson offense. Overall, INFO was feasibly and effectively implemented, as the individual improved his understanding of firesetting in general and his own motivations and risk factors for engaging in firesetting and developed a relapse prevention plan to avoid future offending behaviors.

Incarcerated clients experience high rates of opioid use disorder and overdose. It is critical that opioid agonist treatment (OAT) is provided in correctional facilities. However, few receive OAT due to concerns about diversion, misuse, and safety. Buprenorphine extended-release (BUP-XR), a monthly buprenorphine depot injection, could be especially advantageous in the correctional setting as it can prevent diversion and misuse, saving staff resources and time. An injection of BUP-XR is costly compared with a monthly supply of buprenorphine/naloxone (BUP/NX) tablets. We demonstrate that when factoring in the added costs of medication preparation, administration, monitoring, and personnel, it is more economical to provide BUP-XR than BUP/NX. Other facilities, by utilizing our cost breakdown, can determine whether BUP-XR is economically advantageous at their own facility.

In 2020, the COVID-19 pandemic resulted in one in five individuals incarcerated in U.S. correctional institutions contracting COVID-19 and 1,700 deaths. Correctional adult transition centers house incarcerated individuals who typically do not have on-site health care access. A COVID-19 outbreak could devastate this population, who live in high-density conditions and have been documented as high risk for poor health outcomes. Owing to a robust practice partnership between a college of nursing and two adult transition centers, a nurse-led COVID-19 initiative was implemented to minimize transmission in the facilities and ensure appropriate health care referral for residents who tested positive for COVID-19. The initiative identified six residents with positive results, who were transferred to a state prison infirmary for management and to minimize risk for other residents.

An overwhelming number of justice-involved individuals arrive in correctional settings with many complex physical and mental health conditions. Consequently, health care interventions are needed to stabilize and prevent further deterioration of these conditions. This opinion article discusses the significance of nursing care in correctional settings. The goal is to raise awareness and convince readers that this is an important issue to address. The article presents evidence from practice, court cases, and published research that supports the arguments and facts, with focus on the overarching correctional goals of public safety and rehabilitation, and the role of nurses in the achievement of those goals. Corrections and health care administrators must engage in meaningful and compromising ways to attain the correctional goals for the benefit of justice-involved individuals and the community at large.

Approximately 2.2 million people are incarcerated in the United States. The carceral population is aging due to strict sentencing laws, which has increased the frequency and acuity of off-site medical care. Inpatient providers must follow departments of correction procedures when treating incarcerated patients, which often prevents adherence to standards of care and puts the health of patients at risk. Shackling is a common requirement during hospitalization and is associated with increased risk for complications. Current state and federal policies regarding shackling lack specifics to prevent patient harm. Incarcerated people have a constitutionally protected right to health care, but with current policy, we are not meeting this essential responsibility. Updates to policy are needed to ensure that patients receive compassionate, safe, and constitutionally mandated health care.

The jail population is disproportionately affected by poor health outcomes compared with the general population. Despite this, many jail systems do not have adequate surveillance of various health indicators, making it difficult to identify and address health concerns within this setting. In this commentary, the authors highlight four public health crises within the jail setting and identify gaps in data surveillance. The public health domains discussed in this commentary are HIV, suicide, overdose, and COVID-19. Authors also explore current barriers to data collection and reporting within the jail setting and provide recommendations for improved surveillance efforts.

This study sought to evaluate the association of a solitary confinement ban with self-harm among adolescents in New York City's jail system. Data were extracted from medical records on 5,038 adolescent incarcerations from October 1, 2013, through July 12, 2016, and compared incarcerations before the ban (February 20, 2015) with those after the ban. Of the 2,503 adolescent incarcerations pre-ban, there were 171 self-harm gestures among 106 incarcerations (4.2% of incarcerations). Post-ban, there were 2,100 adolescent incarcerations and 105 self-harm gestures among 71 incarcerations (3.4% of incarcerations; p < .01). The post-ban group experienced significantly lower self-harm risk compared with the pre-ban (Crude incident rate ratio, 1.35 vs. 1.81; p < .05). In adjusted analysis, the hazard of self-harm associated with solitary confinement exposure was 1.51 times that of incarcerations with no solitary exposure (p < .05) . This signifies negative health outcomes of adolescent solitary confinement and the need for policy change consideration.

This article examined the factors associated with thoughts of ending life in a sample of incarcerated men. Data were obtained from the Cancer Risk in Incarcerated Men Study, a pilot study designed to examine cancer health disparities and cancer health education in a racially/ethnically diverse sample of male smokers in three state prisons in the northeast region of the United States from 2015 to 2017. Of the 225 participants, only 11 reported having thoughts of ending life. The median age of the participants was 38 years. Thoughts of ending life had a significant association with race/ethnicity. Latinos and Whites were 8 out of the 11 participants who had thoughts of ending life. The majority of participants who had thoughts of ending life reported a history of solitary confinement. Almost half of all participants reported that they sometimes or often felt a risk of attack or abuse from prison officers. Findings demonstrate the need to investigate further the association of mental health symptomology with incarcerated individuals' perceived experience with suicidal thoughts and behavior.

Research illustrates that participation in physical activity is advantageous to overall health. Incarcerated populations are one subset that would benefit most from consistent engagement in physical activity, yet little is known about programs created to fulfill this need. The purpose of this study was to determine activity levels and social behaviors of incarcerated adolescent males during a structured sport-leadership program. Participants were 23 incarcerated males. The System for Observing Children's Activity and Relationships during Play was employed to evaluate activity and social behaviors. A major finding of this study demonstrated that incarcerated youth engaged in moderate to vigorous physical activity for a large portion of the sport-leadership programming time (50.6%). In this study, prosocial (11.7%) and antisocial (7.1%) interactions mirrored those observed in residential summer camps, on playgrounds, and during recess.

We aim to characterize the legal landscape of incarcerated patients' pain management malpractice claims and to discuss the ethical and policy implications that result. The most common rationales for lawsuits were failure to completely treat (38 [46.3%]), failure to offer (34 [41.4%]), and delay of treatment (6 [7.3%]). In cases won by defendants, the most common rationale for verdicts was no deliberate indifference occurred (74 [86.6%]). We found that incarcerated individuals were often unsuccessful in litigating claims for inadequate pain management despite several cases pointing toward treatment strategies far below what would be ethically accepted as standard of care in the community setting.

Incarcerated populations experience higher rates of sexually transmitted infections (STIs) than the general population, alongside inconsistent testing strategies. In response, universal opt-out STIs (chlamydia, gonorrhea, syphilis, and HIV) screening was implemented at admission in a short-term correctional facility in Alberta, Canada, for individuals ≤35 years. A cross-sectional, retrospective evaluation of testing outcomes between March 2018 and February 2020 was completed. Descriptive statistics were used to stratify STIs by gender, age group, and date for univariate analysis. Despite low uptake (31.2%), opt-out screening resulted in high positivity rates (14.9%, 10.8%, 29.5%, and 0.3%, respectively) and treatment completion (93.7%) while capturing a high proportion (52.6%) of asymptomatic cases. Opt-out screening at admission is feasible and can improve STI testing in high-risk individuals experiencing incarceration in Canada.

The U.S. Department of Justice indicates that 83% of individuals released from state prisons in 2005 were arrested at least once during a 9-year follow-up period. With only 17% of released individuals not rearrested, it could be argued that correctional facilities fail to provide the necessary resources that individuals need for proper rehabilitation and reintegration. Thus, there is a need for alternative jail and prison programming. This article reviews the leading program, cognitive behavioral therapy, and advocates for the integration and use of mindfulness-based interventions (MBIs) in carceral settings. Specifically, this article reviews the literature on MBIs and their significance in corrections.