Journal of Correctional Health Care

Dyslexia is the most common learning disability and involves difficulty in reading, writing, and spelling in your native language despite at least average intelligence. A disproportionate share of incarcerated individuals have both dyslexia and are African American. Behavior manifestations associated with dyslexia often lead to life choices resulting in incarceration. Dyslexia is rarely considered as playing a role in unemployment, drug misuse, and incarceration. Dyslexia screening upon prison admission permits identification of individuals with dyslexia and allows for specialized reading classes to boost self-esteem and develop a skill set that is desirable in the workforce upon release. Dyslexia should be recognized as a social determinant of health whose early recognition and intervention may engender self-confidence in those affected and encourage them to be positively engaged in society.

The Federal Bureau of Prisons clinical skills training development (CSTD) team accomplished the planning, creation, and execution of a first-ever national clinical skills assessment program (CSAP) for nurses and advanced practice providers (APPs). Clinical skills assessment is a part of nurse and APP credentialing and privileging and must be completed for new hires along with continued biennial recredentialing accreditation standards. A training resource manual, discipline-specific skills checklist, pre-/postprogram written examination, and standard operating procedures were created. The CSTD team used commercially available manikins, food items, and easily obtainable office supplies for simulated experiential skills assessments. The CSAP provided a consistent, reproducible, and scalable approach for the orientation, assessment, and, if indicated, remediation for correctional nurses and APPs.

Like women who are incarcerated, women sentenced to probation have high levels of physical and mental health morbidities. They rely heavily on hospital emergency departments (EDs) for health care in community settings. We examined the prevalence of nonurgent ED use in a cohort of women with a history of probation system involvement in Alameda County, California. We found that two-thirds of ED visits were nonurgent, even though most women had health insurance. Factors associated with nonurgent ED use included having one or more chronic health conditions, severe substance use, low health literacy, and recent arrest. Among a subgroup of women who also received primary care, dissatisfaction with a recent primary care visit was also associated with nonurgent ED use. The heavy use of the ED for nonurgent care in this study may reflect a need to provide options better attuned to the multiple forms of instability and barriers to wellness faced by women with criminal legal system involvement.

This study aims to determine associations between sources of stress and substance use problems among men under community supervision programs. We used ordinary least squares regression models to test the hypotheses that the traumatic life events and stressors of men under community supervision and their partners, respectively, were associated with the substance use problems of men under community supervision. The sample included 230 men involved in community supervision programs in New York City and 230 women who were their intimate partners. We found that the traumatic events and the depression and anxiety of men under community supervision and partner's substance use problems were associated with the substance use problems of the men. These findings underscore the importance of addressing trauma in substance use treatment for men under community supervision. Future research can explore how stressful events impact substance use, sources of coping for couples, and the association between racism, traumatic events, stress, and substance use.

Clinical Trial Registration: NCT01690494

In 2020–2021, a Colorado corrections facility experienced four COVID-19 outbreaks. Case counts, attack rates (ARs) in people who are detained or incarcerated (PDI), and mitigation measures used in each outbreak were compared to evaluate effects of combined strategies. Serial PCR testing, isolation/quarantine, and masking were implemented in outbreak 1. Daily staff antigen testing began in outbreak 2. Facility-wide COVID-19 vaccination started in outbreak 3 and coverage increased by the end of outbreak 4 (PDI: <1% to 59%, staff: 27% to 40%). Despite detection of variants of concern, outbreaks 3 and 4 had 97% lower PDI ARs (both 1%) than outbreak 2 (29%). Daily staff testing and increasing vaccination coverage, with other outbreak mitigation strategies, are important to reduce COVID-19 transmission in congregate settings.

Correctional health professionals are vulnerable to the negative mental health outcomes associated with the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional survey was conducted to assess anxiety symptoms in health professionals who work in correctional/detention facilities and identify associated risk factors. Data were collected from 192 health professionals from March 23 to June 30, 2021. The prevalence and degree of anxiety symptoms were assessed by the Generalized Anxiety Disorder (GAD) scale. Chi square, Mann–Whitney U, and Pearson's correlation were used to assess the associations among anxiety scores and demographic data, COVID-19 exposures, medical and psychological history, and isolation practices. Of the sample, 27.1% had at least moderate levels of anxiety (GAD-7 score >10), which is highly suggestive of a diagnosis for GAD. Main factors associated with higher levels of anxiety included female gender, younger age, type of facility, less access to personal protective equipment, and a history of chronic medical problems. The psychological burden of COVID-19 on correctional/detention health professionals is significant, and behavioral health interventions should be considered for this unique population.

In congregate living settings when active coronavirus disease 2019 (COVID-19) transmission is present, limiting the scope of dental care to urgent and emergent treatment minimizes exposure risk for patients and staff. Engineering controls to mitigate aerosol production during dental procedures, including enhanced high-volume evacuation, high-efficiency particulate absorbing air filtration, and the use of a dental dam provide additional protection for dental providers and staff. Properly fitted N-95 respirators are of particular importance to limit COVID-19 transmission when SARS-CoV-2 containing aerosols may be present. When patients are known to be COVID-19 positive, the use of powered air-purifying respirators is appropriate. Further protection against the spread of disease among patients and staff may be provided by point-of-care testing for patients prior to dental procedures during outbreaks.

Individuals who have been incarcerated or under community supervision have elevated cancer mortality. This review summarizes existing knowledge on implementation and outcomes of cancer screening for justice-involved individuals to identify opportunities for reducing cancer disparities. This scoping review identified 16 studies published between January 1990 and June 2021 that reported cancer screening rates and outcomes in U.S. jails or prisons or for individuals under community supervision. Most studies evaluated cervical cancer screening, while fewer studies evaluated screening for breast, colon, prostate, lung, and hepatocellular cancers. Although incarcerated women are often up to date with cervical cancer screening, only about half had recent mammograms and only 20% of male patients were up to date with colorectal cancer screening. Justice-involved patients are at high risk of cancer, yet few studies have evaluated cancer screening for these populations and screening rates for many cancers appear low. The findings suggest that intensification of cancer screening for justice-involved populations may address cancer disparities.

Psychopathy is associated with higher levels of violence as well as general and violent recidivism after release from prison. A disorder with a long and rich clinical and research history, psychopathy has gained an undeserved reputation as a syndrome that is unresponsive to treatment. This article presents information that undermines long-standing problematic assumptions regarding the treatability of individuals with psychopathic traits and posits that implementing treatment programs in correctional settings is critical to decrease recidivism and violence. We discuss several treatment programs that have evidenced some success in the treatment of individuals with psychopathy and have the potential to be widely implemented in correctional settings, as well as general tenets of successful treatment programs and specific targets.