Journal of Correctional Health Care recent issues

Editor's Letter

Miles, J. R. — Mon, 28 Sep 2009 12:12:08 PDT

Health Inequalities in Correctional Institutions: Implications for Health Inequalities in the Community

Agozino, B., Volpe, S. L. — Mon, 28 Sep 2009 12:12:08 PDT

In this feasibility study, we conducted a meta-analysis of health inequalities, especially around issues of nutrition and exercise, in correctional institutions compared to the community. The project explored the extent to which the inequalities found in the health of people in the community are mirrored by inequalities found in prison. Existing data were examined to assess what light they might shed on existing health inequalities, with emphasis on lifestyle issues that contribute to obesity. The project raised questions about the sources of health inequalities and how they could be reduced. Specifically, the study compared the diet and exercise lifestyles of prisoners versus the community to examine whether they correlate with the frequency of obesity, hypertension, and type 2 diabetes mellitus in the two populations.

MRSA Prevention and Control in County Correctional Facilities in Southwestern Ohio

Webb, J. A., Czachor, J. S. — Mon, 28 Sep 2009 12:12:08 PDT

The number of methicillin-resistant Staphylococcus aureus (MRSA) infections in correctional facilities around the country has been increasing. Considering the potential health impact of MRSA, it is important that correctional facilities have prevention and control protocols in place. The study results summarize the prevention and control preparedness activities of county jails in the Greater Dayton area of Ohio. Protocols and control measures were in place for environmental control (95.4%), MRSA screening (88.4%), standard precautions (84.3%), treatment (83.6%), personal hygiene (80.6%), and education (80.4%). Statistical analysis found no significant difference between rural and urban county jails in their handling of MRSA issues. The findings suggest significant compliance with MRSA prevention and control protocols among county jails in the Greater Dayton area.

Health Care Policies Addressing Transgender Inmates in Prison Systems in the United States

Brown, G. R., McDuffie, E. — Mon, 28 Sep 2009 12:12:08 PDT

Inmates with gender identity disorders (GID) pose special challenges to policy makers in U.S. prison systems. Transgender persons are likely overrepresented in prisons; a reasonable estimate is that at least 750 transgender prisoners were in custody in 2007. Using the Freedom of Information Act, requests were mailed to each state, the District of Columbia, and the Federal Bureau of Prisons in 2007. The requests were for copies of policies, directives, memos, or other documents concerning placement and health care access of transgender inmates. By April 2008, 46 responses were received; 6 states did not reply. Information was qualitatively analyzed and summarized. There was substantial disparity in transgender health care for inmates with GID or related conditions. Most systems allowed for diagnostic evaluations. There was wide variability in access to cross-sex hormones, with some allowing for continuation of treatment and others allowing for both continuation and de novo initiation of treatment. There was uniformity in denial of surgical treatments for GID.

Creation of a Metabolic Monitoring Program for Second-Generation (Atypical) Antipsychotics

Reeves, R., Kaldany, H., Lieberman, J., Vyas, R. — Mon, 28 Sep 2009 12:12:08 PDT

Second-generation or ‘‘atypical’’ antipsychotics can cause metabolic derangements that lead to diabetes and cardiovascular disease. To potentially minimize these adverse effects, the University of Medicine and Dentistry of New Jersey — University Correctional HealthCare (UCHC) and the New Jersey Department of Corrections (NJ DOC) created a metabolic monitoring program that was incorporated into the electronic medical record. This program is used statewide by UCHC psychiatrists working within the NJ DOC.

Developing the Mental Health Awareness of Prison Staff in England and Wales

Walsh, E., Freshwater, D. — Mon, 28 Sep 2009 12:12:08 PDT

In 2010, the prison population in England and Wales could reach a high of 91,500, according to a recent population projection. HM Prison Service (U.K.) reports that in 2004 to 2005, there were 33,144 prison officers employed to care for the prisoners in the prison system. This article focuses on the mental health of this prisoner population and the training needs of staff caring for them. It reports the experience of a national project, funded by the Department of Health, in which the project team developed and piloted mental health awareness training for prison officers on the residential units and for staff who work with prisoners and lack a mental health background. Key findings from the posttraining evaluation are highlighted. Participant feedback demonstrates the value placed on this type of training by those working in the prison setting.

Detection of Staphylococcus aureus Including MRSA on Environmental Surfaces in a Jail Setting

Mon, 28 Sep 2009 12:12:08 PDT

We examined jail environmental surfaces to explore whether they might serve as reservoirs of viable methicillin-resistant Staphylococcus aureus (MRSA). We swabbed 132 surfaces, inoculated primary and secondary mannitol salts and oxacillin-resistant screening agar, and used API tests to identify S. aureus and E-tests to determine methicillin/oxacillin resistance. We recovered S. aureus from 10 (7.6%) surfaces; eight (6.1%) isolates were MRSA. We ran pulsed-field gel electrophoresis on six resistant isolates and observed three patterns, one of which was identical to that identified in a previous study of inmates’ nasal specimens. Finding MRSA-contaminated surfaces on a variety of environmental surfaces in the absence of an overt outbreak emphasizes that correctional facilities should have protocols for environmental cleaning as a component of MRSA prevention.

Consequences of High Incarceration Rate and High Obesity Prevalence on the Prison System

Leddy, M. A., Schulkin, J., Power, M. L. — Mon, 28 Sep 2009 12:12:08 PDT

Incarceration and obesity rates have both increased in the United States. An implication is that there will be more obese inmates, which likely will raise the prevalence of obesity-related diseases, affecting the cost and performance of correctional health care. Other issues include increased costs of transport, restraint, and housing. There is surprisingly little published information on inmate obesity prevalence. The few published research studies suggest obesity prevalence in prisons reflects that of their region. Cardiovascular-related prisoner deaths appear to be associated with state-level obesity, though other risk factors are likely involved. Weight gain while incarcerated is common, and the prevalence of diabetes is increasing. The data suggest that preventive care is not a priority in prisons. Evidence from Japan suggests restricted diets and enforced activity can improve inmate health.

Journal of Correctional Health Care: Self-Study Program

Mon, 28 Sep 2009 12:12:08 PDT

Information for Authors

Mon, 28 Sep 2009 12:12:08 PDT

Call for Reviewers

Mon, 28 Sep 2009 12:12:08 PDT

Editor's Letter

Miles, J. R. — Mon, 22 Jun 2009 11:11:41 PDT

The Enduring Menace of MRSA: Incidence, Treatment, and Prevention in a County Jail

Deger, G. E., Quick, D. W. — Mon, 22 Jun 2009 11:11:41 PDT

Nationwide, methicillin-resistant Staphylococcus aureus (MRSA) presents an increasing hazard to inmates. This article reviews our 1-year (2005) experience with skin and soft tissue infections (SSTIs) in a medium-sized county jail. As part of a quality assurance process, the authors cultured every SSTI presenting to our institution. The authors found that a full 68% of SSTIs (50 of 74) were MRSA species, and new MRSA cases presented regularly throughout the year. Inmates usually have poor understanding of infectious processes and need constant support and education. Correctional health care providers must approach their antibiotic treatment for today's SSTIs with the knowledge that MRSA is very common. This article reviews treatment options, preventive measures, and institutional hygiene.

A Qualitative Exploration of HIV/AIDS Health Care Services in Indian Prisons

Guin, S. — Mon, 22 Jun 2009 11:11:41 PDT

HIV illness has emerged as one of the pressing public health concerns in correctional systems. This article is a qualitative exploration of the state of health care services with regard to HIV/AIDS in three correctional facilities in Maharashtra state in India. Case studies of 10 reported cases of HIV-positive inmates were prepared from their narratives obtained through face-to-face in-depth unstructured interviews. The data were analyzed thematically. High-risk behavior among prisoners, inadequate access to health care services for HIV-positive inmates, and lack of HIV/AIDS prevention programs emerged as some of the major areas of concern. Collaboration of the Prison Department with the National Aids Control Programme is a key recommendation.

Resumption of Smoking After Release From a Tobacco-Free Correctional Facility

Mon, 22 Jun 2009 11:11:41 PDT

Approximately 70% of incarcerated people smoke tobacco, and an estimated 12% of all smokers in the United States leave correctional facilities annually. Many facilities prohibit smoking, but no published study has measured the relapse to tobacco after release. In a study of 200 people with chronic health conditions reentering the community from jail, 165 (83%) were cigarette smokers. Of these, 129 were interviewed at 1 and/or 6 months after release. Self-reported sustained abstinence rates were 37.3% at the end of the first day, 17.7% for the first week, 13.7% for 1 month, and 3.1% for 6 months. These abstinence rates are lower than those reported after military basic training and medical hospitalization but similar to rates after inpatient psychiatric and addiction programs. More efforts and resources are needed to determine successful tobacco cessation interventions during incarceration and after release.

Alcohol, Marijuana, and Perceptions of Influence on Social and Sexual Behavior Among African American Adolescent Female Detainees

du Plessis, L. D., Holliday, R. C., Robillard, A. G., Braithwaite, R. L. — Mon, 22 Jun 2009 11:11:41 PDT

Juvenile detainees comprise a population that engages in high-risk behavior. This study examined sexual risk and substance use behavior and the perceptions of African American female adolescent detainees (N = 765) regarding the influence of alcohol and marijuana use on their social and sexual behaviors. Overall, 58% and 64% reported alcohol and marijuana use, respectively. Alcohol's perceived influence on sexual behavior (p < .001) was significantly different between those who drank and those who did not; marijuana's influence on social (p < .01) and sexual (p < .001) behavior was significantly different between those who used marijuana and those who did not. There is a need for further study of the influence of substance use on social and sexual behavior among African American female adolescent detainees.

Brief Motivational Intervention to Reduce HIV Risk and to Increase HIV Testing Among Offenders Under Community Supervision

Alemagno, S. A., Stephens, R. C., Stephens, P., Shaffer-King, P., White, P. — Mon, 22 Jun 2009 11:11:41 PDT

Risky drug- and sex-related behaviors put criminal offenders at high risk for HIV. Intervening with this population under supervision can potentially reduce risk. This study reports a randomized trial that examines the efficacy of brief negotiation interviewing (BNI) compared to usual education activities. BNI is a computerized, self-directed intervention that combines a short structured interview with a brief counseling session. The study examined whether BNI could decrease HIV risks and increase testing for HIV in a cohort of criminal-justice-involved clients. The trial randomly assigned 212 participants to experimental (108) and control (104) conditions. Interview data were collected at baseline and at 2-month follow-up. Results indicate that the BNI intervention group had a significantly higher rate of HIV testing and was more likely to consider behavioral changes.

A Personal Retrospective: In the Eye of the Accreditation Storm (Part II of II)

Stanley, J. A. — Mon, 22 Jun 2009 11:11:41 PDT

Intended for those who already see the value of standards for correctional health care and the impact accreditation can have on the field, this article is a personal reflection from the perspective of a recently retired director of accreditation for the National Commission on Correctional Health Care. Based on 11 years in that role, the author discusses issues and controversies in the field. Part I addresses the relationships between correctional and community health care, explores the essence and role of standards, and examines aspects of accreditation. Part II addresses Evolution to Revolution, Keys to Continued Progress, and Solving Correctional Health Care Puzzles.

Position Statement: Prevention of Juvenile Suicide in Correctional Settings

National Commission on Correctional Health Care — Mon, 22 Jun 2009 11:11:41 PDT

Journal of Correctional Health Care: Self-Study Program

Mon, 22 Jun 2009 11:11:41 PDT

Information for Authors

Mon, 22 Jun 2009 11:11:41 PDT

Call for Reviewers

Mon, 22 Jun 2009 11:11:41 PDT

Editor's Letter

Miles, J. R. — Thu, 26 Mar 2009 11:13:15 PDT

Predicting Medication Costs and Usage: Expenditures in a Juvenile Detention Facility

Tennyson, D. H. — Thu, 26 Mar 2009 11:13:15 PDT

This retrospective study examined prescription medication records for 1 year in a county-funded juvenile detention facility. Findings show that 7% of the detained youths were prescribed psychotherapeutic agents, which accounted for approximately 83% of the annual medication budget. Of the 799 male and 227 female detained youths, 14% of the males and 27% of the females were prescribed medications, with some prescribed as many as 23 different medications during their short-term stay. More than 93% of the total medication costs were accounted for by psychotherapeutic agents, antibiotics, and allergy/asthma medications at an average monthly cost of $46.50 per youth. Male youths who were prescribed medications cost $324 per month; their female counterparts cost $170 per month.

Using Arrest Charge to Screen for Undiagnosed HIV Infection Among New Arrestees: A Study in Los Angeles County

Thu, 26 Mar 2009 11:13:15 PDT

Despite high documented HIV prevalence, few jail systems offer universal HIV screening, nor is this always feasible. The authors evaluated undiagnosed HIV infection and HIV risk history by arrest charge among 1,322 new arrestees to examine whether specific charges may help prioritize jail-based screening. Undiagnosed HIV prevalence was 2.7% and 1.0% among males and females, with 32% and 45% reporting recent STD diagnoses or high-risk behaviors for HIV. HIV risk history distinguished HIV-infected males but not females. Males with parole violation, sex, or theft charges had high undiagnosed HIV infection rates relative to other males. A weaker trend was observed for females with parole violation, drug, or violent charges. These charges represented 30% and 66% of males and females studied and 56% and 100% of their undiagnosed HIV infections, respectively. Using arrest charge to target screening may efficiently increase HIV diagnosis in jail inmates where universal HIV screening is not possible.

How Public Health and Prisons Can Partner for Pandemic Influenza Preparedness: A Report From Georgia

Thu, 26 Mar 2009 11:13:15 PDT

As pandemic influenza becomes an increasing threat, partnerships between public health and correctional facilities are necessary to prepare criminal justice systems adequately. In September 2007, the Planning for Pandemic Influenza in Prison Settings Conference took place in Georgia. This article describes the collaboration and ongoing goals established between administrative leaders and medical staff in Georgia prison facilities and public health officials. Sessions covered topics such as nonpharmaceutical interventions, health care surge capacity, and prison-community interfaces. Interactive activities and tabletop scenarios were used to promote dynamic learning, and pretests and posttests were administered to evaluate the short-term impact of conference participation. The conference has been followed by subsequent meetings and an ongoing process to guide prisons' preparation for pandemic influenza.

Institutional Responses to Self-Injurious Behavior Among Inmates

DeHart, D. D., Smith, H. P., Kaminski, R. J. — Thu, 26 Mar 2009 11:13:15 PDT

To date, little research has systematically investigated perceptions of mental health professionals regarding motivations for self-injury among prison inmates. To help fill this gap, the authors used descriptive techniques to examine self-injurious behavior among inmates from the perspective of correctional mental health professionals. A quantitative survey assessed perceptions of mental health staff regarding etiology, motivations, and manifestations of self-injury. A qualitative interview component was used to explicate responses from the survey. Inmate cutting, scratching, opening old wounds, and inserting objects were the most commonly witnessed behaviors. Findings suggest that self-injury occurred regularly and that a subset of inmates are responsible for recurrent events. Mental health professionals perceived the motivation for inmate self-injury to be both manipulative and a coping mechanism. They described current management strategies and corresponding needs for training and resources.

Vulnerable Populations, Prison, and Federal and State Medicaid Policies: Avoiding the Loss of a Right to Care

Perez, L. M., Ro, M. J., Treadwell, H. M. — Thu, 26 Mar 2009 11:13:15 PDT

Unknown numbers of incarcerated people are losing public benefits. Instead of suspending these until the prisoner or detainee is released into society, some states are simply terminating benefits upon incarceration. Although there is evidence to suggest that this policy is having negative consequences for those who are reentering society and on their communities and systems of care, the precise impact is not clear because a systematic monitoring of these actions is nonexistent. A more efficient system would (a) suspend benefits and automatically reinstate the same to those eligible upon release and (b) establish a monitoring mechanism that would provide an accurate accounting of how these benefits are being applied.

A Personal Retrospective: In the Eye of the Accreditation Storm (Part I of II)

Stanley, J. A. — Thu, 26 Mar 2009 11:13:15 PDT

Intended for those who already see the value of standards for correctional health care and the impact accreditation can have on the field, this article is a personal reflection from the perspective of a recently retired director of accreditation for the National Commission on Correctional Health Care. Based on 11 years in that role, the author discusses issues and controversies in the field. Part I addresses the relationships between correctional and community health care, explores the essence and role of standards, and examines aspects of accreditation. Part II (to be published in Volume 15, Issue 3) focuses on the current ``revolution'' in correctional health care, keys to continued progress, and how to deal with correctional health care puzzles.

Journal of Correctional Health Care: Self-Study Program

Thu, 26 Mar 2009 11:13:15 PDT

Editor's Letter

Miles, J. R. — Fri, 02 Jan 2009 09:20:50 PST

Attention-Deficit/Hyperactivity Disorder and Correctional Health Care

Eme, R. F. — Fri, 02 Jan 2009 09:20:50 PST

Two thirds of all felons released from state prisons are rearrested within 3 years. This appalling recidivism rate explains the intense and growing interest on the topic of desistance from crime. Yet, inexplicably, one of the major factors affecting desistance from crime and the recidivism rate has received scant attention. That factor is attention-deficit/hyperactivity disorder (ADHD). This article establishes the widespread prevalence of ADHD in the prison system and the critical importance of identifying and treating ADHD as an essential component for any best practice models for preventing crime and reducing recidivism. It also examines the major mechanisms whereby ADHD increases the risk for crime and recidivism.

Suicide-Related Litigation in Jails and Prisons: Risk Management Strategies

Daniel, A. E. — Fri, 02 Jan 2009 09:20:50 PST

Litigation related to suicide in jails and prisons is not an uncommon occurrence. This article summarizes the basic legal premises behind such litigations, which involve claims of medical malpractice and/or deliberate indifference. Common causes of omissions and commissions in correctional mental health care practice leading to such litigation are outlined. A few select court decisions are reviewed and, based on the author's experience, risk management strategies and procedures for clinicians and for correctional officers are provided.

Small Reservoirs: Jail Screening for Gonorrhea and Chlamydia in Low Prevalence Areas

Spaulding, A. C., Clarke, J. G., Jongco, A. M., Flanigan, T. P. — Fri, 02 Jan 2009 09:20:50 PST

Public health agencies can use jail as an opportunity to reach populations disproportionately affected by sexually transmitted infections (STI). The emphasis that STI control programs place on screening jail entrants varies considerably. Nine million individuals passed through U.S. jails in 2005, many in counties where STIs are rare. A pilot program of screening for Neisseria gonorrhoeae and Chlamydia trachomatis was implemented at the intake sites for the combined jail and prison system of Rhode Island, a state with a low prevalence of STIs. Prevalence of either gonorrhea or chlamydia among detainees was 4.6%, but in women aged 25 and younger, the rate was 24 times that of similar-aged women statewide. Screening led to treatment for 22 (81%) of the infected inmates and 10 of their partners. The heterogeneity of both jail demographics and STI epidemiology suggests a need to tailor the choice of screening strategy to local conditions.

Prescription Drug Abuse Among Adolescent Arrestees: Correlates and Implications

Alemagno, S. A., Stephens, P., Shaffer-King, P., Teasdale, B. — Fri, 02 Jan 2009 09:20:50 PST

This preliminary study examines the correlates of prescription drug abuse in a sample of adolescents in an urban juvenile detention center in Ohio. The study measures risk in 359 incarcerated females (20.1%) and 1,425 males (79.9%) by asking questions related to problems with alcohol, drug use, treatment history, mental and physical health problems, sexual behavior, anger management, physical violence, and family support. The results of the study suggest that incarcerated adolescents may benefit from interventions targeting prescription drug misuse. Female adolescent detainees abuse prescription drugs at a higher level than male adolescent detainees (17% vs. 10%). The correlates of prescription drug abuse are complex and multidimensional and offer opportunities for further study.

The Benefits of Meditation Practice in the Correctional Setting

Sumter, M. T., Monk-Turner, E., Turner, C. — Fri, 02 Jan 2009 09:20:50 PST

This research examined the impact of a structured meditation program intervention on female detainees, comparing an experimental group and a control group for medical symptoms, emotions, and behaviors before and after the intervention. A 2 1/2-hour meditation session was held once a week for 7 weeks. Study participants completed a medical symptoms checklist before the program began and after it ended. At the posttest period, the experimental group experienced fewer sleeping difficulties, less desire to throw things or hit people, and less nail or cuticle biting; were more hopeful about their future; and felt less guilt. Meditation was beneficial for this population and may be a cost-effective tool for inmates and administrators. Meditation effects, especially among inmates, merit further research attention.

Contextualization of Physical and Sexual Assault in Male Prisons: Incidents and Their Aftermath

Wolff, N., Jing Shi, — Fri, 02 Jan 2009 09:20:50 PST

Physical and sexual assault are part of the prison experience. Approximately 21% of male inmates are physically assaulted during a 6-month period. Sexual assault is estimated at between 2% and 5%. Although prevalence evidence is growing, less is known about circumstances surrounding and resulting from these incidents. This article presents an analysis of approximately 2,200 physical and 200 sexual victimizations reported by a random sample of 6,964 male inmates. Physical injury occurred in 40% of physical assaults and 70% of sexual assaults between inmates and in 50% of assaults perpetrated by staff. Emotional reactions to assaults were experienced by virtually all victims. Context information is vital in the development and implementation of prevention and therapeutic interventions.

Journal of Correctional Health Care: Self-Study Program

Fri, 02 Jan 2009 09:20:50 PST