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Purpose – Prison health is public health. Yet, efforts to protect against as well as slow the spread of COVID-19 are virtually impossible in prison settings where “what we know” may not match with policies. As the COVID-19 pandemic continues, incarcerated people are uniquely at risk as correctional facilities are “super-spreader” sites for prisoners and staff alike. The purpose of this chapter is to explore the impact of COVID-19 in prisons along with the additional personal and social costs associated with the pandemic (e.g., lockdowns, limited visitation, etc.) that can also impact the health status of those “doing COVID time.”

Methodology/Approach – This chapter examines the multifaceted impact of the COVID pandemic on those (in)directly impacted in correctional settings. It is not an empirical work.

Originality/Value – This chapter provides insight into the often taken-for-granted impact of the COVID pandemic on those who live and work in prison settings. The recommendations may be of interest to those who “do the time,” those who work in such settings, and social justice advocates and others involved in policy-making.

There is limited research on the mental health of pregnant women in prison in England, mother and baby unit (MBU) applications and associated factors. Eighty-five pregnant women were interviewed in eight different prisons in England, UK. Schedules for the Clinical Assessment of Neuropsychiatry (SCAN) and Edinburgh Postnatal Depression Scale (EPDS) were used to assess mental health; Severity of Dependence Questionnaire (SOD-Q) for drug misuse; Alcohol Use Identification Test (AUDIT) for hazardous drinking and the Structured Clinical Interview for DSM-IV (SCID-II) to identify personality disorder. About 51% of participants had depression and 57% had anxiety. Those with prior social services involvement, diagnosis of personality disorder or history of suicidality were less likely to be admitted to MBUs. The high levels of depression and anxiety can have negative impacts on both the mother and her unborn child. Factors which influence MBU admission suggest those who might benefit most from MBU placement are least likely to be admitted. Other countries offer feasible alternatives to imprisonment for pregnant women and mothers which could be implemented in England.

By highlighting the real world experiences of cause lawyers who work on behalf of HIV-infected prisoners (e.g., “activist prisoner lawyering”), this article reports on the often-difficult negotiations over roles (litigator v. activist) that such actors face. The article investigates through the stories of activist prison lawyers, in the words of one such respondent, how “different approaches need to be taken in different settings.” For activist prison lawyers, when a client's life literally hangs in the balance litigation may be the only option. In other instances, using a case to bring public awareness to broader movement objectives may be chosen as a proper course of action. The article elucidates how such negotiations often entail the dilemma of balancing broader goals of the prisoner rights movement with the immediate, indeed sometimes life and death, circumstances facing the individuals and communities they represent. The article concludes with a call for future work on cause lawyers and social movements in other contexts to problematize law as a static, dichotomous variable that either does or does not bring desired institutional or societal change. Viewing law as a dichotomous variable masks the politically significant effects litigation may have for influencing both institutional arrangements and social consciousness over time. Furthermore, the dichotomous conception of law as a catalyst/not a catalyst for social change also glosses over the importance of the meso-level of analysis. By paying attention to the demands of a specific legal context, the immediate circumstances of a specific situation, and the way the former and the latter may be inextricably linked, future studies can make important and nuanced contributions to our understanding of the complex relationship between law, and social change.

Around 7% of the female prison population are pregnant (Albertson, O'Keeffe, Lessing-Turner, Burke & Renfrew, 2014; Kennedy, Marshall, Parkinson, Delap, & Abbott, 2016; Prison Reform Trust, 2019). However, although recent years have witnessed growing academic interest in relation to mothering and imprisonment, limited attention has been paid to exploring the experiences of pregnancy for women serving a custodial sentence. Combining health and criminological research, this chapter offers a unique perspective of women's accounts of pregnancy and imprisonment, highlighting the specific challenges faced by pregnant women in negotiating the prison environment, whilst also illustrating the adaptive strategies adopted to cope with pregnancy and new motherhood in the context of imprisonment.

The Universal Declaration of Human Rights outlines fundamental protections for all human beings. Critically, such rights and protections are particularly applicable to those imprisoned throughout all carceral spaces: the right to physical security; freedom from torture and other cruel and unusual punishments; equal protection under the law; and a right to a community standard of living, including food, clothing, medical care, and social services. The need for special vigilance in applying these principles to justice settings for children and women entwined in these spaces has been met with the development and implementation of the United Nations Rules for the Treatment of Women Prisoners and Non-Custodial Measures for Women Offenders (2010) or the Bangkok Rules. These Rules provide for a women-centered approach to human rights within correctional environments. The Bangkok Rules are based on several dominant themes relevant to women in prison and additionally emphasize the importance of alternatives to custody. Since their adoption over 10 years ago, there has been clear progress in implementing and promoting the Bangkok Rules throughout Southeast Asia, as we will describe in this chapter. While we applaud these efforts, there is still much work to do within the region. We argue that attention is needed both within and outside of women’s prisons to expand the promise of the Bangkok Rules beyond current efforts. In our view, the attention inside prison walls must now turn to addressing intersections between gender and other marginalized statuses, ensuring all forms of safety, dignity, and respect. Outside prison, reform of egregious and punitive drug laws is essential. Equally important, is the critical need to develop a more robust response in terms of non-custodial measures and other non-prison-based responses to women in conflict with the law.

This review integrates and builds linkages among existing theoretical and empirical literature from across disciplines to further broaden our understanding of the relationship between inequality, imprisonment, and health for black men. The review examines the health impact of prisons through an ecological theoretical perspective to understand how factors at multiple levels of the social ecology interact with prisons to potentially contribute to deleterious health effects and the exacerbation of race/ethnic health disparities.

This review finds that there are documented health disparities between inmates and non-inmates, but the casual mechanisms explaining this relationship are not well-understood. Prisons may interact with other societal systems – such as the family (microsystem), education, and healthcare systems (meso/exosystems), and systems of racial oppression (macrosystem) – to influence individual and population health.

The review also finds that research needs to move the discussion of the race effects in health and crime/justice disparities beyond the mere documentation of such differences toward a better understanding of their causes and effects at the level of individuals, communities, and other social ecologies.

This chapter uses Goffman’s concept of total institutions in a comparative case study approach to explore the role of psychotropic drugs in the process of transinstitutionalization.

This chapter interprets psychotropic drug use across four institutionalized contexts in the United States: the active-duty U.S. military, nursing homes and long-term care facilities, state and federal prisons, and the child welfare system.

This chapter documents a major unintended consequence of transinstitutionalization – the questionable distribution of psychotropics among vulnerable populations. The patterns of psychotropic use we synthesize suggest that total institutions are engaging in ethically and medically questionable practices and that psychotropics are being used to serve the bureaucratic imperatives for social control in the era of transinstitutionalization.

Psychotropic prescribing practices require close surveillance and increased scrutiny in institutional settings in the United States. The flows of mentally ill people through a vast network of total institutions raises questions about the wisdom and unintended consequences of psychotropic distribution to vulnerable populations, despite health policy makers’ efforts regulating their distribution. Medical sociologists must examine trans-institutional power arrangements that converge around the mental health of vulnerable groups.

This is the first synthesis and interpretive review of psychotropic use patterns across institutional systems in the United States. This chapter will be of value to medical sociologists, mental health professionals and administrators, pharmacologists, health system pharmacists, and sociological theorists.