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The purpose of this paper is to discuss five domains impacted by the transformation of correctional mental health care in the USA: public health, public safety, legal obligations, fiscal responsibility and ethical standards, as well as critical issues such as administrative segregation, suicide prevention and reentry planning.

In the last four decades, the USA has seen a sizable growth in its criminal justice system and corrections population. It has also seen reductions in civil and community-based mental health care. Persons with mental disabilities have come to represent a highly disproportional segment of the corrections population. The paper discusses the implications and underlying causes of these developments as well as recent responses to them.

This set of circumstances is starting to change the mission of correctional health services from crisis intervention and suicide prevention to include preparation for the inmate's almost inevitable return to the community.

Such changes have led to further developments in correctional mental health care, in particular, policy designed to treat mental illness, reduce its destructive outcomes such as suicide, and facilitate successful reentry into the community in attempts to reduce recidivism and improve clinical outcomes. Mental health care professionals working within corrections have likewise faced ethical challenges in effectuating treatment.

Incarcerated women around the globe are predominantly of reproductive age. Most of these women have been pregnant before, and many want to be sexually active and avoid pregnancy upon release. Yet few of these women are on a regular method of contraception. Providing contraceptive services for women in custody benefits individual and public health goals of reducing unintended pregnancy. This policy briefing reviews evidence for an unmet need for family planning in the correctional setting, and policy implications for expanding services. The paper aims to discuss these issues.

The authors describe four model programs in the USA with established contraceptive services on site, highlighting practical steps other facilities can implement.

Correctional facilities health administrators, providers, advocates, and legislators should advance policies which should counsel women on family planning and should make a range of contraceptive methods available before release, while remaining sensitive to the potential pressure these women may feel to use birth control in this unique environment.

Family planning services for incarcerated women benefits individuals, facilities, and the community.

Policies which enable correctional facilities to provide comprehensive family planning to incarcerated women – including reproductive life goals counseling and contraceptive method provision – promote equity in access to critical reproductive health services and also provide broad scale population level benefits in preventing unintended pregnancy or enabling counseling for healthy pregnancies for a group of women who often have limited access to such services.

This policy briefing highlights an area of health care in prisons and jails which gets little attention in research and in policy circles: family planning services for incarcerated women. In addition to reviewing the importance of such services for this population, the authors also highlight model family planning programs in correctional facilities. These provide actionable insights for other administrators and providers.

Patient navigation is an evidence-based approach for enhancing medical and support service co-ordination and ensuring linkage to medical care for people living with HIV released from jail. The paper aims to discuss this issue.

This brief describes the benefits of patient navigation and issues to consider when implementing a navigator program. The authors use process data to describe the type and amount of navigation services delivered as part of a randomized study, the “The San Francisco Navigator Project.”

Navigation programs are able to accommodate a range of service needs; most clients required multiple types of services, particularly during the first two months after release.

Navigation programs should be prioritized because they provide unique and essential support for people leaving jail during the particularly vulnerable time immediately after release navigation plays a crucial role in retaining individuals in care and preventing onward transmission of HIV.

Using a seven-day cycle menu and commissary items at a rural county jail, this study aims to describe provisions of micronutrients known to be associated with mental health disorders and if they meet dietary guidelines.

The nutritional content of a seven-day cycle menu and four available commissary food packs were evaluated using NutritionCalc® Plus software (McGraw-Hill Education version 5.0.19) and compared to Dietary Reference Intakes (DRI).

Menu mean values of Vitamin B6, Vitamin B12, Vitamin C and zinc met DRI recommendations. However, Vitamin D (for men and women), magnesium (for men only) and omega-3s (for men only) did not meet the DRI recommendations.

As deficits of Vitamin D, magnesium and omega-3s are known to exacerbate bipolar disorder, anxiety and depression, small changes to food would increase the offerings and potential intake of nutrients that may improve mental health.

Purpose – This chapter gives an overview of the impact that the COVID-19 pandemic has had on institutional corrections in the United States and the responses correctional institutions have taken to lessen those impacts.

Methodology/Approach – A review of the extant literature was conducted to gather information on COVID-19 and the institutional corrections systems within the United States.

Findings – The impacts of the COVID-19 pandemic on correctional institutions within the United States were more pronounced due to the demographic characteristics of inmates and facility challenges. Responses to outbreaks or potential outbreaks in jails and prisons in the United States included screening measures, restricted inmate movement and visitation, and decarceration efforts.

Originality/Value – This chapter builds upon literature by discussing the challenges posed to correctional institutions in the United States in the face of the COVID-19 pandemic and summarizing the measures taken to reduce the impact of COVID-19 on inmates, institutional staff, and community members alike.

Despite ranking among the most prevalent mental health conditions and their likely contributions to violent offending, post-traumatic stress disorder (PTSD), panic disorder (PD) and alcohol use disorder (AUD) have not been examined closely among adult males detained in rural jails. The purpose of this paper is to assess the prevalence of co-occurring PTSD, PD and AUD within this population and identify their associations with violent offenses.

The sample consists of 349 males recently booked into local jails. The Comprehensive Addictions and Psychological Evaluation – 5 was administered to assess mental health conditions. Bivariate statistics and multivariate logistic regression were used to examine associations between PTSD, PD, AUD and violent offenses.

A disproportionate number of participants met criteria for PTSD, PD and AUD. Co-occurrence was prevalent among detainees booked for violent offenses with 25% reporting symptoms of all three disorders. PD emerged as the strongest single condition associated with violence, while the combination of PTSD, PD and AUD significantly increased the likelihood of violent offenses.

A better understanding of the relationship between mental health conditions and violent offenses is essential for efficacious assessment and treatment. Appropriately informed mental health care for jail detainees can increase public safety and guide practices for addressing these conditions within criminal justice populations.

There is limited research on mental health within the rural jail detainee population. To the authors’ knowledge, this is the first study to examine the association between PTSD, PD, AUD and violent offenses drawn from local detention centers.

Advocacy is an important tool for translating population health objectives and research findings into policy and practice, as well as for enhancing stakeholder support for programmes and activities with a potential to improve the health of populations. At the inception of modern prisons, health advocacy approaches focused on appealing to humanitarian and religious sentiments of stakeholders to improve the well‐being of prisoners. This approach achieved limited results, not least because of persistent apathy of custodial authorities and the public to prisoners’ wellbeing. From the mid twentieth century onwards, a constitutional and human rights approach evolved, with courts becoming actively involved in mandating minimum health standards in prisons. Penal populism eroded public support for a judicial recourse to improving prison health services, and encouraged governments to institute procedural barriers to prisoner‐initiated litigation. The author proposes an approach premised on public health principles as an appropriate platform to advocate for improvements in prison health services in this era. Such an advocacy platform combines the altruistic goals of the humanitarian and constitutional rights approaches with an appeal to community’s self‐interest by alerting the public to the social, financial and health implications inherent in released prisoners suffering from major communicable and chronic diseases re‐entering the community.

Women involved in the carceral system (CS) experience several conditions that increase their risk for HIV (e.g. high rates of substance use, psychiatric disorders, histories of victimization). The purpose of this study is to explore perspectives on potential strategies to connect women in the CS to pre-exposure prophylaxis (PrEP) services.

This study conducted in-depth interviews with 27 women involved in the CS eligible for PrEP. Using vignettes, interviews explored attitudes, barriers and facilitators toward PrEP screening, referral and linkage facilitated via a CS stakeholder, an mHealth application or providing PrEP service referrals during detention via a navigator.

Most women were, on average, 41.3 years, from racial and ethnic minority groups (56% black/African American; 19% Latinx). Inductive thematic analysis revealed CS involved women expressed mostly positive attitudes toward CS-based PrEP implementation. Younger women were more accepting of and interested in mHealth interventions. Implementation facilitators included leveraging relationships with trusted allies (e.g. “peers”) and existing systems collaborations. Recommended implementation strategies included providing HIV and PrEP-specific education and training for system stakeholders and addressing issues related to privacy, system mistrust and stigma.

Results provide a critical foundation for the implementation of interventions to improve PrEP access for women involved in the CS and have important implications for implementation strategies for all adults involved in the CS. Improving access to PrEP among this population may also support progress toward addressing national disparities in PrEP uptake, where women, black and Latinx populations have substantial unmet need.

The purpose of this paper is to explore incarcerated women's awareness, beliefs, and experiences with human papillomavirus (HPV) infection and vaccination.

Researchers conducted focus groups with 45 incarcerated women in an urban Midwestern US jail to assess how women talked about their Papanicolaou (Pap) test screening and abnormal Pap test follow-up experiences. Some focus group questions specifically assessed individual awareness, beliefs, and experiences with HPV infection and vaccination. Based on these data, the authors described participants’ awareness of HPV, as well as used open coding to ultimately extract themes related to beliefs and experiences with HPV infection and vaccine.

While all 45 participants reported experiencing an abnormal Pap test event within the last five years, only two-thirds of participants (n=30) reported having heard of the HPV infection. Several themes emerged from the analysis of the data: the women's beliefs about cause and severity of HPV; frustration with age requirements of the vaccine; varied experiences with vaccinations for themselves and their children; the impact of media exposure on knowledge; and desire for more HPV infection and vaccine information.

Incarcerated women's awareness and limited experiences with HPV infection and vaccination may be a barrier to adequate screening and cervical cancer prevention. This study has implications for the development of cervical health education for this high-risk group of women, who are four to five times as likely to have cervical cancer as non-incarcerated women.

In this chapter, I address how criminal justice policies, and discrimination and prejudice within the US criminal justice system, negatively affect trans men. By focusing on trans men’s unique incarceration experiences using 15 in-depth interviews, I recommend four key policy changes for correctional facilities: (1) allow trans men to choose the gender of the correctional facility in which they are housed; (2) allow trans men to wear undergarments that align with their gender identity; (3) provide trans men access to trans-appropriate healthcare; and (4) implement harsher penalties for non-compliance of Prison Rape Elimination Act Standards. These four policies would improve the life chances of trans men during their incarceration and post-incarceration.