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Article
Publication date: 29 November 2013

Jennifer E. Johnson, Yael Chatav Schonbrun, Jessica E. Nargiso, Caroline C. Kuo, Ruth T. Shefner, Collette A. Williams and Caron Zlotnick

The purpose of this paper is to explore treatment needs and factors contributing to engagement in substance use and sobriety among women with co-occurring substance use…

Abstract

Purpose

The purpose of this paper is to explore treatment needs and factors contributing to engagement in substance use and sobriety among women with co-occurring substance use and major depressive disorders (MDDs) as they return to the community from prison.

Design/methodology/approach

The paper used qualitative methods to evaluate the perspectives of 15 women with co-occurring substance use and MDDs on the circumstances surrounding their relapse and recovery episodes following release from a US prison. Women were recruited in prison; qualitative data were collected using semi-structured interviews conducted after prison release and were analyzed using grounded theory analysis. Survey data from 39 participants supplemented qualitative findings.

Findings

Results indicated that relationship, emotion, and mental health factors influenced women's first post-prison substance use. Women attributed episodes of recovery to sober and social support, treatment, and building on recovery work done in prison. However, they described a need for comprehensive pre-release planning and post-release treatment that would address mental health, family, and housing/employment and more actively assist them in overcoming barriers to care.

Practical implications

In-prison and aftercare treatment should help depressed, substance using women prisoners reduce or manage negative affect, improve relationships, and obtain active and comprehensive transitional support.

Originality/value

Women with co-occurring mental health and substance use disorders are a high-risk population for negative post-release outcomes, but limited information exists regarding the processes by which they relapse or retain recovery after release from prison. Findings inform treatment and aftercare development efforts.

Details

International Journal of Prisoner Health, vol. 9 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

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Article
Publication date: 21 December 2015

Ambika Bhushan, Shan-Estelle Brown, Ruthanne Marcus and Frederick L Altice

Little is understood about the self-described barriers that recently released HIV-infected prisoners face when accessing healthcare and adhering to medications. The…

Abstract

Purpose

Little is understood about the self-described barriers that recently released HIV-infected prisoners face when accessing healthcare and adhering to medications. The purpose of this paper is to elucidate these barriers from the perspective of released prisoners themselves.

Design/methodology/approach

A qualitative assessment using 30 semi-structured interviews explored individuals’ self-reported acute stressors and barriers to health-seeking during community re-integration for recidivist prisoners. Leventhal’s Self-Regulation Model of Illness (SRMI) is applied to examine both structural and psychological barriers.

Findings

The SRMI explains that individuals have both cognitive and emotional processing elements to their illness representations, which mediate coping strategies. Cognitive representations of HIV that mediated treatment discontinuation included beliefs that HIV was stigmatizing, a death sentence, or had no physiological consequences. Negative emotional states of hopelessness and anger were either acute or chronic responses that impaired individuals’ motivation to seek care post-release. Individuals expressed feelings of mistrust, fatalism and denial as coping strategies in response to their illness, which reduced likelihood to seek HIV care.

Originality/value

Interventions for HIV-infected individuals transitioning to the community must incorporate structural and psychological components. Structural support includes housing assistance, employment and health insurance, and linkage to mental health, substance abuse and HIV care. Psychological support includes training to enhance agency with medication self-administration and HIV education to correct false beliefs and reduce distress. Additionally, healthcare workers should be specifically trained to establish trust with these vulnerable populations.

Details

International Journal of Prisoner Health, vol. 11 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

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Article
Publication date: 19 December 2016

Rabia Ahmed, Cybele Angel, Rebecca Martel, Diane Pyne and Louanne Keenan

Incarcerated women have a disproportionate burden of infectious and chronic disease, in addition to substance use disorder and mental health illness, when compared to the…

Abstract

Purpose

Incarcerated women have a disproportionate burden of infectious and chronic disease, in addition to substance use disorder and mental health illness, when compared to the general population (Binswanger et al., 2009; Fazel et al., 2006; Fuentes, 2013; Kouyoumdjian et al., 2012). Women often enter the correctional system in poor health, making incarceration an opportunity to address health issues. The purpose of this paper is to explore the barriers to accessing health services that female inmates face during incarceration, the consequences to their health, and implications for correctional health services delivery.

Design/methodology/approach

Focus groups were conducted in Canadian correctional center with female inmates. Focus groups explored women’s experiences with accessing health services while incarcerated; the impact of access to health services on health during incarceration and in the community; and recommendations for improving access to health services. Thematic analysis was completed using N-vivo 10.

Findings

The women described multiple barriers to accessing health services that resulted in negative consequences to their health: treatment interruption; health disempowerment; poor mental and physical health; and recidivism into addiction and crime upon release. Women made three important recommendations for correctional health service delivery: provision of comprehensive health entry and exit assessments; improvement of health literacy; and establishment of health support networks. The recommendations were organized into an “Accessing Health Services Resource Manual” for incarcerated women.

Originality/value

There is a paucity of existing literature examining provision of health services for female inmates. These findings have relevancy for correctional and community health care providers and organizations that provide health services for this vulnerable population.

Details

International Journal of Prisoner Health, vol. 12 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

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Article
Publication date: 1 April 2006

Jilla Burgess‐Allen, Michele Langlois and Paula Whittaker

The ex‐prisoner population is an under‐researched, socially excluded group, whose broad health needs are seldom assessed and often unmet. This qualitative study aims to…

Abstract

The ex‐prisoner population is an under‐researched, socially excluded group, whose broad health needs are seldom assessed and often unmet. This qualitative study aims to identify the broad health needs of ex‐prisoners living in an urban borough in the NorthWest of England. We interviewed 27 exprisoners and 14 of the service providers who work with them, from all the resettlement pathways. We asked them about the resettlement experience and how it impacts on ex‐prisoners’ health, what broad health concerns ex‐prisoners have, and how these could be rectified or improved. This study contributes detail from the perspective of ex‐prisoners themselves, and the workers who know their needs best. We have been able to demonstrate that the transition from prison to community is often a health depleting experience, particularly when accommodation has not been adequately arranged. We have found that whilst ex‐prisoners doubtless suffer very poor health they do not often prioritise their own health. However, the majority of ex‐prisoners clearly suffer particularly from mental health and substance misuse problems. Much can be done to tackle these issues by improving communication and partnership working between key stakeholders.

Details

International Journal of Prisoner Health, vol. 2 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

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Article
Publication date: 17 May 2021

Matthew Martin, Megan A. Phillips, Mary Saxon, Kailey Love, Laurie Cessna, Deborah L. Woodard, Mary Page, Kenneth Curry, Alyssa Paone, Bobbie Pennington-Stallcup and William Riley

People living with opioid use disorder (OUD) disproportionately encounter the criminal justice system. Although incarcerated individuals with OUD face higher risk for…

Abstract

Purpose

People living with opioid use disorder (OUD) disproportionately encounter the criminal justice system. Although incarcerated individuals with OUD face higher risk for withdrawals, relapses and overdoses, most jails fail to offer comprehensive medications for OUD (MOUD), including recovery support services and transition of care to a community provider. The purpose of this paper is to describe the development and implementation of a comprehensive MOUD program at a large county jail system in Maricopa County, Arizona.

Design/methodology/approach

The authors used the Sequential Intercept Model (SIM) to develop a community-based, multi-organizational program for incarcerated individuals with OUD. The SIM is a mapping process of the criminal justice system and was applied in Maricopa County, Arizona to identify gaps in services and strengthen resources at each key intercept. The program applies an integrated care framework that is person-centered and incorporates medical, behavioral and social services to improve population health.

Findings

Stakeholders worked collaboratively to develop a multi-point program for incarcerated individuals with OUD that includes an integrated care service with brief screening, MOUD and treatment; a residential treatment program; peer support; community provider referrals; and a court diversion program. Recovery support specialists provide education, support and care coordination between correctional and community health services.

Originality/value

OUD is a common problem in many correctional health centers. However, many jails do not provide a comprehensive approach to connect incarcerated individuals with OUD treatment. The Maricopa County, Arizona jail system opioid treatment program is unique because of the ongoing support from recovery support specialists during and after incarceration.

Details

International Journal of Prisoner Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1744-9200

Keywords

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Article
Publication date: 11 September 2017

Janet J. Myers, Kimberly A. Koester, Mi-Suk Kang Dufour, Alison O. Jordan, Jacqueline Cruzado-Quinone and Alissa Riker

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…

Abstract

Purpose

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.

Design/methodology/approach

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.”

Findings

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.

Originality/value

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.

Details

International Journal of Prisoner Health, vol. 13 no. 3/4
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 16 March 2015

Tyson Pankey and Megha Ramaswamy

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

Abstract

Purpose

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

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

International Journal of Prisoner Health, vol. 11 no. 1
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 12 September 2016

Yazhini Subramanian, Muhammad Naeem Khan, Sara Berger, Michelle Foisy, Ameeta Singh, Dan Woods, Diane Pyne and Rabia Ahmed

The purpose of this paper is to assess the impact of short-term incarceration on antiretroviral therapy (ART) adherence, virologic suppression, and engagement and…

Abstract

Purpose

The purpose of this paper is to assess the impact of short-term incarceration on antiretroviral therapy (ART) adherence, virologic suppression, and engagement and retention in community care post-release.

Design/methodology/approach

A retrospective chart review of patients who attended the human immunodeficiency virus (HIV) Outreach Clinic at a Canadian remand center between September 2007 and December 2011 was carried out. Data extraction included CD4 lymphocyte count, HIV viral load, ART prescription refills, and community engagement and retention during and one-year pre- and post-incarceration.

Findings

Outpatient engagement increased by 23 percent (p=0.01), as did ART adherence (55.2-70.7 percent, p=0.01), following incarceration. Retention into community care did not significantly improve following incarceration (22.4 percent pre-incarceration to 25.9 percent post-release, p=0.8). There was a trend toward improved virologic suppression (less than 40 copies/ml; 50-77.8 percent (p=0.08)) during incarceration and 70. 4 percent sustained this one-year post-incarceration (p=0.70).

Originality/value

The impact of short-term incarceration in a Canadian context of universal health coverage has not been previously reported and could have significant implications in optimizing HIV patient outcomes given the large number of HIV-positive patients cycling through short-term remand centers.

Details

International Journal of Prisoner Health, vol. 12 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

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Article
Publication date: 12 September 2016

Muazzam Nasrullah, Emma Frazier, Jennifer Fagan, Felicia Hardnett and Jacek Skarbinski

The purpose of this paper is to describe factors associated with incarceration as well as the association between recent incarceration and HIV-related sexual risk…

Abstract

Purpose

The purpose of this paper is to describe factors associated with incarceration as well as the association between recent incarceration and HIV-related sexual risk behaviors, access to insurance, healthcare utilization (emergency department (ED) and hospital use), antiretroviral therapy (ART) prescription, and viral suppression.

Design/methodology/approach

Using 2009-2010 data from a cross-sectional, nationally representative three-stage sample of HIV-infected adults receiving care in the USA, the authors assessed the demographic characteristics, healthcare utilization, and clinical outcomes of HIV-infected persons who had been recently incarcerated (detention for>24 hours in the past year) using bivariate analyses. The authors used multivariable logistic regression to examine associations of recent incarceration with insurance status as well as clinical and behavioral outcomes.

Findings

An estimated 22,949 (95 percent confidence interval (CI) 19,062-26,836) or 5.4 percent (CI: 4.7-6.1) of all HIV-infected persons receiving care were recently incarcerated. Factors associated with recent incarceration were age <50 years, being a smoker, having high school diploma or less, being homeless, income at or below the poverty guidelines, having a geometric mean of CD4 count <500 cells/μL, and using drugs in the past 12 months. Results from multivariable modeling indicated that incarcerated persons were more likely to use ED services, and to have been hospitalized, and less likely to have achieved viral suppression.

Originality/value

Recent incarceration independently predicted worse health outcomes and greater use of emergency services among HIV-infected adults currently in HIV care. Options to improve the HIV continuum of care, including pre-enrollment for healthcare coverage and discharge planning, may lead to better health outcomes for HIV-infected inmates post-release.

Details

International Journal of Prisoner Health, vol. 12 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

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Article
Publication date: 17 May 2021

Ye In (Jane) Hwang, Natasha Ann Ginnivan, Paul Leslie Simpson, Susan Baidawi, Adrienne Withall, Brie Williams and Tony Butler

The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight…

Abstract

Purpose

The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight key matters for better risk management and care of this population during this and future infectious disease pan/epidemics.

Design/methodology/approach

The present commentary draws on current policies, practices and literature regarding the health, needs and management of older incarcerated adults in Australia to discuss risk, care and early release for this population during the COVID-19 pandemic.

Findings

Incarcerated persons experience poorer health and accelerated age-related decline compared to those in the general community. The present situation offers the opportunity to fill knowledge and practice gaps, including policies for staff training, identification of dementia and cognitive decline, assessment of mobility issues, addressing barriers to health-seeking, possibilities of medical or compassionate release, risk assessment and release protocols and post-release needs.

Practical implications

While Australian prisons have acknowledged the vulnerability of older persons, more focused adaptation of COVID-19-related policies to consider adults as young as 45 years are needed. Appropriate ethical identification and management of cases in this population is needed, as is discussion on issues of decarceration and medical release. Re-conceptualisation of incarcerated adults as “citizens in need of care”, rather than as “offenders to be secured”, will be beneficial. Robust, local evidence is needed to assist decision-making.

Originality/value

This is a comprehensive, focused review of relevant evidence, policies and practices for a growing subpopulation of prisoners worldwide with complex needs and particular vulnerability to the COVID-19.

Details

International Journal of Prisoner Health, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1744-9200

Keywords

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