Search results

Overcrowding in prisons has a negative impact on health care and consequently the international standards insist that accommodation for prisoners must include sufficient space. Despite this, the article shows that overcrowded prison systems, defined as those holding more prisoners than they are intended to accommodate, are to be found in every part of the world; indeed, almost 70% are overcrowded, and many others are overcrowded in some prisons. Moreover, overcrowding is not just widespread; it is often severe, with many prison systems having levels of occupancy that far exceed the official capacity. Furthermore, the official capacities of prisons often allow insufficient space per prisoner, so that there is in fact overcrowding even in prison systems where the prison population is lower than the officially stated capacity. Again, prison populations continue to rise, often without parallel increases in the space available. It is suggested that attempts to improve prison health should include strategies to reduce prison populations and eliminate overcrowding.

This paper presents an actor-based conceptualization of the increasing oscillatory pattern of prison overcrowding in Colombia. The research proposes a dynamic hypothesis that explains that unintended behavioural pattern as a result of delayed balance feedback loops shaped by decision-making processes of actors that intend to control crime. This system matches a well-known systemic archetype that explains those persistent oscillations. The paper also introduces a simulation model for testing that dynamic hypothesis and for delivering concrete courses of action. This work illustrates the relevance for policymakers to understand the dynamic complexity of social systems as the outcome of the agency of actors who take action to defend their own interests. Such actions ultimately form a complex web of interactions that drive the performance of such systems with unintended consequences. In particular, the construction of explicit models provides better chances of devising policies that consider the system-level implications of those interactions.

This work uses system dynamics modelling. First, the paper presents a conceptual model anchored in operational thinking, which refers to the identification of actors and decisions, and the manner in which those decisions ultimately build the respective social system in which the oscillatory pattern emerges. Second, it identifies key feedback structures that result from those chains of decisions. Finally, the paper introduces a simulation model for suggesting policy implications for decisionmakers.

The increasing oscillatory pattern that prison overcrowding in Colombia has displayed over the last 20 years is the outcome of a wide variety of laws that increase sanctions on criminal conducts, a phenomenon known as “legislative inflation”. Such reactions against crime are propelled and sustained by society and policymakers as the result of static and linear thinking that simply delivers “more punishment” of crime – harsher legislation and longer prison terms – which ultimately boosts long-term prison overcrowding and further cycles of crime control and overcrowding. Such actions create permanent negative feedback loops that involve various material and information delays, which – coupled with the reinforcing feedback loops – explain the previously mentioned behavioural pattern. Through a system dynamics simulation model, this paper tests and explains the proposed dynamic hypothesis and shows how policymakers can enhance and develop their dynamic understanding to explore and design effective policies intended to tackle prison overcrowding.

This paper presents a practical and concrete case that bridges the fields of criminal policy and prison management through systems thinking. It uses the case of prison overcrowding in Colombia to demonstrate the relevance of incorporating systemic thinking into the cognitive portfolio of policymakers if they aspire to improve complex systems.

Criminal policy and prison management are different fields that typically belong to different traditions (law and criminal psychology for the former, public administration for the latter). The work presented here bridges those perspectives under a single engineering and systemic perspective that answers questions in both fields and serves as a unifying framework for designing more coherent criminal policies that meet the practical requirements and restrictions that prison management implies.

Prison institutional conditions affect risk for self-harm among detainees. In particular, prison overcrowding may increase the likelihood of self-harm by creating competition for resources, space, and enhancing a “deprivation state.” The purpose of this paper is to examine the association between overcrowding and prisoner acts of self-harm.

This cross-sectional study took place at Geneva’s pre-trial prison (capacity:376) between 2006 and 2014. Outcomes were acts of self-harm that required medical attention, and self-strangulation/hanging events (combined into one group, as these are difficult to differentiate). Dichotomous predictors were overcrowding index- annual mean daily population divided by capacity ( > 200 percent vs < 200 percent), and year group (2006-2009 vs 2011-2014).

Self-harm and self-strangulations/hangings increased in 2011-2014 compared to 2006-2010 (p < 0.001). Overcrowding in excess of 200 percent was associated with self-strangulation/hangings (p < 0.001) but not with all self-harm events. In terms of pertinent demographics that would affect self-harm, there was no prison change in gender, area of origin, foreign residency, religion, or psychiatric treatment.

The present study is limited by the definition and identification of self-harm. The distinction between self-strangulation and self-hanging, and the precise classification of an intent to die is difficult to make in practice, especially with limited prison data records available. The relevant literature addresses the complexity of the association between non-suicidal and suicidal behavior. Despite this, the combined category self-strangulations/hangings gives some indication of severe self-harm events, especially since the methodology of categorization employed was consistent throughout the entire period of the study. Other limitations include the small sample size and the lack of individual patient data and prison data to help control for confounding factors. Despite these drawbacks, pertinent data (socio-demographics and number of prisoners treated for mental health and drug abuse) remained stable over the years. Thus, there are no apparent changes in the inmate population that could be linked to an increase in self-harm. High-security placements and mean prisoner stay have increased over time, with a decrease in staff to prisoner ratio – and these must be looked into further as contributors. Additionally, qualitative methods such as semi-structured interviews and focus groups could delineate the impact of overcrowding on prisoner well-being and self-harm potential.

The authors observed a significant increase in self-harm and self-strangulation/hangings over time, and overcrowding was significantly associated with self-strangulation/hangings (but not with all self-harm events). Overcrowding can impose destructive effects on the psychological and behavioral well being of inmates in prison, influencing a myriad of emotional and livelihood factors that predispose to harmful behavior.

This report should alert public health and prison authorities to this issue, and garner resources to address such an alarming rise. The findings from this short report demonstrate the need for a further examination of the mechanisms affecting self-harm among prisoners in this population, particularly the relationship between self-strangulations/hangings and overcrowding.

A cross‐section of 1980 US data on the prison population and its rate of inflow is examined. Regression analysis is used to investigate the impact of prison overcrowding, race, crime and unemployment on the above variables. Racial composition and overcrowding are found to have significant positive impacts on the numbers in prison and the rate of inflow. Unemployment does not have a significant influence, nor does the crime rate influence inflow, but it does have a significant positive correlation with the level of the prison population.

This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non‐binding or so‐called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.

Young prisoners are one of the most vulnerable groups in society for mental health problems and ill-being. Therefore, there is a crucial need to understand their physical, psychological and social situations. This study aims to explore young Cambodian prisoners’ experiences and perceptions of mental health and well-being, their determinants and their coping strategies.

Six focus group discussions were carried out in three prisons with a total of 48 young prisoners between the ages of 15 and 24 years (50% women, 50% men). Semi-structured questions guided the discussions, and thematic analysis was applied to analyse the data.

Young prisoners reported multifaceted experiences of mental health and well-being. The majority described adverse mental health experiences, while some revealed better well-being, partly influenced by the socio-economic support from outside the prisons and previous involvement or not in drug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio-emotional support and rituals were described as the most important coping mechanisms.

This pioneering study from Cambodia gives young prisoners an opportunity to voice their experiences and perceptions of mental health and well-being in the prison setting. The findings in this study underline the importance of prison authorities tackling overcrowding to promote well-being and reduce mental health problems. Also, the coping mechanisms outlined by the participants should be considered when planning psychosocial interventions.

The Central Asian republics are among the countries which currently experience the world’s fastest growing HIV/AIDS epidemic. At the same time, they are threatened by the re‐emergence of tuberculosis (TB), with the highest rates of new TB cases among the Former Soviet Republics. One of the groups that is at highest risk from TB and HIV/AIDS and that is, at the same time, the major regional drivers of the epidemics is the prison population. Up to an estimated third of HIV/AIDS infected persons in Central Asia are within the penitentiary system. At the same time, prisons are known to be the ‘epidemiological pump’ for TB in the region, fuelled by overcrowding, poor ventilation and inadequate nutrition. Both AIDS and TB incidence and death rates among prisoners are much higher than in the civilian population, with an alarming rising trend. Prison health is a key issue of public interest, especially in the context of an epidemiological crisis as in Central Asia. This paper looks at the spread of HIV/AIDS and TB in the region and analyses the role prisons play as one of the main multipliers.