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The United States imprisons a higher proportion of its population than any other nation. Mass Incarceration Nation offers a novel, in-the-trenches perspective to explain the factors – historical, political, and institutional – that led to the current system of mass imprisonment. The book examines the causes and impacts of mass incarceration on both the political and criminal justice systems. With accessible language and straightforward statistical analysis, former prosecutor turned law professor Jeffrey Bellin provides a formula for reform to return to the low incarceration rates that characterized the United States prior to the 1970s.
Mental health interventions for Italian (and European) prisoners with mental disorders remain a problematic issue, despite radical changes in general psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. Indeed, according to the American Psychological Association, 64% of incarcerated individuals report mental health concerns.
The aim of this study is to describe the mental health intervention model implemented since January 2020 for prisoners allocated in the Parma Penitentiary Institutes (PPI). This approach is specifically based on specialized, “person-centered” and “person-tailored” therapeutic-rehabilitation plans in line with psychiatric treatments usually provided in community mental health-care centers of the Parma Department of Mental Health.
All the processes and procedures included in the PPI intervention model were first carefully described, paying special attention to the service for newly admitted prisoners and each typology of specialized therapeutic-rehabilitation treatment potentially provided. Additionally, a preliminary descriptive process analysis of the first six months of clinical activity was also performed.
Since January 2020, 178 individuals entered the PPI service for newly admitted prisoners. In total, 83 (46.7%) of them were engaged in the services of the PPI mental health-care team (35 with pathological addiction and 48 with mental disorders): 56 prisoners were offered an integrated mental health intervention and 27 exclusively an individual psychological or psychiatric treatment.
The results support the potential applicability of an integrated mental health intervention in prison, planning a person-tailored rehabilitation in close collaboration with the prisoners, their families and the local mental health/social services.
The risk rate of criminality is increased in ADHD, especially in children who, in addition to ADHD, express externalizing behavior of oppositional defiant disorder (ODD), later followed by conduct disorder (CD), substance misuse and antisocial personality disorder (ASPD). Studies report ADHD to be about ten times more common in prison populations than in the general adult population. Prisoners with ADHD have compared to prisoners without ADHD, an earlier onset of offending, higher rates of coexistent psychiatric disorders, and are more often incarcerated due to violent- and drug-related offences. Within prison settings, inmates with ADHD are more often reported for intra-institutional aggression and they are often experienced as more difficult to manage and costly to rehabilitate. Further, they relapse comparably more often and faster into criminality after being conditionally released. Despite high prevalence rates of ADHD within prisons and serious consequences related to untreated ADHD, few controlled trials have evaluated methylphenidate treatment in prisoners with ADHD and coexistent disorders. Evidence and clinical experience of pharmacological and psychosocial interventions of prison populations with ADHD will be presented briefly.
Old age population is growing steadily during last decades (WHO 2017). Old population suffer from more morbidity including mental disorders (De Lorito,2018). This fact also applies for prison population (Yortons 2006) and in the lasts years has been an increasing interest for this topicThe aging of the world population is reflected in the penitentiary setting, with a progressive increase of elderly inmates. These prisoners present complex clinical processes with multiple comorbidities, requiring a specialized approach. In the 2020, the old age population in prison (considered over 60 years old) is around 5% in Catalonia (377 inmates,), same proportion (5%) in Spain.If we consider the cut-off point 50 y.o. (as other research) the proportion is 12% Our aims are to describe sociodemographical and clinical characteristics of old age inmates (over 50 y. o.) who required to be admitted to psychiatric unit in Catalan prisons between 2016 and 2020. The asample of this study will be around 150 inmates admitted in our unit. Elderly inmates present a high prevalence of substance abuse (especially alcohol), affective symptoms (depression) and cognitive deterioration. Likewise, is observed a significant presence of personality disorders, anxiety, post-traumatic disorders, psychotic disorders, and physical comorbidities. Prisoners over 50 have a different profile from the rest of the prison population. They suffer more physical and mental illnesses, so they require specific health and social approach. It would be advisable to adapt clinical care by optimizing resources, developing prison psychogeriatrics and establishing specific evaluation and treatment method
The estimation of the percentage of mentally ill among prisoners and of the most severe psychiatric disorders has been the subject of few studies in Tunisia.
To study in a general way the extent of psychiatric disorders among prisoners. To describe the socio-demographic and judicial characteristics of prisoners. To describe the clinical, evolutionary and therapeutic characteristics of the main psychiatric disorders.
This is a cross-sectional and descriptive study, carried out over a period of 4 months (February 2021-May 2021) on one hundred and twelve inmates of the civil prison of Mahdia followed in psychiatry. Data were collected using a pre-established questionnaire. It is made up of 30 items.
The prevalence of mental disorders in prison was 9.03%. The descriptive study revealed an average age of 37.57 years, a majority having a single marital status (62.5%), the professional activity before imprisonment were workers in 61.6%, a history of imprisonment more than twice in 62.5% of cases and 50.89% declared having been victims of physical acts, psychological or sexual abuse during their childhood. Murder, armed robbery, drug trafficking and rape were the most frequent offenses with respective rates of 25.2; 17.07; 13.82 and 9.75%. Anxiety was noted in 53.57% of cases, of the respondents, depressive syndrome was in 28.57% of cases, schizophrenia was reported in 18, 75% of cases and substance-related disorders were noted in 21.42% of cases.
Longitudinal studies should, in the coming years, try to understand the impact of imprisonment on the onset and evolution of psychiatric disorders.
Many male prisoners have significant mental health problems, including anxiety and depression. High proportions struggle with homelessness and substance misuse.
This study aims to evaluate whether the Engager intervention improves mental health outcomes following release.
The design is a parallel randomised superiority trial that was conducted in the North West and South West of England (ISRCTN11707331). Men serving a prison sentence of 2 years or less were individually allocated 1:1 to either the intervention (Engager plus usual care) or usual care alone. Engager included psychological and practical support in prison, on release and for 3–5 months in the community. The primary outcome was the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), 6 months after release. Primary analysis compared groups based on intention-to-treat (ITT).
In total, 280 men were randomised out of the 396 who were potentially eligible and agreed to participate; 105 did not meet the mental health inclusion criteria. There was no mean difference in the ITT complete case analysis between groups (92 in each arm) for change in the CORE-OM score (1.1, 95% CI –1.1 to 3.2, P = 0.325) or secondary analyses. There were no consistent clinically significant between-group differences for secondary outcomes. Full delivery was not achieved, with 77% (108/140) receiving community-based contact.
Engager is the first trial of a collaborative care intervention adapted for prison leavers. The intervention was not shown to be effective using standard outcome measures. Further testing of different support strategies for prison with mental health problems is needed.
A higher proportion of people in prison have a history of traumatic brain injury (TBI) than the general population. However, little is known about potentially related persistent symptoms in this population.
To compare symptom reporting in men with and without a history of TBI following admission to a correctional facility.
All men transferred to the South Auckland Correctional Facility in New Zealand complete a lifetime TBI history and the Rivermead Post-Concussion Symptom Questionnaire (RPQ) as part of their routine health screen. Data collected between June 2020 and March 2021 were extracted and anonymised. Participants were classified as reporting at least one TBI in their lifetime or no TBI history. The underlying factor structure of the RPQ was determined using principal components analysis. Symptom scores between those with and without a TBI history were compared using Mann Whitney U tests.
Of the N = 363 adult male participants, 240 (66%) reported experiencing at least one TBI in their lifetime. The RPQ was found to have a two-factor structure (Factor 1: cognitive, emotional, behavioural; Factor 2: visual-ocular) explaining 61% of the variance. Men reporting a TBI history had significantly higher cognitive, emotional and behavioural (U = 50.4, p < 0.001) and visuo-ocular symptoms (U = 68.5, p < 0.001) in comparison to men reporting no TBI history.
A history of TBI was associated with higher symptom burden on admission to a correctional facility. Screening for TBI history and current symptoms on admission may assist prisoners experiencing persistent effects of TBI to access rehabilitation.
This paper compares across six nations the mental health systems available to prisoners with the highest acuity of psychosis and risk combined with the lowest level of insight into the need for treatment. Variations were observed within and between nations. Findings highlight the likely impact of factors such as mental health legislation and the prison mental health workforce on a nation's ability to deliver timely and effective treatment close to home for prisoners who lack capacity to consent to treatment for their severe mental illness. The potential benefits of addressing the resulting inequalities are noted.
Self-harm, including suicide, is common among prisoners. Staff attitudes and perceptions regarding self-harm may affect quality of care and patient safety.
To systematically review the experiences, perceptions and attitudes of staff in adult prisons regarding self-harm.
Systematic searches of EMBASE, Medline, PsycINFO and CINAHL databases were conducted, and supplemented by hand-searching and grey literature review, to identify relevant English-language articles published since the year 2000. Articles were screened by two authors and evaluated with standardised quality appraisal tools. Qualitative data were analysed thematically, whereas quantitative data were narratively synthesised because of high study heterogeneity.
Two thousand articles were identified, of which 32 were included, involving 6389 participants from five countries. Most studies were moderate (n = 15) or poor (n = 10) quality, and seven were rated as good quality. Staff frequently witnessed self-harm and described multiple perceived risk factors and causes of this. Perceptions that self-harm is ‘manipulative’ or ‘attention-seeking’ were associated with hostility toward prisoners and lower quality of care. Perceived barriers to preventing and managing self-harm included low staffing levels, prison environments and culture, poor staff confidence and insufficient training. The importance of multidisciplinary teamwork and building staff–prisoner relationships were highlighted. Staff occasionally experienced intense psychological reactions to self-harm, which resulted in adaptive or maladaptive coping that influenced their capacity to care.
There are mixed attitudes and perceptions toward self-harm among prison staff. Further training, support and resources are required to protect staff's well-being and improve self-harm prevention and management in prisons.
This essay analyzes one of James Baldwin’s least commented-upon essays, “Equal in Paris,” through the lens of current debates about transatlantic differences regarding race, equality, and citizenship. In his essay, Baldwin narrates how he was imprisoned in Paris for several days a year after his arrival in France. Baldwin constructs his essay not as a political manifesto about race, citizenship, and equality. Rather, through a powerful and cinematographic description, he leads the reader to share the narrator’s distressing experience of disjunction and terror he had while in prison. This literary choice can be understood in the context of Baldwin’s rejection of theologies of damnation and redemption that, according to him, motivate protest writings.
This chapter introduces the theme of mental illness in prison, situating it in the broader historiography of crime and punishment and the history of psychiatric care and institutional provision. It explains how our book redresses the neglect of prisons as a locus for the management of mental disorder, a major oversight given the number of mentally ill people confined in them during the nineteenth century. The introduction elucidates our particular methodology, with its emphasis on individual prison archives that provide a rich counter-balance to the sifted and mediated accounts of official inquiries and published annual reports. It outlines the potential of drawing on examples from England and Ireland, which, while sharing ideologies and with similar systems of prison administration, varied in interpretation and implementation. We summarise the expansion and remit of prisons in the nineteenth century, including the importance of the prison cell as a carefully curated space for reform and rehabilitation.
Disorder Contained is the first historical account of the complex relationship between prison discipline and mental breakdown in England and Ireland. Between 1840 and 1900 the expansion of the modern prison system coincided with increased rates of mental disorder among prisoners, exacerbated by the introduction of regimes of isolation, deprivation and hard labour. Drawing on a range of archival and printed sources, the authors explore the links between different prison regimes and mental distress, examining the challenges faced by prison medical officers dealing with mental disorder within a system that stressed discipline and punishment and prisoners' own experiences of mental illness. The book investigates medical officers' approaches to the identification, definition, management and categorisation of mental disorder in prisons, and varied, often gendered, responses to mental breakdown among inmates. The authors also reflect on the persistence of systems of punishment that often aggravate rather than alleviate mental illness in the criminal justice system up to the current day. This title is also available as Open Access.
Prisoners have long been recognised as a disenfranchised group. This paper positions non-religious prisoners as further excluded from pastoral care. While chaplaincies aim to serve prisoners of all faiths and none, this paper suggests a hierarchy of access in which the benefits of chaplaincy are more available to some prisoners than others. Shortcomings in secular care mean that non-religious offenders are often the only group unable to connect with like-minded people and it is argued that they are disadvantaged as a result. The paper also explores the challenges for pastoral carers seeking to support inmates equally. It considers the barriers on both sides of the care relationship, specifically the disincentives to chaplaincy engagement faced by prisoners of no faith and the obstacles encountered by the Non-Religious Pastoral Support Network in accessing service users and delivering care. Finally, recommendations are made to narrow the gaps between religious and non-religious prisoners.
Chapter 3 discusses how the captive population of Germans, Italians and Japanese, their patriotism sharpened by group incarceration, railed against confinement in Australian and New Zealand’s camps. Using “escape” as its central theme, the chapter examines breakout attempts at camps in Murchison, Cowra and Featherston, offering insights into enforcement of 1929 Geneva Convention regulations for POW treatment. The chapter introduces the dodecagon-shaped POW camp as a unique design tested in Australia for the accommodation of racially different combatants and a continuation of a longer history of convictism. New Zealand’s wartime camps repurpose and adapt facilities associated with quarantine.
dre cummings discusses Meek Mill’s 2018 song, “Trauma,” as a way to enter the debate about the psychological effects of growing up racial minority in poverty-stricken environments. In “Trauma,” Meek Mill deftly describes the Adverse Childhood Experiences (ACEs) that marred his own individual upbringing, then expresses the trauma’s faced by African American communities the nation over. Recent powerful research indicates that the more ACEs a child faces while growing up, the more likely that such trauma will cause negative health outcomes in those individuals as adults. Meek Mill makes it clear in “Trauma” that African American children that grow up in US urban centers face a dramatic number of ACEs throughout their young lives. This chapter, using “Trauma’s” framework, will not only acknowledge the built-in Adverse Childhood Experiences for those that grow up poor and black in America, but also argues that the criminal justice system itself, particularly law enforcement culture in the United States, stands as an Adverse Childhood Experience in and of itself.
The US South is the epicenter of the epidemic of mass incarceration. Prisons have experienced substantial challenges in preventing COVID-19. Incarcerated individuals and prison staff are at a high risk for infection due to minimal available preventive measures. Prisons are not closed systems and many staff come from communities in close proximity to the facility. Characteristics of the communities immediately surrounding prisons are an overlooked but critical factor to better understand the role prisons play in pandemics.
We used facility-level COVID-19 data from the COVID Prison Project to identify the number of unique outbreaks between May 2019 and May 2020. We used a county-level composite indicator of economic distress (DCI score) to identify the environment surrounding each prison (2015–2019). We modeled the number of outbreaks to DCI scores using negative binomial regression, adjusting for race/ethnicity (African American and Latino/Hispanic), age (65 and older), and rurality level.
Our sample included 570 prisons in 368 counties across 13 Southern states. We found that score was positively and significantly associated with prison COVID-19 outbreaks (aRR, 1.012; p < 0.0001), and rurality was potentially a stronger surrogate measure of economic distress (aRR, 1.35; p, 0.02). Economic stability is a key precursor to physical health. Poorer communities have been disproportionately impacted by the pandemic, and we found that prisons located in these communities were more susceptible to recurring outbreaks. Prison-based disease prevention interventions should consider the impact that the outside world has on the health of incarcerated individuals.
This chapter examines the paradigmatic discourses about emotions of White abolitionism and during the “disintegration” of legal slavery in the Atlantic world. This chapter highlights the mutations of ideas of “feelings” in the "post-emancipation” era and their role in the continuation of slavery, while also addressing the escalation of emotional archetypes of race and slavery in twentieth-century media.
The tropes of bondage that pervade Emily Dickinson’s lyric poems were significant to contemporary American accounts of the lyric and its relation to individual liberty. Dickinson is often held up as the paradigmatic lyric poet: reclusive, but unbounded in her imagination; pure voice, speaking on the other side of the door. Dickinson herself returns endlessly to tropes of the prison, chains and bonds. At times she even expresses a sadistic delight in imagining the torture of others. The chapter argues that, given the convulsions of her time and her family’s direct political engagements with the Kansas-Nebraska Act, the Fugitive Slave Act and the Civil War, it is surprising that slavery is almost entirely absent from Dickinson’s poetry. The chapter reflects on the tropes of incarceration or bondage in Dickinson’s poetics, to consider what the missing slave means for the model of lyric that she has come to represent.
This chapter turns to the sorrow songs, beginning with the famous passage from Frederick Douglass’s autobiographies. It focuses on the ethnography of African American song traditions in the late nineteenth and early twentieth centuries, a period of professionalisation of folklore studies in the American academy. White folklorists claimed the songs were irrational, primitive, childlike, unmediated expressions of feeling; other qualities were discovered by African American ethnographers, including Zora Neale Hurston. The songs were also forms of exploitative labour. The chapter includes a reading of Paul Laurence Dunbar’s poem ‘A Corn Song’. Dunbar’s shifts between African American vernacular and ‘standard’ English illuminate the tendency of white folklorists to call attention to the failure of the printed and disembodied textual transcription to transmit the real power of the performed lyric. The chapter considers the attempt to secure an ‘authentic’ Black sound through recordings in prisons and labour camps. It also challenges the notion of authenticity through a reading of Olio by Tyehimba Jess, a work that seeks to recover – through a form of poetic ventriloquy – the thoughts and feelings of the artists whose work was appropriated by white critics, scholars and producers in this period.
While multicultural policy might be represented as a failure, or multicultural reality as threatening, the Gothic – as a psychoanalytic mode with a ready shorthand for the representation of violence, alienation and monstrosity – is ideally suited to return what mainstream discourse represses, to engage with the subject of fear and to speak the unspeakable. This chapter demonstrates how contemporary Gothic literature functions to reveal that which multicultural discourse seeks to repress: racism and inequality. I argue that alternative accounts of cultural contact foreground socio-economic inequality, racism and structural violence, while registrations of the impossible and the absurd function to signify a failure in discourse. The Gothic aesthetic is equally suited to represent sectarian violence as a source of fear through the literalisation of monstrosity, and I argue that in engaging with the mechanics of monster-making, contemporary Gothic offers a critique of the construction of fear (and terror) as a tool of (rather than a threat to) governments. Finally, I consider contemporary Gothic’s engagement with the afterlife as a space of multicultural harmony, equality and justice, holding a heterotopic mirror up to the inequalities of the present in which the management of diversity is hostage to political corruption and economic disparity.