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International Journal of Prisoner Health
Number of Followers: 8  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1744-9200 - ISSN (Online) 1744-9219
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  • Measuring the quality of life of incarcerated individuals
    • Pages: 1 - 13
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 1-13, March 2019.
      Purpose Measuring quality of life (QoL) under incarceration can be used to track successful rehabilitation and risk of re-offending. However, few studies have measured QoL among general incarcerated populations, and it is important to use psychometrically strong measures that pose minimal burdens to respondents and administrators. The paper aims to discuss these issues. Design/methodology/approach The aim of this analysis was to explore the utility of a short generic tool measuring overall QoL, the QOL5, in an incarcerated population. The authors drew data from the Norwegian Offender Mental Health and Addiction Study, a cross-sectional survey of 1,499 individuals from Norwegian prisons. Findings Factor analysis suggested a unidimensional structure that explained 53.2 percent of variance in QoL scores. Intrascale correlations were high and internal consistency was acceptable (α=0.764). The QOL5 was strongly correlated with mental health, moderately correlated with exercise frequency and weakly correlated with ward security. Practical implications The QOL5 is a short measure that presents minimal burden to respondents and administrators. The authors recommend its further use in incarcerated populations to measure overall QoL as well as cross-cultural adaptation and validation in more languages. Originality/value In this analysis of the largest published sample to date of incarcerated individuals and their QoL, the QOL5 appears to be an acceptable and valid measure of overall QoL.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-04T10:04:15Z
      DOI: 10.1108/IJPH-02-2018-0005
  • Mental healthcare interfaces in a regional Irish prison
    • Pages: 14 - 23
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 14-23, March 2019.
      Purpose The purpose of this paper is to study the demographic, clinical characteristics and outcomes for those prisoners referred to secondary mental healthcare in a regional Irish prison and the proportion of individuals diverted subsequently from prison to psychiatric settings. Design/methodology/approach The authors conducted a retrospective review of 130 successive psychiatric assessment case records at a regional mixed gender prison serving six southern Irish counties. The authors analysed demographics, clinical characteristics and outcomes. Where diversion out of prison was undertaken, Dangerousness, Understanding, Recovery and Urgency Manual (DUNDRUM) scores were retrospectively completed to assess security need. Findings In total, 8.6 per cent of all committals from liberty were referred by a general practitioner and 8.1 per cent subsequently assessed by the visiting psychiatrist. Predominantly, these were young males charged with a violent offence. In all, 42.2 per cent of those assessed by secondary care were diagnosed with a substance misuse disorder and 21.1 per cent with a personality disorder. In total, 20.3 per cent suffered from a psychotic disorder and 10.6 per cent with an affective disorder. Of those seen by psychiatric services, 51.2 per cent required psychotropic medication, 29.2 per cent required psychological input and 59.3 per cent required addiction counselling. In all, 10.6 per cent of those assessed were diverted from prison, the majority to approved centres. Mean DUNDRUM-1 scores suggested that those referred to high and medium secure hospitals were appropriately placed, whereas those diverted to open wards would have benefited from a low secure/intensive care setting. Originality/value The multifaceted need set of those referred strengthens the argument for the provision of multidisciplinary mental healthcare into prisons. The analysis of security needs for those diverted from prisons supports the need for Intensive Care Regional Units in Ireland.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-02-20T12:06:03Z
      DOI: 10.1108/IJPH-06-2017-0029
  • Identification of service development needs for incarcerated adults with
           autism spectrum disorders in an Australian prison system
    • Pages: 24 - 36
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 24-36, March 2019.
      Purpose The purpose of this paper is to identify and deliberate the service development needs required for the improvement of service provision for incarcerated adults with autism spectrum disorder (ASD) in NSW, Australia. Design/methodology/approach Consultation groups were conducted to bring together n=5 key stakeholders from heath and correctional-based services in the prison system. A facilitated asynchronous e-mail-based discussion occurred amongst group members between consultation group meetings. Findings Two main themes were identified: detecting persons with ASD and providing appropriate care. Participants discussed current service gaps with regard to the identification of people with ASD at the point of contact with the prison service, and the difficulties associated with diagnosing prisoners with ASD. The need for effective alert systems to detect persons with ASD in custody was identified. The current absence of ASD-specific support services in prison was highlighted, and recommendations for improvement suggested. Practical implications Current health and correctional-based service provision failed to adequately support incarcerated adults with ASD. Improvements in prison-entry screening processes, alert systems and diagnostic practices are required. Multidisciplinary collaboration between prison-based and external service providers is required for the development of a model of care based on individualised case management to adequately support incarcerated adults with ASD in prison. Originality/value Given the lack of reported service provision for incarcerated adults with ASD internationally, other prison-based services are likely to experience similar service development needs and see the relevance of the recommendations made directly from the study findings.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-04T10:04:20Z
      DOI: 10.1108/IJPH-11-2017-0051
  • Challenges to mothering while incarcerated: preliminary study of two
           women’s prisons in Java, Indonesia
    • Pages: 37 - 45
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 37-45, March 2019.
      Purpose The purpose of this paper is to present the characteristics of incarcerated women in two prisons in Java, Indonesia and discuss the specific problems and needs incarcerated women with children face with regard to mothering. Design/methodology/approach A cross-sectional survey using a semi-structured questionnaire was administered to 399 incarcerated women in two prisons. Focus group discussions provided additional information on mother’s experiences in prison. Findings This research finds that children’s welfare was an important concern for mothers while in prison and that they faced various problems in maintaining family ties during their incarceration, including distance, costs and time for family to visit (49.3 percent), and challenges to being able to communicate with family and children (26.6 percent). Originality/value This study contributes to the limited research on incarcerated women in Indonesia, broadly, and on mothering and incarceration, in particular, and suggests that women’s needs as mothers have not been taken into consideration by prisons and the criminal justice system.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-04T10:04:02Z
      DOI: 10.1108/IJPH-06-2017-0031
  • An evaluation of Take Home Naloxone program implementation in British
           Columbian correctional facilities
    • Pages: 46 - 57
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 46-57, March 2019.
      Purpose To understand how the Take Home Naloxone (THN) program is implemented in two pilot correctional facilities in British Columbia (BC), Canada, in order to identify areas for program improvement and inform the expansion of the program to other Canadian correctional facilities The paper aims to discuss these issues. Design/methodology/approach Two focus groups and one interview were conducted with healthcare staff at two pilot correctional facilities. Sessions were audio recorded, transcribed verbatim and divergent and convergent experiences within and between the facilities were explored in an iterative process. Key themes and lessons learned were identified and later validated by focus group participants. Findings Key themes that emerged included: challenges and importance of the train-the-trainer program for healthcare staff conducting participant training sessions; potential for improved prison population engagement and awareness of the program; tailoring program resources to the unique needs of an incarcerated population; challenges connecting participants to community harm reduction resources following release; and clarifying and enhancing the role of correctional officers to support the program. Research limitations/implications The correctional setting presents unique challenges and opportunities for the THN program that must be considered for program effectiveness. Originality/value This evaluation was conducted to inform program expansion amidst a historic opioid overdose epidemic in BC, and adds to the limited yet growing body of literature on the implementation and evaluation of this program in correctional settings globally.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-02-20T12:11:43Z
      DOI: 10.1108/IJPH-12-2017-0058
  • High frequency of HBV in HIV-infected prisoners in Mozambique
    • Pages: 58 - 65
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 58-65, March 2019.
      Purpose The purpose of this paper is to determine the prevalence of hepatitis B virus (HBV) among 448 HIV-infected prisoners from 32 prisons in Mozambique. Design/methodology/approach All HIV seropositive prisoners were screened for HBV. Findings Of the 448 HIV seropositive prisoners, 51 (11.4 percent, 95%CI: 9.3–13.9 percent) were HBsAg-positive and was significantly higher in prisoners aged
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-04T10:04:18Z
      DOI: 10.1108/IJPH-11-2017-0056
  • The psychiatric management of prisoners on hunger strike: developing a
           management algorithm using the Delphi technique
    • Pages: 66 - 75
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 66-75, March 2019.
      Purpose The assessment and management of prisoners on hunger strikes in a custodial setting is complex. There is limited clinical guidance available for psychiatrists to draw upon in such cases. The purpose of this paper is to develop a management algorithm through expert elicitation to inform the psychiatric care of prisoners on a hunger strike. Design/methodology/approach A Delphi method was used to elicit views from Irish forensic psychiatrists, a legal expert and an expert in ethics using a structured questionnaire. Themes were extracted from the results of the questionnaire to propose a management algorithm. A consensus was reached on management considerations. Findings Five consultant forensic psychiatrists, a legal expert and an expert on psychiatric ethics (n=7) consented to participation, with a subsequent response rate of 71.4 per cent. Consensus was achieved on a proposed management algorithm. Assessment for mental disorder, capacity to refuse food and motivation for food refusal are seen as key psychiatric tasks. The need to work closely with the prison general practitioner and the value of multidisciplinary working and legal advice are described. Relevant aspects of law included mental health, criminal law (insanity) and capacity legislation. Originality/value This study outlines a management algorithm for the psychiatric assessment and management of prisoners on a hunger strike, a subject about which there is limited guidance to date. Although written from an Irish perspective, this study outlines key considerations for psychiatrists in keeping with international guidance and therefore may be generalisable to other jurisdictions.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-02-20T03:40:17Z
      DOI: 10.1108/IJPH-06-2017-0030
  • Constructing positive narrative identities in a forensic setting: a single
           case evaluation of phototherapy
    • Pages: 76 - 90
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 76-90, March 2019.
      Purpose The purpose of this paper is to evaluate the use of a phototherapeutic technique called “Talking Pictures” within the forensic setting. This approach involves the use of a set of photographs to facilitate clients’ disclosure, self-growth and promote the development of positive self-narratives. The use of art therapies and the construction of adaptive identity narratives have been proven to support desistance and increase resocialization in the prison population. Design/methodology/approach A 42-year-old Italian male offender was met for six therapy sessions and invited to talk about his past, present and future through the use of photographs. Session transcripts were analysed using the software for linguistic analysis T-LAB. Findings Results show a progression in the language used during the sessions: in the beginning the client uses a denotative language with many concrete nouns and no emotional words, in subsequent sessions his speech begins to assume more symbolic connotations and emotional words are used to describe past traumas as well as to find new meanings to present events. Moreover, the fixity of the client’s self-image is contrasted with the emergence of new sides to his personality encompassing agency and self-worth. Research limitations/implications The study is based on a single case, therefore results cannot be generalised to the prison population; moreover, the absence of any follow-up and standardized measurements of the client’s progression should be addressed by future research by both involving larger samples and including follow-up and quantitative measures of the study results. Practical implications The paper provides details on an innovative technique that might be used to explore the offenders’ goods and values and to develop truly redemptive rehabilitation programmes. Originality/value This paper adds to the scant literature on phototherapy in prisons and connects it with a reflection on desistance indicating that phototherapeutic interventions might be used to promote positive self-narratives, thus increasing desistance.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-04T10:04:18Z
      DOI: 10.1108/IJPH-11-2017-0057
  • Mental health and wellbeing benefits from a prisons horticultural
    • Pages: 91 - 104
      Abstract: International Journal of Prisoner Health, Volume 15, Issue 1, Page 91-104, March 2019.
      Purpose In the context of current prison safety and reform, the purpose of this paper is to discuss findings of an impact evaluation of a horticultural programme delivered in 12 prisons in North West England. Design/methodology/approach The programme was evaluated using quantitative and qualitative methods, including Green Gym© questionnaires, the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) and Biographic-Narrative Interpretive Method interviews. Findings Against a backdrop of high rates of suicide, self-harm and poor mental health, the horticultural programme studied proved beneficial to prisoner participants, the most marked effect was on mental health and wellbeing. In addition to data related to the original mental health outcome indicators, the study revealed multiple layers of “added value” related to mental health arising from horticultural work in a prison setting. Research limitations/implications The main research limitations were the limited completion of follow-on questionnaires due to prisoners being released and the inability to conduct longitudinal data collection post-release. There was also concern about response bias and lack of resource to compare with the experience of prisoners not participating in the programme. Social implications Positive impacts on prisoners’ mental health and wellbeing included increased confidence, social interactions with staff and other prisoners and gaining skills and qualifications and work experience, increasing potential for post-release employment. Originality/value Benefits of horticulture work on health are well established. However, to date, there is little research concerning the effects this work may have on mental wellbeing of prisoners both within prisons and more so upon their release back into the community.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-04T10:04:19Z
      DOI: 10.1108/IJPH-11-2017-0055
  • A conceptual model on reintegration after prison in Norway
    • Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Many offenders struggle when attempting to reintegrate into society after release from prison, and the conditions they face after release often lead to reoffending. The purpose of this paper is to present a conceptual model on reintegration after prison. The model has the potential to guide practitioners in their understanding of the relationships between welfare services and the agency of the offender. Design/methodology/approach The model was developed from a small-scale study in the Norwegian Criminal Justice system, which is well known for its emphasis on rehabilitation and crime prevention. Data collection aimed to explore the reintegration process from the perspective of the hard-to-reach and vulnerable population of serial offenders. Nine prisoners in two different prisons were interviewed. A thematic analysis identified two main themes that related, first, to the personal challenges the offenders faced in the rehabilitation and reintegration process and, second, to the factors in the welfare services that interacted with the prisoners’ psychosocial issues in the reintegration process. Findings Findings suggest that the interaction between the psychosocial needs of the prisoners and the organization of the welfare services is complex and does not harmonize. The findings underpin the argument that the current reintegration strategies for certain groups of inmates need to be questioned and challenged. Research limitations/implications The model is a conceptual model intended to provide a lens from which to reinterpret offenders’ experiences of reintegration and applied to only the small and exploratory study described in this paper. As such, it requires further testing and substantiation, and the model and the study’s findings should be regarded as tentative and cannot be generalized to a larger population. The prisoners were selected by the first author for convenience, and it is possible that this also influenced the findings. Other inmates may have presented other experiences. Originality/value There are few studies looking into reintegration from the reoffenders’ perspective, and this study also presents a model that serves as a reflective and analytical tool to developing new approaches to supporting offenders in their reintegration into society from prison in the future.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-05-31T07:44:43Z
      DOI: 10.1108/IJPH-06-2018-0032
  • A cross-sectional evaluation of opt-in testing for sexually transmitted
           and blood-borne infections in three Canadian provincial correctional
           facilities: a missed opportunity for public health'
    • Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Incarceration provides an opportunity for screening and treatment of sexually transmitted and blood-borne infections (STBBIs) in high-risk groups. The purpose of this paper is to determine positivity rates of STBBI screening within correctional facilities using opt-in strategies and estimate the proportion of admissions tested. Design/methodology/approach A cross-sectional, retrospective review of testing data from January 2012 to August 2015 from three provincial correctional facilities located in Alberta, Canada was completed. Analysis variables included STBBI, gender, facility, collection year and age. STBBI-stratified analysis was performed to identify correlates for positivity using univariate and logistic regressions. Findings Overall prevalence of chlamydia was 11.2 percent and gonorrhea was 3.5 percent; correlates for both were younger age and facility type. The syphilis prevalence rate was 3.2 percent; correlates included being female, older age, adult facilities, with later years being protective. In total, 14 (0.3 percent) newly diagnosed HIV cases were found, prevalence increased with age. HBV prevalence was 1.7 percent with no significant correlations. Nearly one-tenth (n=422) of those screened for HCV antibody were positive; all variables were significantly correlated. Overall estimates of the proportion of admissions tested by STBBI were low and ranged from 4.8 to 16.1 percent. Originality/value This study found high rates of STBBI in correctional facilities and showed that only a small proportion of the population was tested using an opt-in strategy. Shifting to an “opt-out” strategy may be warranted.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-05-31T07:38:42Z
      DOI: 10.1108/IJPH-07-2018-0043
  • Quality of prison life, violence and mental health in Dubrava prison
    • Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose The purpose of this paper is to explore the association between the quality of prison life and mental health among prisoners and the occurrence of violence. Design/methodology/approach In total, 203 prisoners from Dubrava Correctional Center in Kosovo participated. Data on background characteristics of the prisoners, quality of prison life, mental health symptoms and exposure to physical, psychological and sexual violence were collected through interviewer-administered questionnaires. Data were analyzed using general linear models (GLM) and manual backwards model search with step-wise exclusion. Findings The GLM analysis showed a significant negative association between anxiety symptom load (−1.4), physical violence (−1.5) and psychological violence (−1.9), and quality of prison life. Furthermore, it appeared that prisoners rating of quality of life (QoL) increased with time among prisoners not exposed to violence, while this was not seen among prisoners exposed to violence. Finally, there was an inverse association between the dimensions of respect, fairness, humanity and good staff/prisoner relations, and the proportion of prisoners exposed to violence. Originality/value An environment with higher levels of respect, fairness, humanity and good relations between staff and prisoners was associated with lower levels of violence. Hence, a prison that focuses on promoting QoL and good mental health among prisoners will show lower levels of violence, thereby making the prison a more tolerable place for the prisoners and a better working environment for prison staff.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-05-31T07:34:02Z
      DOI: 10.1108/IJPH-10-2017-0047
  • Polypharmacy and drug-drug interactions among older and younger male
           prisoners in Switzerland
    • Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose The purpose of this paper is to determine the prevalence of polypharmacy and drug–drug interactions (DDIs) in older and younger prisoners, and compared if age group is associated with risks of polypharmacy and DDIs. Design/methodology/approach For 380 prisoners from Switzerland (190 were 49 years and younger; 190 were 50 years and older), data concerning their medication use were gathered. MediQ identified if interactions of two or more substances could lead to potentially adverse DDI. Data were analysed using descriptive statistics and generalised linear mixed models. Findings On average, older prisoners took 3.8 medications, while younger prisoners took 2.1 medications. Number of medications taken on one reference day was higher by a factor of 2.4 for older prisoners when compared to younger prisoners (p = 0.002). The odds of polypharmacy was significantly higher for older than for younger prisoners (>=5 medications: odds ratio = 5.52, p = 0.035). Age group analysis indicated that for potentially adverse DDI there was no significant difference (odds ratio = 0.94; p = 0.879). However, when controlling for the number of medication, the risk of adverse DDI was higher in younger than older prisoners, but the result was not significant. Originality/value Older prisoners are at a higher risk of polypharmacy but their risk for potentially adverse DDI is not significantly different from that of younger prisoners. Special clinical attention must be given to older prisoners who are at risk for polypharmacy. Careful medication management is also important for younger prisoners who are at risk of very complex drug therapies.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-15T11:21:39Z
      DOI: 10.1108/IJPH-07-2018-0040
  • Animal-assisted therapy in a Canadian psychiatric prison
    • Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Prison-based animal programs are becoming increasingly common in North America. The majority focus on community and animal well-being, with less explicit therapeutic goals for human participants. The purpose of this paper is to measure the objectives of a canine animal-assisted therapy (AAT) program in a Canadian psychiatric prison and examine whether the program supports inmates’ correctional plans. Design/methodology/approach A modified instrumental case study design was applied with three inmates over a 24-AAT-session program. Quantitative and qualitative AAT session data were collected and mid- and end-of-program interviews were held with the inmates, their mental health clinicians and the therapy dog handlers. Findings Inmates connected with the therapy dogs through the animals’ perceived offering of love and support. This development of a human–animal bond supported inmates’ correctional plans, which are largely situated within a cognitive-behavioral skill development framework. Specifically, inmates’ connections with the therapy dogs increased recognition of their personal feelings and emotions and positively impacted their conduct. Research limitations/implications The findings suggest that prison-based AAT programs emphasizing inmate mental well-being, alongside that of animal and community well-being generally, merit further exploration. It would be worthwhile to assess this AAT program with a larger and more diverse sample of inmates and in a different institutional context and also to conduct a post-intervention follow-up. Originality/value This is the first study of a prison-based AAT program in a Canadian psychiatric correctional facility.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-01T02:30:08Z
      DOI: 10.1108/IJPH-04-2018-0020
  • Exploring HIV infection in a UK vulnerable prisoner population in response
           to newly identified cases
    • Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Prison populations are considered at elevated risk of blood borne virus (BBV) transmission. Between December 2015 and February 2016, four new cases of HIV infection were diagnosed across two male vulnerable prisoner (VP) custodial units in Wales, UK. Cases were identified through routine BBV testing. The paper aims to discuss these issues. Design/methodology/approach As a result of identifying four new HIV cases, targeted BBV testing across the VP units using dried blood spot testing for HIV, Hepatitis C (HCV) and Hepatitis B was undertaken. Findings A total of 617 men were offered testing, 256 (41 per cent) were tested. No further cases of HIV were identified. Eight men were identified as HCV antibody positive. There was no evidence to suggest the four original cases of HIV were linked. Practical implications Embedding universal BBV screening within prison health provision will ensure timely identification of cases. Further research is needed to better understand BBV transmission risks within subsets of the prison population such as the VP and sex offending groups. Originality/value Little is known about the prevalence of BBVs in vulnerable prison populations. The findings add to the knowledge available for practitioners in the field.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-02-27T08:29:13Z
      DOI: 10.1108/IJPH-03-2018-0010
  • Behind prison walls: HIV vulnerability of female Filipino prisoners
    • Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose The imprisoned population is increasing worldwide and is overrepresented in the HIV epidemic. The purpose of this paper is to explore the HIV vulnerability of female Filipinos who are pre-trial prisoners, as the specific needs of imprisoned women are poorly understood and fewer resources are granted to pre-trial detainees, especially in low and middle-income countries (LMICs). Design/methodology/approach This study was based on a Qualitative Descriptive Design. In total, 18 semi-structured interviews were conducted with prisoners and NGO directors. Data were analysed through Framework Analysis, using the individual, social and community categories of the Modified Socio-Ecological Model. Findings Results from this study suggest that the prison environment and management practices maximise the HIV vulnerability in the sample. This vulnerability is shaped by low HIV knowledge, combined with the existence of multiple social vulnerabilities prior to incarceration. Social implications HIV care in Filipino prisons needs urgent attention from government and international organisations, as it is a major public health and human rights concern. International goals of ending the epidemic by 2030 cannot be reached if efforts are not translated into action within this setting. Originality/value In the Philippines, few studies have addressed this issue and little is known about the conditions of Filipino prisons. This paper aims to fill a gap in literature regarding the vulnerability of imprisoned women in LMICs, which is even more limited in examining pre-trial detention.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-02-26T12:42:09Z
      DOI: 10.1108/IJPH-12-2017-0060
  • Trends in addiction treatment in Irish prisons using national surveillance
           data, 2009–2014
    • First page: 105
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Many studies show that incarcerated populations have higher rates of problem drug use than the general population. The purpose of this paper is to analyse trends in addiction treatment demand in prisons in Ireland from 2009 to 2014 using available national surveillance data in order to identify any implications for practice and policy. Design/methodology/approach National surveillance data on treatment episodes for problem drug and alcohol use from 2009 to 2014, collected annually by the National Drug Treatment Reporting System (NDTRS), were analysed. Findings In total, 6 per cent of all treatment episodes recorded by the NDTRS between 2009 and 2014 were from prison services. The number of prison service treatment episodes increased from 964 in 2009 to 1,063 in 2014. Opiates were the main reason for treatment, followed by alcohol, cocaine and cannabis. The majority (94–98 per cent) of treatment episodes involved males (median age of 29 years) and low educational attainment, with 79.5–85.1 per cent leaving school before completion of second level. The percentage of treatment episodes with a history of ever injecting drugs increased from 20.9 per cent in 2009 to 31.0 per cent in 2014. Practical implications This study can help policy development and service planning in addiction treatment in prison as it provides an insight into the potential needs of incarcerated populations. It also provides a baseline from which to measure any changes in provision of treatment in prison over time. Originality/value This is the first study to analyse treatment episodes in prison using routine surveillance data in Ireland. Analysis of these data can provide useful information, not currently available elsewhere.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-01T02:28:59Z
      DOI: 10.1108/IJPH-02-2018-0006
  • Offenders’ perceptions of the UK prison smoking ban
    • First page: 114
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Despite overall reductions in levels of smoking in the UK, rates of offender smoking remain high. In 2016, it was announced that prisons in England and Wales would gradually introduce a smoking ban. The purpose of this paper is to explore offenders’ perceptions around the upcoming smoking ban. Design/methodology/approach A total of eight focus groups were conducted in four prisons across the North of England. Both smoking and non-smoking offenders participated in the focus groups, and thematic analysis was used to explore the findings. Findings Themes generated from the data were “freedom and rights”, “the prison environment” and “guiding support”. Participants discussed how the smoking ban was viewed as a punishment and restricted their freedom, with perceptions as to why the ban was being implemented centring around others trying to control them. Participants expressed concerns around the financial implications of the smoking ban on already stretched prison resources. Participants also recommended improving the nicotine replacement therapy on offer, and increasing the range of leisure activities within the prison to prepare for the smoking ban. Originality/value Overall, it was apparent that participants’ awareness of the smoking ban was generally poor. It is recommended that offenders need to be made more aware of the smoking cessation support they will receive and given the opportunity to ask questions about the smoking ban. Increasing offenders’ awareness of the ban may reduce stress associated with a perceived lack of choice around their smoking behaviours.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-02-26T12:23:22Z
      DOI: 10.1108/IJPH-06-2018-0034
  • Promoting gender responsive support for women inmates: a case study from
           inside a prison
    • First page: 126
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Most women who serve time in prison will eventually be released and expected to reintegrate back into society. To maximize the chances of success, careful support is usually required. An example of this support work was the Healthy Relationships Program (HRP, 2016) offered to women inmates of the Adelaide Women’s Prison (South Australia) pre-release. The content of the HRP was influenced by a gender-responsive framework and constructed as a social work program. The purpose of this paper is to report on a small qualitative study that used semi-structured interviews pre- and post-program to explore women participants’ expectations, perceptions and experiences of the program. In this paper, the focus is on the women inmates’ interview transcripts where a thematic analysis was conducted. Two main research questions drove this analysis. First: How did the women experience the HRP' Second: What does their reported experience reveal about the ongoing need for gender-responsive support' The key findings are that domestic violence and relationships with children are strong motivators for participation in programs; therefore, gender-responsive support is still required in prison programs. However, the paper also advocates that future iterations of gender-responsive support and social work interventions become more consciously intersectional feminist in orientation. Design/methodology/approach A qualitative design was used to explore what women thought the HRP taught them. Individual face-to-face interviews were used to explore women’s perceptions, ideas and experiences of healthy relationships. Thematic analysis was used to draw out the themes across interviews. Findings The key arguments made are that gender-responsive support is still required but that future iterations of gender-responsive support become more consciously intersectional feminist in orientation. Research limitations/implications The researchers experienced strict time restrictions to conduct interviews and therefore depth was somewhat compromised. To try and compensate for this restriction, the researchers visited potential participants as part of program recruitment and information sharing to help enable and build general rapport before the interviews. Time restrictions and prison security protocols did not allow for researchers to check transcripts with the women. Practical implications Reporting on this case study also showed that social work practice can influence relationships with institutions, such as prisons, that perpetrate marginalization and therefore enable a setting that facilitates safe participation in programs. Social implications Gender-responsive frameworks provide the much needed validation of gender differences, but also require a feminist intersectional lens to more consciously aid in the conceptualization and evaluation of future programs for women in prison. It is this intersectional lens that is more likely to bring multiple experiences of oppression into focus so that personal issues and problems can be analyzed in a richer wider social context, particularly intersections between gender, class and/ethnicity race. Originality/value This paper has reported on women’s expectations and experiences of a health relationships program and provides insight and learnings for future practitioners intending to run similar programs. Overall, the women participants were able to articulate their own personal learnings about interpersonal relationships and were able to acknowledge the impacts of abuse and violence in their lives in the program.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-02-27T03:22:39Z
      DOI: 10.1108/IJPH-03-2018-0011
  • Comparative study between prison- and community-based treatment
           satisfaction for opioid use disorder in Lebanon
    • First page: 138
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Opioid substitution treatment (OST), such as Buprenorphine, has become a well-established evidence-based approach for the treatment of inmates with opioid use disorder (OUD) in most of the developed world. However, its application in Lebanon remains mainly as a community-based intervention. The purpose of this paper is to highlight the need of its implementation within the Lebanese correctional system. Design/methodology/approach The work is a pilot cross-sectional study that compares two groups: 30 male adult prisoners with OUD convictions receiving symptomatic treatment and 30 male adult community patients with OUD receiving Buprenorphine. The objective was to measure the difference in the patients’ general perception and satisfaction of the treatments available. OUD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria and the level of satisfaction was measured by “Treatment Perceptions Questionnaire (TPQ).” Findings The prison group reported significantly lower satisfaction when compared to the community group (total TPQ mean scores: M=34.73, SD =4.12 and M=16.67, SD =4.78, respectively, with t (56.76) =15.68, p=0.000). Furthermore, age, marital status, education level and elapsed time in treatment had no significant interactions with the total TPQ score. Originality/value The major principles of the ethics of care and evidence-based safe practices will be proposed for the introduction of Buprenorphine to Lebanese prisons. This work provides an opportunity for the expansion of the Lebanese OST program and consequently other countries in the region could benefit from this experience.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-02-28T03:38:29Z
      DOI: 10.1108/IJPH-12-2017-0064
  • Comparing health status, disability, and access to care in older and
           younger inmates in the New South Wales corrections system
    • First page: 153
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose The purpose of this paper is to compare the rates of chronic illness, disability and access to care between older and younger inmates who took part in a large epidemiological study in New South Wales, Australia. Design/methodology/approach Data are presented from a cross-sectional study based on a sample of inmates from correctional sites in NSW. The inclusion of results here was guided by the literature with regard to their relevance to older people, and older inmates in particular. Findings Results indicate that a higher proportion of older inmates suffer a range of chronic illnesses, with prevalence often many times higher than that of younger inmates. Older inmates are more likely to be classified as disabled and have a disability which impacts their mobility. Older inmates also reported accessing medical services in prison more recently than younger inmates and were more likely to have seen both nurses and general practitioners. Practical implications Older inmates appear to be considerably more resource intensive than younger inmates. The increasing proportion of inmates who are classified as older thus poses a pressing challenge to those working in the carceral space and, in particular, those responsible for providing healthcare to incarcerated people. Originality/value The impact of aging prisoners on resource demand has yet to be effectively measured. This study provides an important first step towards that goal.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-11T08:37:02Z
      DOI: 10.1108/IJPH-04-2018-0017
  • Hepatitis B and Hepatitis C in prisons: a prevalence study
    • First page: 162
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Prisons, which are hazardous places for various contagious diseases, carry additional risks for HBV and HCV because of the communal lifestyle (common use of tools like razor blades, tattoo applications, intravenous drug use and homosexual intercourse). The purpose of this paper is to determine the prevalence of HBV and HCV, and also provide information for prisoners in this respect. Design/methodology/approach This study included 180 prisoners from the Buca F-Type Closed Prison, and 180 prisoners from the Foça Open Prison in Turkey. After the training seminars, serum levels of HBsAg, anti HBs, anti HBc total and anti HCV in the prisoners were assessed using the MICROELISA method. Findings All the prisoners were male. The mean age was 40(21–73) years. According to the results of 360 prisoners from both prisons, 17 (4.7 percent) prisoners were HBsAg positive and were diagnosed as HBV. Isolated anti HBs was positive in 33 (9.1 percent) prisoners who had been previously vaccinated. In 25 (6.9 percent) prisoners isolated Anti HBc total was positive, and in 61 (16.9 percent) prisoners both Anti HBs and Anti HBc total was positive in those who were considered to be recovered from the HBV. Anti HCV was positive in 2 (0.5 percent) prisoners; the process was repeated twice, and found to be repeatedly positive. Coinfection of HBV and HCV was not detected. Research limitations/implications In this study, the prevalence of HBV and HCV was determined to be similar to those in the normal population. However, it is not expedient to generalize this result and apply it to all prisons. For the sake of public health, prisons should be scanned for infectious diseases, and vaccinations must be applied as necessary, in order to provide protection. Originality/value It is a study to determine the prevalence of HBV and HCV in the prisoner population, which constitute one of the risk groups because of the communal lifestyle (common use of some tools such as the razor blade, tattoo applications, intravenous drug use and homosexual intercourse), and to compare the results with other groups in Turkey and globally.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-01T08:28:49Z
      DOI: 10.1108/IJPH-01-2018-0004
  • Effect of age, time spent in prison and level of education on the
           perceived health and quality of life of elderly prisoners
    • First page: 168
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose The purpose of this paper is to assess the level of perceived health and quality of life of elderly prisoners in France, and to see whether there is a link between aging, time spent in prison and level of education and scores for perceived health and quality of life. Design/methodology/approach The authors’ recruited 138 male prisoners aged 50 and over in seven French prisons. The research protocol comprised a semi-structured interview and two scales. Findings The results revealed low levels of perceived health and quality of life among the elderly inmates. They also showed that age was not statistically associated with most of the dimensions of perceived health on the Nottingham Health Profile (NHP), with the exception of poor mobility. By contrast, age was statistically associated with most of the dimensions of quality of life on the WHOQOL-Bref. Time spent in prison was only associated negatively with the “sleep” dimension of the NHP. Emotional reactions were perceived most positively by the inmates with the highest level of education. Practical implications It seems particularly important to assess the perceived health and quality of life of elderly prisoners in order to ensure their appropriate treatment and management. Originality/value Very few studies have examined the perceived health and quality of life of prisoners, even though this population is particularly vulnerable in terms of physical and mental health.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-12T03:23:03Z
      DOI: 10.1108/IJPH-09-2018-0048
  • Changes in subjective wellbeing of prisoners on remand
    • First page: 181
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose Low levels of subjective wellbeing in prisoners may relate to mental health problems and difficulties in reintegration after imprisonment. The development of subjective wellbeing during imprisonment is mostly unclear. The purpose of this paper is to explore this development in a longitudinal study in association with mental disorders and socioeconomic factors. Design/methodology/approach Subjective wellbeing was assessed via a visual analogue scale and retrieved at admission to remand prison and then again after four and eight weeks. Changes in subjective wellbeing between time-points were analyzed taking into account mental disorders and socioeconomic factors, which were assessed by use of the Mini International Neuropsychiatric Interview – Plus and the Camberwell Assessment of Need – Forensic Version, respectively. Findings On average, subjective wellbeing declined directly after remand prison admission, but differences between individuals were found. At remand prison admission, subjective wellbeing significantly improved rather than declined in prisoners with alcohol and substance use disorders, housing problems, unemployment prior to incarceration and in relatively older prisoners. Other related factors did not add significance to this model. In contrast, during remand imprisonment subjective wellbeing displayed an overall increase. For this increase, no predicting factors were found. However, prisoners with an antisocial personality disorder are more at risk of experiencing a decrease in wellbeing during remand imprisonment. Originality/value In general, the Dutch prison system appears not to result in a decrease in subjective wellbeing in prisoners suffering from a mental disorder during remand imprisonment.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-11T08:43:02Z
      DOI: 10.1108/IJPH-01-2018-0003
  • Prevalence and correlates of low self-reported physical health status
           among prisoners in New South Wales, Australia
    • First page: 192
      Abstract: International Journal of Prisoner Health, Ahead of Print.
      Purpose The purpose of this paper is to examine the prevalence and predictors of low self-reported physical health status among NSW prison inmates. Design/methodology/approach Cross-sectional random sample of 1,098 adult male and female prisoners, interviewed as part of the 2015 Justice Health and Forensic Mental Health Network Patient Health Survey. Findings Almost a quarter of participants had “low self-reported physical health status”. Independent predictors of “low health status” were having been in out of home care before the age of 16 years, being illiterate, smoking 20 or more cigarettes a day, not eating more than one serve of fruit a day, not being physically active in the 12 months before incarceration, higher body mass index score and low self-reported mental health status. Many of these predictors are modifiable risk factors for chronic disease, which could be targeted during incarceration. Originality/value This paper demonstrates the utility of a using a single item measure of self-reported physical health status among Australian prisoners, and helps to characterise those prisoners in greatest need of intervention for issues relating to their health.
      Citation: International Journal of Prisoner Health
      PubDate: 2019-03-12T10:05:04Z
      DOI: 10.1108/IJPH-06-2018-0039
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