INCARCERATION AND POPULATION HEALTH IN WEALTHY DEMOCRACIES*

Everywhere you look, incarceration seems to be doing harm. Research has implicated incarceration not only in worse outcomes for individuals, their families, and their communities but also in growing inequality. Yet incarceration may not always harm society—even if it does harm those who experience it. To consider this possibility, I build an argument demonstrating how the macro‐level consequences of incarceration may be distinctively harmful in the United States, focusing on the incarceration–health relationship as one indicator of a broader phenomenon. I then test my hypothesis by using an unbalanced panel data set including 21 developed democracies (N = 414) and a series of ordinary least‐squares models predicting three measures of population health as a function of incarceration. Models including only a main effect of incarceration demonstrate an inverse association between changes in incarceration and changes in population health. Models including an incarceration by U.S. interaction, however, indicate that the population health consequences of changes in incarceration are far worse in the United States than elsewhere. Taken together, the results indicate that the United States is exceptional for both its rate of incarceration and its effects of incarceration, although it is unclear what drives this exceptionalism in effects.     

ASSOCIATIONS OF FATHERS' HISTORY OF INCARCERATION WITH SONS' DELINQUENCY AND ARREST AMONG BLACK,WHITE, AND HISPANIC MALES IN THE UNITED STATES*

Nearly 13 percent of young adult men report that their biological father has served time in jail or prison; yet surprisingly little research has examined how a father's incarceration is associated with delinquency and arrest in the contemporary United States. Using a national panel of Black, White, and Hispanic males, this study examines whether experiencing paternal incarceration is associated with increased delinquency in adolescence and young adulthood. We find a positive association with paternal incarceration that is robust to controls for several structural, familial, and adolescent characteristics. Relative to males not experiencing a father's incarceration, our results show that those experiencing a father's incarceration have an increased propensity for delinquency that persists into young adulthood. Using a national probability sample, we also find that a father's incarceration is highly and significantly associated with an increased risk of incurring an adult arrest before 25 years of age. These observed associations are similar across groups of Black, White, and Hispanic males. Taken as a whole, our findings suggest benefits from public policies that focus on male youth “at risk” as a result of having an incarcerated father.     

THE COLLATERAL CONSEQUENCES OF INCARCERATION REVISITED: A QUALITATIVE ANALYSIS OF THE EFFECTS ON CAREGIVERS OF CHILDREN OF INCARCERATED PARENTS*

While policy makers have long extolled the benefits of incarceration, criminologists have expended considerable effort demonstrating the harmful collateral consequences of incarceration. Sampson (2011) recently challenged researchers to move beyond this dichotomy and to assess the “social ledger” of incarceration, where both the potential benefits and harms associated with incarceration are examined. To shed light on the variation in the collateral consequences of incarceration, we focus on the experiences of a valuable group of individuals directly impacted by imprisonment: those caring for children of incarcerated parents. Drawing from in‐depth interviews with a diverse group of caregivers (N= 100), we examine the various consequences (both positive and negative) that occur in their lives as a result of incarceration, as well as the causal processes responsible for the outcomes we observe. Our findings reveal marked variation in the effects of incarceration on caregivers. Such effects are shaped by (1) the prisoner's prior parental involvement, (2) the interpersonal relationship between caregiver and prisoner, and (3) the caregiver's family support system. These findings have important implications for future work conducted on the collateral consequences of incarceration for caregivers, children, and families.     

The price that US minority communities pay: mass incarceration and the ideologies that fuel them

Mass incarceration of minorities has generated alarming attention. This concern is a result of the massive social injustice perpetrated by the ideologies that force mental and physical imprisonment on the poor. The outcome of this social injustice generates punitive inequalities that become entrenched in US social experiences. Once incarcerated, an individual carries a permanent label that brands him/her as an eternal ‘criminal’ and deactivates him/her from mainstream society. This translates into exclusion from responsible educational and occupational participation. Disadvantaged members of minority groups caught in this unforgiving social imprisonment often turn to the underground economy, which, unfortunately, increases the possibility of arrest, or re-arrest. The imprisoning ideology that stereotypes the disadvantaged community, leads to increased incarceration, hypersegregation, social abandonment, and creates a theater for venomous law enforcement practices. The impact of mass incarceration and the ideologies that sustain them on disadvantaged minority communities is the focus of this examination.     

Parent coordinators: Effective interventions in adolescent mental health

The mental health system in the US was not meeting the increasing needs of teens before the pandemic started in 2020. The pandemic served to stress adolescents and their parents while significantly limiting the availability of services. Separated parents may have disputes about whether adolescents have mental health care needs, what services the child needs, where those services will be obtained, and who will be involved. The Parenting Coordinator as a dispute resolution professional can assist families in reaching agreements and meeting their teen's needs for care.     

History of spouse violence against mother: Correlated risks and unique effects in child mental health

The present study examined mental health risk associated with lifetime occurrence of spouse violence against mother among 303 10 to 12 year-old inner-city children. Maternal report data showed a 30% prevalence rate for lifetime occurrence of spouse violence in this sample. Results of correlational analyses indicated that violence against mother was associated with several other historical risk factors including divorce, parental drinking problems, and incarceration of father. Multiple regression analyses controlling for the effects of demographic and historical risk factors that correlated with violence against mother revealed that violence accounted for significant unique variance in girls' self-reports of conduct problems, but did not account for unique variance in boys' symptomatology. Implications of these results for understanding the effects of violence against mother on children and for the development of empirically based interventions for children in those families are discussed.     

Psychiatric symptoms and mental health court engagement

People with mental illnesses are overrepresented in the criminal justice system. Many interventions have been implemented to treat the underlying causes of criminal justice involvement and prevent people with mental illnesses from recidivating. Mental health courts (MHC) are one of these programs. This analysis examines the relationship between psychiatric symptoms and MHC engagement. Eighty MHC participants from two Midwestern MHCs were interviewed. Symptom severity was assessed at baseline using the Brief Psychiatric Rating Scale. MHC engagement was estimated by treatment adherence, substance use, days spent in jail, probation violations, and MHC retention during a six-month follow-up period. Using nonparametric statistical tests and logistic regression, results indicate symptoms of depression, anxiety, and guilt are more severe at baseline for those people who are incarcerated during the follow-up period. Symptoms of anxiety are more severe for people who are terminated or went missing during the follow-up period. Further research is needed to determine the directionality and causality of these relationships. MHCs professionals should be aware of the relationship between symptom severity and MHC engagement and attempt to connect participants with treatment and services as early as possible and individualize treatment plans based on current symptoms and need.     

Interventions with women offenders: a systematic review and meta-analysis of mental health gain

Currently, a conjunction of policy, legislative change in health and social care and the criminal justice system, combined with funding for innovative services make it opportune to assess the evidence base for interventions with women offenders. Women offenders have a distinctive criminological, health and social profile and a gender specific approach to their difficulties is advocated. This systematic review and meta-analysis focus on mental health gain in adult women offenders in forensic health settings, criminal justice institutions and in the community, following therapeutic interventions. Interventions were assessed in terms of specific outcome measures of depression, trauma symptomatology and global mental health status. Comprehensive search strategies yielded 3018 articles, from which we obtained 199 full text articles. Seventeen articles were included in the final review, of which six were excluded from the meta-analysis as there was no comparator group. There is a modest, but increasing, body of evidence for the utility of some interventions, notably those addressing the consequences of earlier trauma, including interventions which also address comorbid substance misuse. This does not amount, to date, to a robust evidence base. Limitations of these studies are discussed and include small sample sizes, their restriction mainly to prison populations and that they were substantially undertaken in the US. Variations in outcome measures follow-up and the difficulties inherent in measuring change in this complex population are also detailed. However, the review delineates definite avenues for further work. To achieve this, those responsible for policy, practice and purchase of services should both be mindful of existing evidence and promote additional, high quality research into interventions which are designed around a coherent, theoretical approach.     

Actions taken in response to mental health screening at reception into prison

Screening for mental health problems on reception into custody has been criticised. However, there have been few studies on care pathways through custody as a result of screening identification. We aimed to identify what actions were taken as a result of screening positive for suicidal ideation and mental health problems. Case records for 2166 prisoners newly received into five prisons in England and documented contact with health care professionals in the following month were examined by hand over a four-month period. Altogether, 3% of prisoners were screened as having current suicidal ideas, of whom 30% had no contact with mental health services or risk assessment documentation. Another 21% of new receptions received psychotropic medication, for whom over 60% received no primary mental health assessment, and only 36% received psychotropic medication in prison. Care pathways need to be defined, and screening needs to be delivered as originally intended by initial screen for life-threatening matters, followed by a later, comprehensive assessment of health needs.     

Compulsory mental health care in Norway: The treatment criterion

The Norwegian government has chosen to retain a treatment criterion in the Mental Health Care Act despite the opposition of several user organizations. From a critical user perspective, the only reason for using coercion to require mental health treatment is that the individuals are in a state where they are an immediate danger to themselves and/or their surroundings. This articles aims, first, to provide an overview of research studies concerning the benefits or harmfulness of involuntary treatment after coerced admission and, second, to evaluate studies that try to compare involuntary with voluntary treatment. A systematic overview of studies of compulsory mental health care with regard to treatment criteria, coercion in mental health, and involuntary admission published over the last decade was examined in detail, along with a secondary manual search of references cited in identified publications. Few studies have been conducted on the effect of compulsory mental health care, and the results have been contradictory. More randomized studies are needed to document the kinds of effects that the use of compulsory treatment has on treatment results. Another issue that needs further examination is whether the use of coercion should be transferred to legal bodies with an adjudicatory process.     

The Effect of Incarceration on Marriage and Work Over the Life Course

The current study adopts the life course framework to examine the effect of incarceration on the likelihood of becoming married and attaining full‐time employment. It is hypothesized that men who have been incarcerated will be less likely to marry and to gain full‐time employment. Data from the National Longitudinal Survey of Youth are used to test the hypothesis. Results from the growth‐curve models support the life‐course theoretical model. Across all models estimated, incarceration is negatively associated with marriage and employment. In addition, positive milestones (e.g., education) are associated with improved chances of employment and marriage. The findings reinforce the importance of considering a multitude of life events when estimating life trajectories.     

Racial and Ethnic Differences in the Likelihood of Marriage: The Effect of Incarceration

Researchers have highlighted the importance of marriage when studying variation in deviance over the life course, but few studies have examined the effect that incarceration has on marriage or have considered variation by race and ethnicity. Using data from the National Longitudinal Survey of Youth (NLSY), this study contrasts the effect of incarceration on the likelihood of marriage for White, Black, and Hispanic males. Incarceration reduced the chances of marriage for all men, but had a significantly stronger effect on the marital outcomes for Whites. Although Whites were most likely to be married overall, incarceration was associated with a 59 percent decline in the odds of marriage for Whites, and the odds of marriage decreased 30 percent for Blacks and 41 percent for Hispanics. The association was maintained even after controlling for time‐varying life‐course events and static individual‐level factors. This research has important implications for the study of the incarceration and the consequences it can have for spouses, families, and communities.     

The use and readability of mental health self-help in Scottish prisons

Prisoners are at higher risk of mental health problems than people in the general community. One possible way of optimising mental health care resources in prisons is to offer self-help materials. In order for these to be effective, they must be appropriate for the reading ability of the patient. This study aimed to determine, by way of a survey distributed to Scottish mental health care teams, how self-help resources are being used currently in the Scottish prison system, and to analyse the materials using four different readability tools: FRE, FKGL, SMOG and the Drivel Defence programme. It was found that there is currently widespread provision of self-help to Scottish prisoners; however, only 53% of these materials are suitable for the quoted average prisoner reading age. Mental health practitioners should be aware of this when providing self-help to patients, and consider easy-read options where available.     

The observation of mental disorder and dangerousness in arsonists: a contemporary appraisal of changes in Dutch forensic mental health cases

In the Netherlands pre-trial forensic mental health assessments are conducted to examine whether a mental disorder was present at the time of the offence that affected the free will of a person, in which case criminal accountability is considered diminished or absent. This study aims to investigate societal changes over time in forensic mental health recommendations in arson cases. Seventy-two reports of male arsonists assessed in 1950–2010 were included in this study, 36 arsonists were assessed in the first time period (1950–1979) and 36 in the second period (1980–2010). Results show an association between DSM classification and the conclusion on criminal accountability only in the first period and an association between recidivism risk and the forensic mental health recommendation only in the later period. It is concluded that mental disorder was of greater influence on the conclusion on accountability in the first time period, whilst dangerousness played a more important role on the forensic mental health recommendation in the later time period. Our findings reflect a shift from paternalistic principles to principles of risk control and show that societal changes influence the field of forensic mental health.     

Therapeutic jurisprudence and mental health tribunals: changing patterns of demand and its impact

For decades the mental health system has been ‘in crisis,’ with too little funding, too much demand and fragmented services. In England and Wales, decisions made concerning the care and treatment of those suffering from a mental disorder is governed by the Mental Health Act 1983 (as amended) (MHA 1983). Detention under the legislation is fraught with conflict; patient and clinical views are often at odds. Mental health tribunals enable patients to seek a review of their case and the legality of their detention. This paper argues that with the increased use of formal detention under the MHA 1983, the caseloads of mental health tribunals have similarly risen. Whether it is possible to advance therapeutic benefit to psychiatric patients attending tribunals is open to question. While mental health tribunals have a role to play in generating a positive psychological impact on an applicant, there is a risk that time and resource pressures may inhibit the adoption of a therapeutic approach. This paper considers the key drivers that are currently pushing detention rates up, the impact this is having on mental health tribunal caseloads and whether it is possible to bring therapeutic jurisprudence to the patient.     

Procedural justice in mental health court: an investigation of the relation of perception of procedural justice to non-adherence and termination

Mental health courts (MHCs) operate on the principles of procedural justice (PJ). PJ highlights the importance of process over outcomes in encounters with authority. Subjective perceptions of having voice, being heard by decision-makers, and being treated with respect and concern by figures of authority are influential in assessment of fairness and in cooperation with decisions, regardless of favorability of the outcome. In this paper, we investigate MHC participant perception of PJ in interactions with MHC staff and the association between perceptions and recidivism (i.e. time in jail, new arrests, and probation violations), treatment adherence, and MHC termination. Participants from two MHC programs (n?=?80) took part in this study. Results suggest that perception of PJ during interactions with the entire MHC team is significantly associated with program termination, but not with participant behaviors during MHC. Implications for MHC practitioners and researchers are discussed.     

Review of point-of-reception mental health screening outcomes in an Australian Prison

The point-of-reception into prison is a critical juncture as it provides early opportunities to identify mental illness and initiate treatment. Although large numbers of mentally ill prisoners are received into prison each day, research investigating mental health screening outcomes at the point-of-reception is limited. This study aimed to address this gap by examining reception screening outcomes for all prisoners received into an Australian prison during 2009 (n?=?4229). Overall, 19% of all prisoners were mentally ill, and another 20% had a history of psychiatric illness that required ongoing care. Mentally ill prisoners had a higher risk of suicide or self-harm and required more observation than other prisoners. At reception, no mentally ill prisoners were transferred to the state’s forensic hospital and few were transferred to the prison’s mental health unit, or provided support service referrals. These findings highlight that outcomes made at the point-of-reception are heavily influenced by the availability of prison mental health resources.     

Outcome measurement in forensic mental health research: an evaluation

Abstract

Measuring change resulting from healthcare interventions is critical to evaluating their usefulness. The choice of outcome measure is an important part of such evaluations and is driven by assumptions about what is likely to change and how best to capture this. Despite its importance, forensic mental health has paid little attention to determining which are the best measures of outcome. This study used a panel of relevant professionals to (i) assess the relative importance of different areas of potential outcome measurement and (ii) evaluate specific instruments used currently as outcome measures in forensic mental health research. Although a wide range of potential outcomes were endorsed as appropriate, few corresponding instruments have been used consistently. Only three psychiatric instruments deemed by our panel as feasible, relevant and psychometrically adequate have been used in five or more studies (the Beck Depression Inventory; the Brief Psychiatric Rating Scale, and the Symptom Checklist-90–Revised). Significant measurement gaps were noted in areas such as social and emotional functioning. Although instruments exist that could capture most areas, none were sufficiently developed for routine use as outcomes. Further research to develop robust, sensitive and diverse outcome measures is needed. This is an essential precursor to extending the evidence base for forensic mental health interventions.