Sociological, social psychological, and psychopathological correlates of substance use disorders in the U.S. jail population

The objective of this study was to examine sociological, social psychological, and psychopathological correlates of substance abuse disorders in a nationally representative sample of jail inmates. Criminal history and clinical factors most strongly differentiated convicted inmates with and without substance use disorders regardless of current index offense. Policy implications are discussed in terms of targeting antisocial attitudes and peer associations and more effective clinical treatments for substance use disorders among the inmate population. High rates of co-occurring depression symptoms and anger dyscontrol found among inmates with substance use disorders in this study underscore the need for assessment and evaluation of specialized programs for co-occurring disorders and anger management programs among U.S. inmates.     

Intensive case management as a jail diversion program for people with a serious mental illness: a review of the literature

This article reviews the research on intensive case management (ICM) programs as a jail diversion intervention for people with a serious mental illness (SMI). The review includes two types of ICM programs: (a) general ICM programs that included an assessment of arrests and incarceration rates for people with an SMI and (b) ICM programs specifically implemented as a component of a jail diversion intervention for people with an SMI. Results indicate that general ICM programs (19) rarely led to reductions in jail or arrest rates over time, and these rates were similar to those found in standard mental health services. General ICM programs that included an integrated addiction treatment component (8) had mixed results but a trend toward reductions in rates of arrests and incarceration over time for individuals with an SMI and a co-occurring substance use disorder. Results were mixed for jail diversion interventions with an ICM program, but most ICM programs (8) led to significant reductions in arrests and incarcerations over time. Specific elements of effective ICM jail diversion programs are discussed.     

Social support and one-year outcomes for women participating in prison-based substance abuse treatment programming

In recent decades, the number of women under criminal justice supervision has increased considerably, many of whom are serving time for drug offenses. Furthermore, women in prison are more likely than their non-institutionalized counterparts to suffer from a substance abuse disorder. While there is a growing body of research concerning women offenders’ drug abuse and treatment needs, few studies have examined the substance abuse treatment outcomes of women in the criminal justice system. Using data from Outcome Evaluation of the Forever Free Substance Abuse Treatment Program, this study compared women’s self-reported drug use twelve months after participation in high-intensity (n = 101) and low-intensity (n = 81) prison-based substance abuse treatment programming (N = 182). Women who perceived high levels of emotional social support were less likely to report substance use at 12-month follow-up. Furthermore, perceptions of emotional social support and treatment intensity interacted in their association with relapse, such that the protective effect of social support was strongest for women who participated in high-intensity programming. The results of the analyses highlight the importance of perceived social support for women with substance abuse disorders who are transitioning from prison-based substance abuse treatment programming to the community.     

Prison misconduct among female inmates with mental disorders,substance abuse/dependence,and co-occurring disorders in Taiwan

This survey study attempted to address two research questions: (1) whether female inmates with either singular mental illness or singular substance abuse/dependence disorders were more likely to break institutional rules in prison than their disorder-free counterparts; and (2) whether female inmates with both mental illness and substance abuse/dependence disorders (CODs) were more likely to engage in misbehaviour than either disorder-free or singularly disordered women during the course of their confinement. The current study employed a sample of 643 female inmates and the data for analyses contained information on inmates’ CODs, mental and substance abuse/dependence disorders, and pre-prison and prison experiences. The results showed that female inmates with CODs committed the most misconduct in prisons, but no significant effect was found on prison misconduct among inmates with singular disorders and disorder-free female inmates. Possible explanations for these results were suggested, and public policy implications were discussed in the concluding section.     

Examining the Traumatic Effects of Sexual Victimization on the Health of Incarcerated Women

Data from the 2004 Survey of Inmates in State Correctional Facilities were used to examine the effects of sexual abuse on the physical and mental health of incarcerated women. This nationally representative sample consisted of a cross-section of 2,885 female inmates ranging in age from 16 to 74. Using bivariate analysis, we made comparisons between sexually abused (n = 1,205) and non–sexually abused (n = 1,680) inmates. Abused women were more likely to report increases in health problems and mental health diagnoses, as well as other self-reported mental health conditions, such as paranoia, depressive symptoms, anger, and lifestyle changes. Respondents with extensive sexual abuse histories (multiple and across the life cycle) were also more likely to suffer higher levels of paranoia, depression, chronic health problems, and attempted suicide.     

The Prevalence of Mental Illness Among Inmates in a Rural State

A limited number of recent empirical studies suggest that inmates suffer from high rates of serious mental illness. Different explanations are offered depending on the type of institution: jail or prison. The literature is based largely on urban samples and does not offer comparisons of rates across types of institution within a single study. The present study examined a random sample of 213 jail and prison inmates in a rural state using the Diagnostic Interview Schedule (III-R). Among jail inmates there was little evidence of high rates of serious mental illness, suggesting the criminalization of mental illness may not be as evident in rural settings as urban areas. Among prison inmates, however, high rates of mental disorders were found, supporting previous findings in urban and rural jurisdictions. Implications of the findings are discussed in the context of a consolidated correctional system.     

Gray Matters: Gender Differences in the Physical and Mental Health of Older Inmates

Although there has been a substantial increase in the number of older female inmates incarcerated in the United States, there has been little scholarly attention paid to this population. The purpose of this study is to extend the current understanding of older inmates by examining gender differences in their physical and mental health. Bivariate analyses of one of the largest known samples of older female inmates (n = 142) revealed significant gender differences. Older female inmates reported a greater number of physical health conditions and mental health disorders in all three time periods: in their lifetimes, since admission to prison, and in the previous year. This research informs the need for gender-specific health programming for older female inmates.     

An Analysis of Advertisements: A Lens for Viewing the Social Exclusion of Women in Police Imagery

This study examines whether there are differential relationships among trauma exposure, familial risk and protective factors, substance abuse, and posttraumatic stress disorder (PTSD) among incarcerated and non-incarcerated women. A case-control method was used to match 100 incarcerated women with 100 women in the general population. Incarcerated women had a significantly higher risk of trauma exposure as compared with controls, with odds ranging from 1.7 to 3.7. When group was controlled, exposure to sexual or physical trauma significantly increased the odds of PTSD (odds ratio = 5.0; p < .05), as did substance use in response to traumatic distress (odds ratio = 8.9; p < .001). Family-related characteristics did not appear to moderate this relationship. The findings suggest that incarcerated women are at high risk for PTSD given their high rates of trauma exposure and apparent lack of appropriate coping mechanisms; the results support the use of trauma-specific interventions for this population.     

The effects of treatment exposure on prison misconduct for female prisoners with substance use,mental health,and co-occurring disorders

Inmates with mental health and co-occurring mental health and substance use disorders present difficult challenges for correctional institutions and treatment providers. The complex nature of co-occurring disorders further exacerbates these difficulties and is associated with poor treatment compliance and increased likelihood of engaging in institutional misconduct. The current study examines whether exposure to prison-based treatment reduces involvement in prison misconduct among a sample of female prison inmates controlling for disorder types (i.e. mental health disorder only, substance use disorder only, and co-occurring mental and substance use disorders). Findings revealed that with exposure of more than 181?days of treatment, the odds of misconduct involvement among females with co-occurring disorders more than doubled compared to receiving no treatment. This finding is at odds with treatment retention literature that suggests that a minimum period of time in treatment is needed to affect post-treatment success. Possible explanations for these findings and policy implications are discussed.     

Not All Substance Dependence Problems are Recognized as Risks—Comparing a Medical Health Study with Prison Assessments

Substance abuse is viewed as one of the main factors (criminogenic needs) to be assessed and targeted in prison. Prison assessments of risk and needs are known to validly predict reoffending. However, there seems to be lacking research in how reliably the individual prisoner’s problems, such as substance abuse, are represented in the assessments. In this study, we compare an independent medical health study (N?=?510) with in-prison assessments for the same persons to see whether some of the inmates’ substance abuse disorders were overlooked in prison. We found that sentence plans (257) were in poor agreement with the health study (Kappa 0.315); they recognized only 65 % of all diagnoses. The risk and needs assessments (178) were in closer agreement with the health study, however, alcoholism diagnoses were recognized less accurately (Kappa 0.519) and less frequently (78 %) than drug diagnoses (Kappa 0.627, 87 %). The main factors predicting an assessment of substance abuse risks in prison, analysed through logistic regression were: longer stay in prison and one or more dependence diagnoses. We conclude that, a number of potentially criminogenic dependence problems remain unrecognized since some groups of prisoners are either completely left out from the more thorough instrument, the risk-and-needs assessment, or are not assessed thoroughly enough. This puts prisoners in unequal positions, since all interventions in prison are based on assessments. The study alerts us of the selectiveness of prisoner assessments in practical settings; the unrecognition of problems of shorter sentenced prisoners and prisoners with alcohol dependence.     

Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners

Background: Comorbid substance use disorder(s) and post-traumatic stress disorder (SUD-PTSD) is common among prisoners and linked to an increased risk of criminal recidivism; however, little is known about the characteristics of prisoners with this comorbidity. Aim: This study provides a preliminary examination of the clinical and criminal profile of male inmates with symptoms of SUD-PTSD, and examines whether this profile differs according to whether a person has experienced a trauma while in prison. Methods: Thirty male inmates from two correctional centres in Sydney, Australia, were recruited and assessed using a structured interview. Results: The sample reported extensive criminal, substance use and trauma histories. A history of substance dependence was almost universal (90%) and 56.7% met diagnostic criteria for PTSD with the remainder experiencing sub-threshold symptoms. Forty-three per cent reported a traumatic event while in prison. Those who had experienced trauma in prison, compared to those who had not, were more likely to nominate heroin as their main drug of concern and to be receiving drug treatment in prison. There was also a trend toward inmates who had experienced a trauma in prison being more likely than inmates who had no prison trauma to have experienced a physical assault. Conclusion: Male prisoners with SUD-PTSD are a high-needs group yet treatment responses are poor. Further research examining treatment options for this comorbidity may improve prisoner well-being and reduce recidivism.     

Return to Work for Healthcare Professionals with Substance Use Disorders: Clinical, Legal, and Ethical Challenges

Occupational health providers (OHPs) and other clinicians who assess readiness to work have a difficult task in assessing return to work for healthcare professionals (HCPs) with substance use disorders (SUDs). About 10 to 15 % of HCPs will misuse drugs or alcohol at some time in their career, yet they are often reluctant to seek help. This paper reviews the clinical challenges of assessing SUDs in HCPs, including risk factors, prognosis, and limited evidence base for work restrictions. Furthermore, ethical and legal challenges throughout the return to work process are reviewed for stakeholders such as HCPs with SUDs, OHPs, other providers, employers, and the public at large. Suggestions are made for stakeholders, particularly for OHPs and other providers, who are navigating this complex environment.     

The problem of co-occurring disorders among jail detainees

This paper documents the degree and pattern of overlap of antisocial disorder. alcoholism. drug use disorders, and major depression among 688 randomly selected male jail detainees. Diagnostic assessments were made using the NIMH Diagnostic Interview Schedule. Data indicate that multiple disorders are a serious problem among male detainees. Detainees were more likely to have two or three disorders than to have a single disorder. Of detainees, 44% had a lifetime prevalence of two or more of these syndromes. Few subjects with multiple disorders were found to have primary, or initial onset of, substance abuse disorders or primary depression. Rather, antisocial disorder predominated as the primary syndrome in diagnostic profiles. The preponderance of antisocial disorder among codisordered detainees is disturbing because it is a poor prognostic indicator. Implications for substance abuse intervention, treatment of depression, and intervention with antisocial personality disorder among detainees are discussed.     

Determinants of prisoners’ perceived need for care in association with criminal recidivism

This study explored determinants of perceived need for care among male inmates of general prison wards in Amsterdam (N = 208) with a normative need for care. Also, it assessed the relation between perceived need for care and criminal recidivism. Normative need for care was defined as having a mental health problem, assessed with the Brief Jail Mental Health Screen, or being substance dependent. Perceived need for care was defined as a subjective problem experience and a wish to receive care. Mental health and/or addiction problems were highly prevalent (68%). Of those inmates, only 29% had a perceived need for care. Age and borderline personality disorder were associated with perceived need for care, prior care utilization intermediated these associations. No direct relation between perceived need for care and criminal recidivism was observed. All inmates should be well screened and the benefits of mental health care should be promoted.     

An electrocortical correlate of a history of alcohol abuse in criminal offenders

Abstract

This study tested the hypothesis that a history of chronic alcohol abuse is the key variable underlying the previously reported association between criminal recidivism, impulsivity and differentiation of the Go/NoGo contingent negative variation (CNV). Forty male Singaporean prison inmates were assessed for presence of antisocial personality disorder (APD), a history of alcohol and other substance abuse, and psychopathy. CNV was recorded in the Go/NoGo paradigm in groups comprising inmates with (ALC+: N = 29) and without (ALC?: N = 11) a history of alcohol abuse. As predicted, the ALC+ group showed significantly degraded Go/NoGo CNVs (poor differentiation). This suggests that the “high risk” group of mentally disordered found to recidivate in studies by Howard and Lumsden (1996; 1997) may have shared a history of alcohol abuse. Results are discussed in the context of a developmental biopsychosocial model of risk for engaging in criminal behaviour.     

Gender Differences in Child Abuse and Intergenerational Transmission of Crime and Substance Abuse among Israeli Inmates

The aim of this study was to examine the gender differences in various types of childhood abuse and family history of crime, substance abuse, and mental health problems. Our study was conducted among 110 Israeli female and male inmates (50 female and 60 male inmates). The findings indicated a higher rate of multiple types of childhood abuse among the female inmates compared with the male inmates. The findings also revealed that female inmates reported more prevalence of parents’ substance abuse, crime, and family’s mental health problems than the male inmates did. Moreover, the female inmates reported higher rates of emotional, physical, and sexual abuse associated with family history variables compared with the male inmates. Furthermore, the findings indicated that female inmates whose siblings were involved in substance abuse and crime reported higher rates of sexual and emotional abuse compared with the male inmates. We discussed the implications of these findings.     

Exploring Agreement on Appropriate Responses to Domestic Violence and Sexual Trauma Across Victim Advocates,Mental Health Service Providers,and Substance Abuse Treatment Providers

Abstract

Research suggests that survivors of domestic violence and sexual assault are more at risk than the general population for substance abuse and/or mental health disorders (Kendler et al., 2000). Additionally, research suggests that survivors of both crimes are at risk to be “multiply diagnosed-have” a history of victimization, a mental health diagnosis, and abuse of alcohol and drugs (Steele & Rechberger, 2002). While advocates have called for a change in the treatment of trauma survivors to treat their multiple needs, the availability of collaborative care between victim advocates and behavioral health professionals remains questionable. Using survey data collected from victim advocates, mental health service providers, and substance abuse treatment providers, this study assesses the extent to which providers of different backgrounds agree on how to effectively and appropriately serve domestic violence and sexual assault survivors-the first step in achieving the goal of holistic care.     

Intimate Partner Violence in the Occupied Palestinian Territory: Prevalence and Risk Factors

This paper presents results from a nationally representative cross-sectional survey of married women (N?=?3,500) in the West Bank and Gaza Strip. Interviews assessed the 12-month prevalence of participants’ exposure to psychological, physical, and sexual intimate partner violence (IPV) and risk factors including: demographic characteristics, several factors of marital relations, stressful life events, political violence, status inconsistency, family size, locality, region, help resources in the community, and locality-level acceptance of wife abuse. The prevalence estimates of IPV were: psychological aggression, 50 % minor and 12 % severe; physical assault, 17 % minor and 6 % severe; and sexual coercion, 4 % minor and 6 % severe. Results revealed that stressful life events, husbands’ controlling behavior, and marital conflicts were related to all forms of IPV (all p-values?<?0.05). Greater locality-level acceptance of wife abuse was statistically associated with greater odds of each type of violence except sexual violence. The limitations and implications of the study for future research are discussed.     

Co-occurring psychiatric and substance use disorders among male detainees in Italy

This paper presents data on the prevalence of co-occurring substance use and psychiatric disorders among newly imprisoned males in Italy. Interviewers conducted semi-structured clinical interviews with n = 302 male detainees seven days after their admission to the prison of Perugia from August 2005 through July 2006. Over half of male detainees (54.3%) had either a substance use disorder or another psychiatric disorder. One of every five detainees (20.9%) had comorbid substance use and psychiatric disorders. Compared to detainees with psychiatric disorder only, substance use disorder only, or no disorder, detainees with comorbid substance use and psychiatric disorders were significantly more likely to have severe impairment in the areas of employment, substance abuse, family and social functioning, and psychiatric symptoms. Findings underscore the need for careful diagnostic screening at intake, access to treatment during detention, and an effective transition to services at the time of release.