Doing time: A qualitative study of long-term incarceration and the impact of mental illness

Once convicted, the perpetrator of serious crime embarks upon a new journey: the challenge of adjusting to long-term imprisonment. Prisoners' views of incarceration and the meaning of this experience may affect their later adjustment to life in the community. On the basis of brief narrative responses collected during an epidemiological survey of the psychological health of prisoners in France, this study examined the impact of incarceration on psychological state in a group of 59 inmates serving long sentences. Qualitative content analysis and computer-assisted linguistic analysis (using ALCESTE software) were performed on the textual data of open responses to three standard questions. Using a combination of these two approaches, seven categories of the subjective experience of prisoners in the sample were identified: the Outside World, Others, Punishment, Time, Affects and Impulses, Self-Concept, and Speech. Further qualitative analyses were then performed to compare the responses of Severely Mentally Ill (SMI) subjects and subjects with no psychiatric disorder. These analyses revealed contrasting attitudes towards incarceration. SMI subjects spoke in more hostile and persecutory terms about their experience in prison, attributing suffering to external circumstances, while subjects with no psychiatric disorder evoked similar themes, but with an introspective attitude. The themes evoked by mentally ill individuals in our sample suggest that their reactions to the prison environment arise in part from aspects of their psychiatric symptoms, and this may have relevance to future mental health policy and practices in criminal corrections.     

Reexamining the cruel and unusual punishment of prison life

It has been widely assumed that prison is destructive to the psychological and emotional well-being of those it detains. However, this assumption has rarely been critically examined. The present report evaluated the evidence pertaining to the effects of imprisonment. Studies on the effects of prison crowding, long-term imprisonment and short-term detention, solitary confinement, death row, and the health risks associated with imprisonment provide inconclusive evidence regarding the “pains of imprisonment.” Rather, the evidence points to the importance of individual differences in adapting to incarceration. As the use of incarceration is unlikely to decrease in the near future, research on its effects is urgently needed and a situation-by-person approach may be the most fruitful research strategy.     

The Role of Family Violence on Mental Health and Hopefulness in an Iranian Adolescents Sample

The purpose of this study was to examine the relationship between family violence and both mental health and hope. It was also designed to investigate the roles of gender and ethnicity on these constructs in an Iranian context. Participants included 300 adolescents from Eghid City, Fars Province, Iran selected through systematic random sampling within a survey design. A demographic questionnaire and three inventories were administered. Results indicated significant correlation coefficients between family violence, mental health, and hope. Males in general had a greater childhood history of physical assault and neglect, and experienced more overall family violence compared to females. Females showed higher psychopathology, including somatic complaints, anxiety/insomnia, social dysfunction, and depression. Ethnicity also played a significant role in nonviolent discipline and psychological aggression toward children.     

Long-term imprisonment leads to cognitive impairment

The effects of long-term imprisonment on cognitive functions are investigated in a longitudinal study. Twenty-four serious offenders in an Austrian penitentiary underwent concentration and memory performance measurements via a questionnaire presented to them under controlled conditions in two sessions at a 42-month interval. The difference in the parameters indicated cognitive impairment after this period that was highly significant (P < 0.01); this can be interpreted as a direct consequence of imprisonment.     

Childhood Violence Exposure: Cumulative and Specific Effects on Adult Mental Health

Childhood exposure to violence and victimization is a significant public health problem, with potentially long-lasting, deleterious effects on adult mental health. Using a longitudinal study design, 123 young adults—identified in adolescence as at-risk for high school dropout—were examined for the effects of multi-domain childhood victimization on emotional distress and suicide risk, net of adolescent risk and protective factors, including family dysfunction. The hypothesis that higher levels of cumulative childhood victimization would be significantly associated with mental health maladjustment in young adulthood was confirmed by the analysis. However, the victimization predictors of adult emotional distress were different than the predictors of adult suicide risk. These findings indicate the need for prevention and intervention approaches that include thorough assessment, and focus on the childhood and adolescent problem areas that are most consequential for long-term psychological well-being.     

Physical Injuries, Pain, and Psychological Trauma: Pathways to Disability

Because physical injuries occur so frequently and are associated with significant mortality and morbidity, these injuries have been acknowledged as a worldwide public health concern. While the greatest cost associated with physical injury is the loss of life, non-fatal injuries are associated with significant personal and societal costs. Traditionally, examinations of the personal costs of physical injuries have emphasized functional losses and limitations, in addition to resulting losses in work productivity and income earning power. Efforts to capture the societal costs associated with physical injury have emphasized medical expenditures related to their treatment as well as costs related to lost work performance and disability compensation. Less emphasized but possibly more relevant to post-injury functional outcomes is the experience of psychological distress that frequently accompanies injury-related changes in function and overall quality of life. Any calculation of the true cost of physical injuries must include a reckoning of their impact on psychological health and the interactive influence of physical and psychological injuries on immediate and long-term recovery of function. In the current article, we briefly summarize data pertaining to the prevalence and cost of physical injuries; we briefly describe the more common consequences of physical injury, including injury-related limitations in physical function, pain and pain-related limitations in physical function, occupational impairment, psychological distress, and impairment in interpersonal relating; we review select theoretical models that are considered to explain the transition from physical injury to disabilities and we identify the pre-, peri-, and post-injury influence of physical and psychological health on injury management, recovery of function, risk of re-injury, and disability.     

对提高公务员心理调适能力的几点思考

目前,我国公务员的心理健康及身体健康状况不容乐观。长期以来,肌体健康问题一直是人类关注的焦点,而心理健康会影响身体健康的问题却被忽视了。现在,越来越多的科学实验及心理学研究揭示了心理健康会影响身体健康这一根本性的问题。因此,提高公务员的心理调适能力,使其以平和的心态面对来自各方面的压力就成为当务之急。     

Exploring the Impacts of Racial Disparity Within the American Juvenile Justice System

The racial disparity in the American juvenile justice system impacts the lives of many youth of color. Youth of color constitute 34% of the U.S. population, however, they make up 62% of the youth charged in the juvenile justice system. The cycle of racial inequality and imprisonment are factors influenced by residential segregation and policing practices. Juvenile justice involvement leads to poorer physical and mental health in youth, stymied social outcomes, poorer familial relationships, decreased graduation and employment rates, increased rates in violence, and long-term negative future outcomes. The article advocates for mental health treatment and family services to be incorporated within incarcerated settings. Clinical strategies and future direction are discussed to begin to combat these various adverse impacts.     

A Pilot Study Evaluating the Effectiveness of a Mindfulness-Based Intervention on Cortisol Awakening Response and Health Outcomes among Law Enforcement Officers

As first responders who are frequently exposed to job-related trauma, police officers are at an elevated risk of adverse mental and physical health outcomes. Evidence-based approaches to stress reduction are sorely needed to address the complex variety of problems that police officers face. In this pilot study we examined the feasibility and preliminary effectiveness of a mindfulness-based intervention designed to address police officer stress. A total of 43 police officers completed an 8-week Mindfulness-Based Resilience Training (MBRT) program, which was designed to improve mindfulness, resilience, stress, health outcomes, and emotional functioning. Using multilevel models we found significant improvement in self-reported mindfulness, resilience, police and perceived stress, burnout, emotional intelligence, difficulties with emotion regulation, mental health, physical health, anger, fatigue, and sleep disturbance. Although there were no significant pre-to-post-MBRT changes in cortisol awakening response (CAR), while controlling for pre-MBRT increase area under the curve (AUC_I), change in mental health was a significant predictor of post-AUC_I. Implications of these findings and areas for future research are discussed.     

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.     

Social Correlates of Delinquency for Youth in Need of Mental Health Services: Examining the Scope Conditions of Criminological Theories

While both traditional criminological inquiry and mental health research have identified internal and external constellations of risk factors associated with juvenile offending, interdisciplinary discourse has been limited. This paper takes a step in bridging the gap between criminological literature and work in the field of children’s mental health by evaluating the combined effects of social and mental health predictors on juvenile delinquency in a sample of youth with diagnosed clinical disorders. Results of multivariate analyses indicate that both traditional social risk factors as well as indicators of the nature and severity of youths’ mental health disorders contribute to delinquency. Moreover, the influence of one well-established risk factor, self-control, on delinquency is moderated by the presence of oppositional defiant disorder. The results of this study suggest that researchers and practitioners should consider the cumulative influence of social risk factors and psychological impairment in the etiology of delinquency.     

伤残鉴定中智能障碍评定的多因素分析

目的探讨智力测验在智力损伤与伤残鉴定中的适应性。方法对366例在精神损伤或伤残鉴定中进行韦氏智力测验的结果及其影响因素进行分析,并与鉴定专家评定结论进行比较。结果①韦氏智力测验结果与专家鉴定结论之间存在明显差异（P〈0．01）,不一致率为68．8％,但二者呈现显著正相关（r=0．431,P〈0．01）。②影响韦氏智力测验的客观因素包括多种身体功能障碍及精神障碍,分别占32．2％（118例）和23．8％（87例）。③在智力测验时表现有主观不合作者为61．5％,而在专家检查中表现有主观不合作者仅为38．8％。结论智力测验受多种主客观因素的影响,不能直接引用评定智力伤残等级,需要结合脑外伤的严重程度、临床检查及社会功能等综合评定智力伤残的等级。     

Work and mental health: learning from return-to-work rehabilitation programs designed for workers with musculoskeletal disorders

Despite the high costs associated with mental health problems in the workplace, few studies have yet been published on the design and evaluation of return-to-work rehabilitation programs for workers with mental health problems. In fact, the best-documented return-to-work rehabilitation programs concern workers with musculoskeletal disorders (MSKD). For this clientele, a disability paradigm has been adopted which explains the multicausality of work disability. Long-term work disability is no longer seen simply as the consequence of impairment, but rather as the result of interactions between the worker and three main systems: the health care, work environment and financial compensation systems. A return to work is thus influenced by a complex set of interrelated factors that must be taken into account in any intervention. Parallels can inevitably be drawn in the field of mental health in the workplace, where individual and organizational factors are involved and must be taken into account in the return-to-work process. This paper presents the first results of an exploratory study aimed at determining the possible links between work rehabilitation programs for workers with MSKD and those for workers with mental health problems. To this end, the components of a work rehabilitation program for workers with MSKD, the Therapeutic Return to Work (TRW) program which addresses psychological factors, work environmental factors and factors related to the involvement of the various stakeholders in the rehabilitation process, are described through a multiple-case analysis and mapping of interventions. The results support the relevance of adopting the disability paradigm and considering the return-to-work clinical activities conducted with workers with MSKD (and their mechanisms of action) in the design of work rehabilitation programs for workers with mental health problems.     

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.     

Dissecting the relationship between mental illness and return to incarceration

Purpose

We examine all releases to parole supervision in a single state over a period of four years to consider how a diagnosis of mental illness is associated with return to incarceration.

Methods

We use survival methods and Cox regression to understand patterns of and influences on return to prison. Our measure of mental illness is based on in-prison clinical diagnoses. Data include a rich set of administrative variables with demographic, criminal history and institutional controls.

Results

Our findings suggest that (1) there is a statistically significant relationship between having a DSM diagnosis and reincarceration, (2) substance-related disorders account for most of that relationship, and (3) there are some important variations among types of disorders examined.

Conclusions

Research that examines mental illness and recidivism without controlling for substance use disorders/problems is likely to be uninformative and misleading. Findings provide qualified support for the notion that programming addressing criminogenic risks and needs may be as important, or more so, than therapeutic programming focusing on mental illness when recidivism reduction is the goal.     

Role of family factors in adolescent delinquency in an Elazig/Turkey reformatory

Family is one of the most important factors in the social and psychological progress of an adolescent. Social behavior disorders in childhood have been reported to be caused by many factors that may lead children to commit a crime. Our study included a total of 106 convicted adolescents from Eastern Turkey in a reformatory and 126 unconvicted adolescents with a similar socio-economic status. A survey form was completed during a face-to-face interview and a review of official records was undertaken. The role of family disruption, education levels of parents, the rate of imprisonment among first- and second-degree relatives, migration as a family from their place of birth, and the number of delinquent children in the family were evaluated. There was a significant difference between the conditions in the families of convicted and unconvicted adolescents. Family factors play an important role in the development of adolescent delinquency. To prevent or decrease this rate of childhood or adolescent delinquency, there needs to be an improvement in the socio-cultural conditions of families.     

Criminal justice and the voluntary sector: a policy that does not compute

The profile of the women who tend to get caught up in the criminal justice system has changed little over the past 30 years. Compared to the general population, they are socially and economically disadvantaged, poorly educated and have high incidence of mental health and substance misuse problems. Experience of physical violence and sexual abuse is depressingly prevalent in their biographies (see for example, Gelsthorpe et al., 2007). In addition, the steep rise, compared to men, in the imprisonment of women throughout the 1990s, most commonly for short sentences of six months or less, exacerbated their marginalisation and failed to reduce reoffending.     

Screening the Mental Health Needs of Youths in Juvenile Detention

There is an increasing number of juveniles coming into the justice system with a variety of mental health and substance abuse concerns. While the actual number of youths with mental health disorders in the juvenile justice system has been difficult to determine, it is estimated to be substantially higher than it is for youths in the general population. In addition, researchers have estimated that a high number of these juveniles experience co‐morbid mental health disorders. The purpose of this study was to examine the number of youths who present symptoms of a mental health disorder at intake into a juvenile detention center in the Midwest. Two hundred‐four youths were assessed with the Massachusetts Youth Screening Instrument‐Second Version (MAYSI‐2; Grisso & Barnum, 2000), a mental health screening instrument. At least 68% of the youths identified symptoms of a mental health disorder at intake. Given the significant number of youths who identified symptoms of a mental health disorder at intake into detention, the need to provide mental health services for juvenile detainees should not be ignored.     

Evaluating the Reliability of Expert Evidence in Compensation Procedures: Are Diagnosticians Influenced by the Narrative Fallacy when Assessing the Psychological Injuries of Trauma Victims?

The current study investigated whether mental health practitioners are influenced by the narrative fallacy when assessing the psychological injuries of trauma victims. The narrative fallacy is associated with our tendency to establish logical links between different facts. In psychodiagnostic assessments, this tendency may result in overdiagnosis of mental disorders when psychological symptoms can be attributed to a traumatic event. Consequently, legal decision makers may be at risk of awarding compensation for psychological injuries which are not severe enough to justify financial reimbursement. To explore this topic, we asked Dutch mental health practitioners whether they would assign a diagnosis of mental disorder to fictitious symptoms of psychological injury. Each participant was presented with two vignettes. The first vignette described symptoms in terms of a generalized anxiety disorder; the second in terms of a major depressive episode. The vignettes varied in the cause (trauma versus cause not specified) and severity (near threshold of DSM diagnosis versus below threshold of DSM diagnosis) of the symptoms. Results indicated that participants more often assigned a diagnosis of mental disorder if the psychological symptoms had been caused by a traumatic event than if that had not been the case. Further analysis of the data suggested that this difference was due to the high numbers of assigned diagnoses of posttraumatic stress and acute stress disorder in the trauma conditions. It was speculated that participants filled in missing information to justify the assignment of such diagnoses, for example by imagining symptoms of intrusion and avoidance.     

Effectiveness of a prolonged incarceration and rehabilitation measure for high-frequency offenders

Objectives

To estimate the incapacitation effect and the impact on post-release recidivism of a measure combining prolonged incarceration and rehabilitation, the ISD measure for high frequency offenders (HFOs) was compared to the standard practice of short-term imprisonment.

Methods

We applied a quasi-experimental design with observational data to study the effects of ISD. The intervention group consisted of all HFOs released from ISD in the period 2004–2008. Two control groups were derived from the remaining population of HFOs who were released from a standard prison term. To form groups of controls, a combination of multiple imputation (MI) and propensity score matching (PSM) was used including a large number of covariates. In order to measure the incapacitation effect of ISD, the number of convictions and recorded offences in a criminal case of the controls were counted in the same period as their ISD counterfactuals were incarcerated. The impact on recidivism was measured by the prevalence and the frequency of reconvictions corrected for time at risk. Robustness of the results were checked by performing a combined PSM and difference-in-difference (DD) design.

Results

The estimate of the incapacitation effect was on average 5.7 criminal cases and 9.2 offences per ISD measure. On average 2.5 convictions and 4 recorded offences per year per HFO are prevented. The HFOs released from ISD showed 12 to 16 % lower recidivism rates than their control HFOs released from prison (Cohen’s h?=?0.3–0.4). The recidivists of the ISD group also showed a lower reconviction frequency than the control group recidivists (Cohen’s d?=?0.2).

Conclusions

The ISD measure seems to be effective in reducing recidivism and crime. The estimated incapacitation effect showed that a large portion of criminal cases and offences was prevented. DD analysis and sensitivity analyses confirmed the robustness of the PSM results. Due to the absence of actual treatment data, the effects found cannot be attributed separately to resocialization, imprisonment, or improvement of life circumstances.