Post release arrest experiences of federal prisoners: A six-year follow-up

The likelihood of further criminal conduct is important in allocation decisions for parole supervision resources. In this article, the relationship between arrest-free time after release (alone and in combination with other variables) and the probability of subsequent arrest is examined for a relatively large random sample of released federal prisoners (N=1,806). A six-year follow-up period is made possible by the use of “rap sheet” records provided by the Federal Bureau of Investigation.Knowledge of this relationship may be used to provide empirical guidance for decisions about the intensity and/or duration of supervision; and a method for the practical application of this knowledge in case decision-making is illustrated.     

Health care in Canada: patterns of funding and regulation

During the 1970s the share of health care expenditure in Canadian GNP remained roughly stable, in the range of 7-71/2 percent of GNP, in marked contrast to its escalation in most other countries (the U.S. in particular) and to previous Canadian experience. The shift to a stable pattern coincided with the completion of the Canadian system of universal comprehensive public hospital and medical care insurance. This paper explores how and why the public insurance system served to contain cost escalation. It then discusses the inadequacy of expenditure experience per se as a basis for health system evaluation--the same data will support claims of both "underfunding" and "spiralling costs." More serious questions involve the influence of alternative patterns of health care funding and delivery on the effectiveness and efficiency of care provision, and the resulting distributional patterns of care and income. A brief sketch is given of the present situation and future possibilities of Canadian health care under these heads.     

Drug-related deaths among recently released prisoners in the Strathclyde Region of Scotland

Drug abuse and its consequences are everyday problems encountered globally, and Scotland is no exception. During a study of drug-related deaths in the Strathclyde region of Scotland it was noted that known drug users who had recently been released from prison were at high risk of dying from a drug overdose. The majority of deaths occurred within one week of the release date and polydrug use was prevalent. Morphine was the most frequently encountered drug and this was found in combination with benzodiazepines in a significant number of cases. This paper highlights the dangers of resuming drug consumption following a period of abstinence.     

The mortality of released Finnish prisoners; a 7 year follow-up study of the WATTU project

Objective. The aim was to compare the mortality of released prisoners and the general population.Method. The study forms a part of the Health Survey of Finnish Prisoners (the WATTU Project). A sample (N=903), representing all Finnish male prisoners, underwent a thorough health survey in 1985. A 7 year follow-up study was performed by means of gathering register data (deaths, hospital care, diseases leading to working incapacity). A population-based age-selected control group was formed for comparison.Results. During the follow-up, 13.2% of the sample died (natural deaths 5.2%, accidental deaths 4.1%, suicides 2.0%), whereas the corresponding figure in the control group was 3.4%. Overmortality among released prisoners, when compared to the general population, was also found in different death categories.Conclusion. The high somatic and psychiatric morbidity and mortality due to prisoner suicide, when imprisoned, has been reported in many earlier studies. This is probably the first study to confirm the high mortality in different death categories of a representative sample of released prisoners compared to a control group representing the general population. It is important to try to help released prisoners to get a new grip on normal life, especially if they also have somatic or mental health problems. More effort should be made to improve the collaboration between different health care systems.     

Using self-report inventories to assess recidivism risk among prisoners about to be released on parole supervision in Sweden

Prison release planning is rarely based on adequate assessment using evidence-based instruments. This study uses well-established self-reports for screening of problem severity and for predicting recidivism, measured as reconvictions during one-year following release, in prisoners about to be conditionally released on probation in Sweden between 2009 and 2010. One Hundred and six prisoners completed the following measures: Karolinska Scales of Personality, Hopkins Symptom Checklist-25, Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test. Results show frequent mental health and substance use problems and high scores on the KSP psychopathy factor. Anxiety and problematic drug use were the two most important factors associated with one-year recidivism. Prior to release, self-reports could be useful for screening of problem severity, and for predicting recidivism.     

The mental health needs of incarcerated youth in British Columbia, Canada

The purpose of the study was to identify the current prevalence of mental disorders and mental health needs among incarcerated male and female youths in Canada, and to present these data in the context of rates found in other jurisdictions. One hundred forty male and 65 female incarcerated young offenders in British Columbia were screened with the Massachusetts Youth Screening Instrument Version 2 (MAYSI-2); provisional psychiatric diagnoses were assessed with the Diagnostic Interview Schedule for Children Version IV (DISC-IV); abuse history and aggressive symptoms of Conduct Disorder (CD) were coded from file information. Nearly all youths (91.9% of males and 100% of females) met the criteria for at least one mental disorder. Substance abuse and dependence disorders were highly prevalent (85.5% of males and 100% of females). Aggressive forms of CD were common (72.9% of males and 84.3% of females), as were exposure to physical abuse (60.8% of males and 54.3% of females) and sexual abuse (21.2% of males and 42.4% of females). Female youths had significantly higher odds of presenting with: (1) substance abuse/dependence disorders; (2) current suicide ideation; (3) sexual abuse; (4) PTSD; (5) symptoms of depression and anxiety; (6) Oppositional Defiant Disorder; and (7) multiple mental disorder diagnoses. Male youths had significantly higher odds of presenting with aggressive symptoms of CD. Overall, rates of mental disorder among this sample of serious and violent young offenders were higher than rates previously reported for incarcerated youths — both in Canada and in other jurisdictions.     

US Judge: inadequate medical care for HIV-positive prisoners is a violation of rights

A federal judge in the United States has determined that Alabama prison officials violated HIV-positive prisoners' constitutional rights and that poor medical care caused HIV-positive prisoners to die early.     

The Hermeneutics of Jurisdiction in a Public Health Emergency in Canada

This paper investigates the state of the law in Canada in regards to a public health emergency, and in particular the jurisdictional logic that might come into effect were a public health emergency to occur. Although there has yet to be a national public health emergency in Canada, threats of such crises are likely to arise in the future. It is therefore recognised as necessary to address Canada’s legal preparedness for a public health emergency and evaluate proposed reforms to the legal structure that could facilitate response. This paper contributes to this goal by identifying multiple jurisdictional factors that could inform legal interpretations in a public health emergency. It considers how the legal system and the courts are dealing with public health as a national security issue (political and collective matter) while taking into account s. 7 of the Canadian Charter (individual rights). It also looks at the power of the government defined in the Emergencies Act [1985, c. 22] and a proposed legal reform that would make it easier for the government to act unilaterally in a public health emergency. The paper draws on the legal theory of Robert Cover to analyse the hermeneutics of jurisdiction that characterise legal interpretations of public health in Canada, as well as the relationship between jurisdiction and legal violence that these hermeneutics imply. It then develops a case study of the use of medical triage in a public health emergency to explore the possibility of holding the state liable under private law for harm caused to individuals by public health decisions. The paper concludes by suggesting that the state’s public health power can be conceptualised as a form of legal violence and that the courts in Canada should adopt a jurisgenerative approach to legal interpretation in the area of public health.     

Incremental validity of ambulatory assessment of acute dynamic risk in predicting time to recidivism among prisoners on parole

ABSTRACT

This study investigates the incremental validity of changes in ten stress-related acute dynamic risk factors, collected through automated telephony over 30 consecutive days following parole, for predicting time to recidivism during the following year. Before release, the participants completed self-report assessment of some stable risk factors – impulsiveness and history of problematic substance use – as well as an assessment of symptoms of anxiety experienced during the weeks prior to release. Analysis of the baseline assessments showed that impulsiveness and a history of problematic substance use, but not pre-release symptoms of anxiety, were associated with recidivism during the parole year. Growth modelling using a linear mixed model was used to assess whether inmates on parole showed changes in acute dynamic risk factors during the first month following release. Individual growth model slopes and intercept were then extracted and used as covariates in a series of Cox regression analyses to test whether changes in acute dynamic risk factors could provide incremental predictive validity beyond baseline stable risk factors. Changes in five dynamic risk factors were associated with an increased risk of recidivism, of which daily drug use and daily summary score showed incremental predictive improvement beyond impulsiveness and history of problematic drug use.     

Community-based care for people with severe mental illness in Canada

The development of mental health services for people with severe mental illness has in many ways paralleled that in other countries, particularly the United States. As reliance on inpatient psychiatric care has been sharply reduced, a wide range of community supports have been developed. Several distinct institutional and legal features have contributed to shaping the nature of these community supports, which are described herein. At present, the result is a highly fragmented system of care. Key evidence-based practices, notably assertive community treatment, supported employment, and integrated treatment for concurrent severe mental illness and substance use disorder, achieve considerable integration at the clinical level, but remain relatively unavailable in most provinces. The policy of regionalization of services risks inhibiting the development of such practices, which require more centralized technical assistance and monitoring. An evolutionary approach of gradually introducing integrated, evidence-based programs may provide the most feasible strategy for improving the system.