Men and women in the same prison: interpersonal needs and psychological health of prison inmates

The purpose of this study was to investigate the gender differences in the state of interpersonal needs and psychological health of male and female prison inmates who live in the same prison. The authors conducted in-person interviews with 118 male and 70 female inmates. The results show that women present a better interpersonal state and psychological health than do men. For both genders, the consequences of fulfilling or not fulfilling interpersonal needs-specifically, social loneliness and sexual satisfaction-are associated with psychological health. These findings suggest the importance of the state of prison inmates' interpersonal needs in promoting psychological health in the context of the prison, where these needs are generally difficult to be met. Making contacts possible between male and female inmates who are in the same prison might help them to better fulfill some of their interpersonal needs, especially those related to their sexual lives.     

Substance use,health, and mental health: problems and service utilization among incarcerated women

This article profiles self-reported substance use, health, and mental health problems among a sample of incarcerated women in Kentucky as well as lifetime service utilization. Findings indicate that a high percentage of women reported use of alcohol, cocaine, and multiple substances during the month before incarceration. In addition, participants reported common health problems such as dental, female reproductive, physical injuries, and mental health problems including depression and anxiety. Participants reported moderate use of emergency room and mental health treatment but limited substance abuse treatment utilization. Implications for criminal justice programs and linkages with community-based aftercare services for women are recommended based on findings that health and mental health problems are associated with service utilization before incarceration.     

Racial differences in violence and self-esteem among prison inmates

Recent scholarship in social psychology suggests that individuals with an elevated sense of self-esteem may respond aggressively or violently when this heightened egoism is threatened. The present study explores differences in self-esteem, aggression, and violent behavior among a sample of 644 male state prison inmates. The results indicated that Black inmates expressed higher levels of self-esteem than White inmates. Although Blacks and Whites did not differ on a psychological measure of aggressive personality, Black prisoners reported more violent behavior than Whites. Moreover, high self-esteem predicted violent behavior inside prison, but only for Whites. This finding suggests that the relationship between high self-esteem and violence may be race-specific.     

The mental health and substance misuse needs of male ex-armed forces personnel in prison

Ex-armed forces personnel constitute the largest known occupational group in prison but there is little evidence regarding their mental health, or substance misuse, needs. A total of 105 participants were interviewed and measures assessing symptoms of common mental health (CMH) problems and substance misuse were completed along with a review of their health care records. Forty (38%) participants screened for current CMH problems (CCMH) and high levels of dual symptomology and alcohol misuse were assessed. Thirty-nine (37%) had a mental health diagnosis recorded, most commonly for post-traumatic stress disorder (PTSD), depression and personality disorder. Those who screened for a CCMH problem were more likely to have pre-service vulnerability to negative health outcomes and those with dual symptomology were more likely to have experienced deployment during their service. Findings suggest the mental health needs of this group are similar to the general prison population. Potentially higher prevalences of PTSD and alcohol misuse may direct service provision.     

Information pathways into prison mental health care

Police and court liaison and diversion services provide important specialist mental health input along critical stages of the criminal justice pathway. Effective sharing of information between the services and relevant justice agencies is essential. However, various problems exist with the flow of information between agencies and services across the criminal justice pathway. This service evaluation explored how clinically relevant information is transferred, by drawing on the perspectives of prison health care staff in a large urban UK male prison. A qualitative service evaluation was conducted using semi-structured interviews with a purposive sample of 11 prison staff. The main themes included: gaps in the transfer of essential information, (particularly concerning risk and offending information); information gathering to fill these gaps; the importance of professional relationships, information sharing between agencies; and information solutions. Improving information transfer across the criminal justice pathway could prevent treatment delays and ensure more timely mental health care in prison.     

Pregnancy in prison,mental health and admission to prison mother and baby units

Little is known about the mental health of pregnant women in prison in England or the factors which impact admissions to prison mother and baby units (MBUs). Research from the UK suggests women with more ‘stable’ backgrounds and lower prevalence of mental disorder are more likely to be admitted to prison MBUs. Eighty-five pregnant women were interviewed in eight different prisons. Schedules for the Clinical Assessment of Neuropsychiatry (SCAN) and Edinburgh Postnatal Depression Scale (EPDS) were used to assess mental health; Severity of Dependence Questionnaire (SOD-Q) for drug misuse; Alcohol Use Identification Test (AUDIT) for hazardous drinking; and the Structured Clinical Interview for DSM-IV (SCID-II) to identify personality disorder. Fifty-one per cent of participants had depression and 57% had anxiety. Those who were working prior to imprisonment were more likely to be admitted to MBUs, and those with a prior social services involvement, diagnosis of personality disorder or history of suicidality were less likely to be admitted. The high levels of depression and anxiety can have negative impacts on both the mother and her unborn child. Factors which influence MBU admission suggest those who might benefit most from MBU placement are least likely to be admitted.     

Rating the prison boss: Examining supervision among prison health care staff

Health care staff are instrumental in prisons given their roles in aiding security and the growing demand for medical services among prisoners. Unfortunately, little attention has been paid to this prison staff subpopulation. This study examined perceptions of supervision among 424 prison health care staff in the Federal Bureau of Prisons. Participants felt that prison supervisors were most effective in clarifying expectations and least effective in giving feedback for performance, involving staff in planning, and extending job autonomy. Using hierarchical linear models (HLM), some unique findings emerged. Efficacy in dealing with inmates was the strongest predictor variable: health care staff who felt more positive and effective with inmates had more favorable feelings toward supervision. Staff working in high- and medium-security prisons had more positive feelings toward supervision than those in minimum security, and younger staff had more favorable attitudes toward supervisors than older staff. The implications of these findings and directions for future research are discussed.     

High mortality rates among inmates during the year following their discharge from a French prison

While the poor health status of prisoners has been highlighted in Western countries, the surveillance of their mortality has been neglected. We studied the mortality of 1305 prisoners released during 1997 from a French prison. Vital status after release was obtained for 86.4% of them. Compared with the general population, ex-prisoners non-natural mortality rates were significantly increased both in the 15-34 and 35-54 age categories (3.5-fold and 10.6-fold respectively) and the risk of death due to overdose was 124 and 274 times higher in the same categories respectively. Prevention and care should be reinforced in the pre-release period without waiting more epidemiological data.     

Attachment and social bonding in maximum and minimum security prison inmates

Attitudes towards social attachment and bonding were evaluated in groups of maximum (N=48) and bonding were evaluated in groups of maximum (N=46) security prison inmates and compared with the attitudes of a group of 49 noncriminal college students. Three primary styles of attachment were considered: avoidant, ambivalent/anxious, and secure. It was predicted that the maximum security condition, a group hypothesized to contain a large number of lifestyle criminals, would evidence more of an avoidant style of attachment compared to minimum security inmates or a group of college student controls. Consistent with this hypothesis, the maximum security inmates exhibited greater avoidance in their attitudes towards relationships than subjects in the other two conditions. The implications of these results are discussed.     

Attachment and social bonding in maximum and minimum security prison inmates

Attitudes towards social attachment and bonding were evaluated in groups of maximum (N = 48) and minimum (N=46) security prison inmates and compared with the attitudes of a group of 49 noncriminal college students. Three primary styles of attachment were considered: avoidant, ambivalent/anxious, and secure. It was predicted that the maximum security condition, a group hypothesized to contain a large number of lifestyle criminals, would evidence more of an avoidant style of attachment compared to minimum security inmates or a group of coliege student controls. Consistent with this hypothesis, the maximum security inmates exhibited greater avoidance in their attitudes towards relationships than subjects in the other two conditions. The implications of these results are discussed.     

Learning disabilities and delinquency: a study of Israeli prison inmates

Research consistently illustrates that several intellectual disabilities--namely, learning disabilities (LD), low intelligence, challenging behavior, and inadequate adaptive behavior, as well as attention deficit hyperactivity disorder (ADHD)--are considered risk factors for antisocial and criminal behavior. Although much attention has been paid to the relationship of LD, ADHD, and criminal behavior, three research topics have been overlooked: the frequency of LD with ADHD among inmates, the relationship between LD and/or ADHD and level of education among prisoners, and the connection between LD and/or ADHD and age of criminal onset. The present study examined the frequency of LD and ADHD in a sample of Israeli-born prisoners, in addition to the frequency of each category by itself, and it investigated the relationship of LD and/or ADHD, school dropout age, and onset of criminal activity.     

Prevalence of mental disorders among sexual offenders in forensic psychiatry and prison

The objective of this study was to compare the prevalence of mental disorders among sexual offenders in forensic psychiatry (SF) with the prevalence of such disorders among sexual offenders in prison (SP) and violent offenders in prison (VP). In a cross-sectional study, 40 of 47 SF detained in forensic psychiatry in Baden-Wuerttemberg, Germany, could be included. They were compared with 30 SP and 26 VP. All study participants were interviewed by means of SCID I and SCID II and assessments of functioning (GAF, BSS). There was a high prevalence of mental disorders (DSM-IV: Axis I) in all three groups (SF: 80%, SP: 63%, VP: 73%). Among SP and VP, this was attributed mainly to substance use disorders. The prevalence and comorbidity of personality disorders was significantly higher in the group of the SF (prevalence: SF: 85%, SP: 27%, VP: 39%). In a psychopathological view, SP were all together more similar to the imprisoned non-sexual delinquent VP than to the SF.     

Deaths among criminal suspects, law enforcement officers, civilians, and prison inmates: a coroner-based study

During the interaction between a criminal suspect and a law enforcement officer, the risk of death to the suspect, police, or civilians is increased. Unfortunately, very little information is available on the death risks arising from this interaction. This study provides an assessment of the risk of death to law enforcement officers, suspects, and bystanders by separating the interactions into the following 4 phases: (1) events prior to and during arrest; (2) police pursuits or chases; (3) transport of the suspects; and (4) during incarceration. A 5-year (1994-1998) retrospective coroner-based study of all deaths that occurred during these 4 phases was conducted in Allegheny County, Pennsylvania. A total of 77 cases were identified; 14 deaths (18.1%) occurred prior to or during arrest, 10 (12.9%) during police chases, 2 (2.6%) occurred while the actors were being transported, and 51 (66.2%) during incarceration. The majority of cases (98.7%) were males, blacks (63.6%), and single (50.6%). The respective risks of death by phase were prearrest/arrest, 6.5 per 100,000 arrests; transport, 0.93 deaths per 100,000 arrests; and incarceration, 268 deaths per 100,000 inmates. Study showed the following: (1) risk of death to offenders was greatest during police pursuits; (2) the risks during arrests are not insignificant and involved an officer being threatened with a weapon in one-third of the events; and (3) deaths among inmates were primarily due to natural causes.     

Self-report rates of physical and sexual violence among Spanish inmates by mental illness and gender

High rates of mental illnesses and victimization have been reported for prison populations. This study estimates physical and sexual victimization rates (inmate-on-inmate and staff-on-inmate) for people with and without mental illnesses residing in Spanish prisons. A random sample of 2484 male and 225 female inmates was drawn from eight prisons in Spain. Self-report data were collected on victimization, mental illness and sociodemographic characteristics. Prevalence rates of physical and sexual victimization during the past six months in prison among men with mental illnesses were higher than for men without reported mental illnesses (39.1% vs. 16.4% and 8.6% vs. 3.3%, respectively). Similar comparative results were found for women with and without mental illnesses (29.7% vs. 17.5% and 13.3% vs. 10.3%, respectively). A positive association was found between mental illnesses and victimization. This evidence suggests the need for integrated trauma treatment and proactive steps to protect incarcerated persons from violence during incarceration.     

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.     

Expressed needs and behavioral risk factors of HIV-positive inmates

Considerable research has found inmates to be at high risk for HIV/AIDS. Furthermore, research has shown additional HIV/AIDS threats faced by females in the general population and especially by those incarcerated. Behavioral interventions and educational programs have been developed based on these studies. However, few empirical studies have examined the self-expressed needs of HIV-positive inmates or the degree to which inmates' needs are gender specific. This pilot study compares the needs of HIV-positive male and female jail detainees. Results illustrate surprisingly few differences between men and women and their HIV-related needs. The primary need identified for both males and females was postrelease housing. Somewhat unexpectedly, HIV treatment and care ranked low on the list of needs. The implications of these finds are discussed.