Showing papers on "Prison published in 1997"

Predicting Prison Misconducts

Abstract: A meta-analysis was conducted on 39 studies that generated 695 correlations with prison misconducts. Predictors of prison misconducts were grouped into 16 domains as follows: (a) personal character...

An Effective Model of Prison-Based Treatment for Drug-Involved Offenders:

Abstract: A multistage therapeutic community treatment system has been instituted in the Delaware correctional system, and its effectiveness has captured the attention of the National Institutes of Health, the Department of Justice, members of Congress, and the White House. Treatment occurs in a three-stage system, with each phase corresponding to the client's changing correctional status—incarceration, work release, and parole. In this paper, 18 month follow-up data are analyzed for those who received treatment in: (1) a prison-based therapeutic community only, (2) a work release therapeutic community followed by aftercare, and (3) the prison-based therapeutic community followed by the work release therapeutic community and aftercare. These groups are compared with a no-treatment group. Those receiving treatment in the two-stage (work release and aftercare) and three-stage (prison, work release, and aftercare) models had significantly lower rates of drug relapse and criminal recidivism, even when adjusted for othe...

Lifetime likelihood of going to state or federal prison.

Abstract: This report presents data on the lifetime likelihood of a US resident being incarcerated in a state or federal prison. The hypothetical measure used in the analysis is based on the assumption that recent incarceration rates and death rates will remain stable and excludes data on admissions to local jails. This measure reveals a 5.1% lifetime chance of incarceration with men more than eight times more likely than women to be incarcerated. Black men are twice as likely as Hispanic men and six times more likely than White men to be imprisoned. Rates of incarceration for women are 3.6% for Blacks 1.5% for Hispanics and 0.5% for Whites. When age factors are included in the calculation the likelihood of going to prisons is shown to decrease with advancing age. The report also discusses adjustments that were made to data derived from 1991 surveys of State and Federal prisoners to obtain the total number of first admissions (the surveys failed to include people who were admitted and released during the 12 months prior to the survey). After including data on the type of offenses for first incarcerations the remainder of the report is devoted to a consideration of the validity of the data analysis. Data from surveys of State prisoners in 1974 1979 1986 and 1991 support the life table finding. A comparison is then made of lifetime rates to other measures of incarceration such as one-day prevalence rates or 1-year admission rates. The life table technique used in this report is then described in detail.

Age, Testosterone, and Behavior Among Female Prison Inmates

Abstract: OBJECTIVE: The objective of the study was to determine how testosterone levels, both alone and interacting with age, were associated with criminal behavior and institutional behavior among female prison inmates. METHOD: Subjects were 87 female inmates in a maximum security state prison. Criminal behavior was scored from court records. Institutional behavior was scored from prison records and interviews with staff members. Testoster-one levels were scored from radioimmunoassay of saliva samples. RESULTS: Product-moment correlations revealed first-order relationships among age, testosterone, criminal behavior, and institutional behavior. Structural equation analysis suggested a causal model in which age leads to lower testosterone, which in turn leads to less violent crime and less aggressive dominance in prison. CONCLUSION: Testosterone is related to criminal violence and aggressive dominance in prison among women, as has been reported among men. Changes in these behaviors with age are in part explained by a decline in testosterone levels. Language: en

Religious programs, institutional adjustment, and recidivism among former inmates in prison fellowship programs

Abstract: This study examines the impact of religious programs on institutional adjustment and recidivism rates in two matched groups of inmates from four adult male prisons in New York State. One group had participated in programs sponsored by Prison Fellowship (PF); the other had no involvement with PF. PF and non-PF inmates are similar on measures of institutional adjustment, as measured by both general and serious prison infractions, and recidivism, as measured by arrests during a one-year follow-up period. However, after controlling for level of involvement in PF-sponsored programs, inmates who were most active in Bible studies were significantly less likely to be rearrested during the follow-up period.

Gender, Race, and Sentencing

Abstract: Race and gender pose empirical and policy problems that are both similar and different for the U S criminal justice system They are similar in that blacks and women occupy subordinate social and economic positions in American life, and their interests are less likely to be represented in the justice system than are those of white men They are different in that blacks are overrepresented in arrest statistics and jail and prison populations while women are underrepresented If over- (or under-) representation is assumed to result from similar effects of bias and subordination, the two patterns are hard to explain The empirical literature on criminal courts reveals policy dilemmas in achieving "just" sentencing practices Blacks (and especially black men) may be more likely than white men or women to benefit from tightly limited discretion and limited individualization of sentencing whereas women (both black and white) may be more likely to benefit from broader discretion and greater individualization

GENDERED ORGANIZATIONAL LOGIC Policy and Practice in Men's and Women's Prisons

Abstract: This article uses Acker's theory of gendered organizations to frame an analysis of the ways in which policies and practices in a men's and a women's prison reflect and reproduce gendered inequalities. The article offers a working definition of one of Acker's key theoretical concepts, the notion of “gendered organizational logic.” Then, using interview data collected from correctional officers in a men's and a women's prison, the article examines the ways in which officer training and assignments, although designed to be nominally generic, assume a male worker and disproportionately benefit male officers working in men's institutions. These findings imply that the perspective could more usefully be conceived as a theory of “masculinized” organizations.

Restorative Justice: How It Works

Abstract: Acknowledgements. Introduction. 1. What is Restorative Justice? 2. A Brief History of Restorative Justice. 3. Restorative Approaches Involving Victims and Offenders Separately. 4. Models of Restorative Justice Involving Victims and Offenders Together. 5. Restorative Approaches for the Early Years of Life 6. Restorative Approaches in Schools 7. Restorative Justice with Victims and Young Offenders in the UK. 8. Restorative Justice with Victims and Adult Offenders in the UK. 9. Restorative Justice in Prisons 1: Prisoners Making Amends.10. Restorative Justice in Prisons 2: Relationships in the Prison Community. 11. Restorative Justice Around the World. 12. Restorative Justice in Complex and Sensitive Cases. 13. Issues in Restorative Justice. 14. Research: A Selection. 15. Restorative Justice after Large-Scale Violence or Oppression. 16. Arts Approaches to Restorative Justice. Postscript: Growing Points. Appendix 1. Restorative Justice Consortium: Principles of Restorative Processes December (2004). Appendix 2. United Nations: Basic Principles on the Use of Restorative Justice Programmes in Criminal Matters (2002). Appendix 3. Glossary. Appendix 4. Further Reading/Resources in Restorative Justice. Appendix 5. Organisations and websites. Appendix 6. Index of case studies. Subject Index. Author Index.

Probation in the United States

Abstract: Probation officers supervise two-thirds of all correctional clientele in the United States. But despite the unprecedented growth in probation populations over the past decade, probation budgets have not grown. The result is that U. S. probation services are underfunded relative to prisons and serious felons often go unsupervised, encouraging offender recidivism and reinforcing the public's view that probation is too lenient and lacking in credibility. Yet, there is much unrealized potential in probation. Recent research shows that probation programs, if properly designed and implemented, can reduce recidivism and drug use. Moreover, certain probation programs are judged by offenders to be more punitive than short prison terms, and the public seems increasingly willing to support intermediate sanctions for nonviolent offenders. Experimentation and evaluation are needed to determine whether adequately funded probation systems can protect society and rehabilitate offenders.

Occupational deprivation and incarceration

Abstract: occupational deprivation is a concept which we are in the early stages of conceptualising and defining. However, that does not make it any less real to those who have experienced extended periods of occupational deprivation. This paper outlines an investigation into the occupational world of a group of inmates in one of New Zealand's largest maximum security prisons. These inmates were part of a special unit as they were identified as having special needs. The project started in response to a request from the prison to establish an occupational therapy programme in the unit. Through further dialogue it became clear that there were more basic questions that needed to be addressed. What was required was an assessment of the occupational needs of the inmates and this was subsequently agreed to and contracted for.. Occupational Needs Assessment Process The process of investigation included a time use survey, a review of current levels of occupational engagement of all inmates and an assessment of ind...

An Assessment of Prison-Based Drug Treatment: Texas' In-Prison Therapeutic Community Program

Abstract: In response to increasing problems associated with drug-abusing offenders, the 1991 Texas Legislature provided a statutory foundation for the development of a comprehensive drug treatment program within the state's criminal justice system. In an effort to assess the impact of the prison-based treatment component of this legislative mandate, the Texas Commission on Alcohol and Drug Abuse funded the Institute of Behavioral Research at Texas Christian University to conduct a comprehensive prison-based treatment assessment (PTA) including studies of the In-prison Therapeutic Community (ITC) treatment process and posttreatment outcomes. This article provides an overview of the research project and findings from the 6-month follow-up study. Preprison and during-treatment information was collected from 293 ITC program participants. Six-month follow-up interviews were completed with 222 ITC program graduates and compared with a comparison sample of 75 parolees who were eligible but not sent to ITC treatm...

Social Support and Psychological Distress in a Group of Incarcerated Young Offenders

Abstract: Using Power, Champion, and Aris's Significant Others Scale, the present study examined the function and structure of social support in a group of incarcerated young offenders. Support across nine key relationships from both outside and inside the prison were examined. The study aimed to examine social support as a key variable in coping with incarceration. Furthermore, the study examined the role that social support plays in the experience of self-reported psychological distress (anxiety, depression, and hopelessness) while incarcerated The importance of prison relationships-with a close friend and members of prison staff in the experience of psychological distress-was highlighted, where distressed inmates were more likely to report discrepancies in the actual/ideal levels of both emotional and practical support. Regression analyses highlighted the importance of relationships with the staff as predictors of anxiety, depression, and hopelessness.

They were cheap and available: prisoners as research subjects in twentieth century America

Abstract: On 20 August 1947 Gerhard Rose, one of Germany's most respected physicians, stood in the prisoner's dock at the Palace of Justice in Nuremberg, Germany, awaiting his sentence for “murders, tortures, and other atrocities committed in the name of medical science.” Dr Rose, the department head for tropical medicine of the Robert Koch Institute, was on trial along with 22 of his medical colleagues, for perpetrating “ghastly” and “hideous” experiments on concentration camp prisoners during the war.1 At one point in the trial when the chief prosecution witness, Dr Andrew C Ivy of the medical school of the University of Illinois, underscored the basic principle “that human experimental subjects must be volunteers,” Dr Rose and his defence counsel vigorously objected, arguing that the United States was guilty of similar medical practices and giving several examples to support this contention.1 The Nazi doctor's first example of American complicity concerned the medical experiments of Dr Richard P Strong, who performed a series of studies in 1906 with “cholera virus upon inmates of the Bilibid Prison in Manila.” The Philippine Islands experiment on prisoners already sentenced to death resulted in 13 fatalities and was eventually attributed to a bottle of bubonic plague serum having been substituted mistakenly for a bottle of cholera serum.2 3 4 5 Strong, who later became professor of tropical medicine at Harvard University, was not deterred by the error and continued experiments on Philippine prisoners. His beriberi experiments six years later also resulted in death, but survivors were compensated with cigars and cigarettes. Another German physician on trial for his life at Nuremberg, Dr Georg August Weltz, the chief of the Institute for Aviation Medicine in Munich, offered the name of another American doctor who used prisoners on behalf of medical science. Dr Joseph Goldberger, a …

Children of Incarcerated Parents

Abstract: Introduction Most of the over one million persons incarcerated in U.S. jails and prisons on any given day and the millions more on probation or parole are parents. Although a considerable body of information has been collected about individuals who have been or are under some form of criminal justice system control, very little is known about their children, particularly those under the age of 18. There are approximately 10 million children in the U.S. who have had one or both parents incarcerated. These children and youth have little or no voice about who, in the absence of the parent who is the primary caregiver, will take care of them, or if they will be allowed to visit or communicate with the incarcerated parent. The children of parents involved in the criminal justice system have no voice because they are invisible to the larger society. The national trend to use incarceration to punish even minor offenses guarantees that children will continue to be adversely affected by policies enacted with no consideration of the harm done to family systems. There are many complex and interrelated contributing factors: the intensification of politically motivated "get tough on crime" rhetoric and the "War on Drugs," public discourse about crime designed to instilled fear, the enactment of increasingly harsh sentencing laws such as "Three Strikes," and the ratings-driven media preoccupation with policing and arrests, leading to public support for a prison-building frenzy. The virtual disappearance of work, along with stores, transportation, and other components of a viable infrastructure, from many inner-city communities has resulted in a concentration of poverty that has devastated neighborhoods and marginalized residents, making them easy first to criminalize and then to dehumanize. The original intent of this article was to examine what is presently known about the children of incarcerated parents. Its scope has been expanded to include the more realistic continuum of parental crime, arrest, incarceration, release, and recidivism that children experience and must contend with as their lives are disrupted, and sometimes shattered. We begin by placing present events into a larger historical and political context. Available information about the children of incarcerated parents is provided, followed by a discussion of caregivers, custody, and visitation issues. The next sections describe what is known about the impact on children of parental involvement in the criminal justice system, as well as observable intergenerational trends, and then look at how law enforcement and social service agencies regard and respond to children of arrested and incarcerated parents. We conclude with interventions that address and alleviate the problems resulting from parental involvement in the criminal justice system. Background In 1990, the United States had the highest incarceration rate in the world, five times higher than France and Germany and over four times greater than Britain's rate (Foote, 1993). California has the dubious distinction of having the largest prison system in the country and the second largest in the world following China (Ibid.). One out of every eight U.S. prisoners is incarcerated in the Golden State. In less than 20 years, California's prison population has exploded by 631%, from 19,000 in 1977 to 139,000 in 1996; over 97,000 persons are presently on parole.(1) An additional 71,000 Californians were local jail inmates as of April 1996(2) and 400,000 former California jail inmates were on probation in 1995 (Criminal Justice Institute, 1994). Changes in mandatory sentencing guidelines enacted during the mid-1970s have led to a significant shift in public policy favoring punishment over rehabilitation. Passage of the "Three Strikes"(3) legislation in the early 1990s has taken a decisive step in making the concept of rehabilitation historically obsolete.(4) To accommodate growing numbers of felons sentenced under the 1,000 new state laws specifying new offenses and increased sentences passed by the legislature (Foote, 1993), California has added 20 new prisons to its original 12 since the early 1980s (CDC, 1994). …

Job control and occupational outcomes among prison workers

Abstract: Management studies have shown considerable theoretical development and empirical support for the proposition that giving workers an opportunity to influence decision making and to control operations results in desirable occupational outcomes. In contrast, the most widely recognized study of prison management, DiIulio's Governing Prisons, argues for a traditional management style that severely restricts prison employees' influence and control, and embodies a bureaucratic model of organization. This study tests whether, at an organizational level, job control influences prison workers' satisfaction and performance. Results from a study of 73 federal prisons support the model suggested by management studies over DiIulio's traditional model: Job autonomy and participation in decision making are associated with enhanced occupational outcomes including higher job satisfaction, stronger commitment to the institution, greater effectiveness in working with inmates, and less job-related stress.

Private prisons and public accountability

Abstract: The growth of private prisons accountability and the political context of privatization accountability, monitoring and capture accountability mechanisms i public sector prisons and their applicability to private prisons letting the contract and setting the terms prison personnel - the administration of punishment and the impact of privatization on penal policy financial accountability an dcontrol comparing public and private prisons special custodial issues and privatization enhancing the prison system - cross-fertilization an dmarketing testing the future growth of privatization a model for public accountability of private prisons.

MAD OR BAD?Child-Killers, Gender and the Courts

Abstract: This article reports some of the findings of a research project on child-killing by parents or parent-substitutes, drawing on a sample of 48 case files from the Director of Public Prosecutions in London from 1984, and a sample of 24 fatal and 23 non-fatal cases reported in the Criminal Appeal Reports and Criminal Appeal Reports (Sentencing) between 1980-90. It was found that the criminal justice system responds very differently to men and women who kill their children at all stages of the legal process, in accordance with the view that men are bad and normal, women are mad and abnormal'. For example, women are less likely than men to be prosecuted; they also predominately use psychiatric' pleas and receive psychiatric or non-custodial sentences. Men, however, tend to use normal' pleas and receive prison sentences. Although this appears to be evidence of men being treated more harshly than women, it is demonstrated that there is some justification for this, on the basis of standard sentencing factors and broader structural reasons. It is also shown that informal mechanisms of social control have a greater impact on the legal processing of women than men. Nonetheless, such dramatically different treatment of the sexes cannot be justified. The paper concludes by suggesting ways to remedy this, drawing on more general criminological debates about sex and sentencing

The prevalence of mental illness among inmates in a rural state.

Abstract: 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.

Mountjoy prisoners: A sociological and criminological profile

Abstract: This report presents the results of a representative sample survey of prisoners in Mountjoy Prison undertaken in May and June of 1996. The aim is to provide a profile of Mountjoy prisoners which focuses on their social and family background, health status with particular emphasis on substance abuse problems, criminal and penal history, and to a limited extent on their experience of and views on prison life and the prison regime.

Harm reduction measures and injecting inside prison versus mandatory drugs testing: results of a cross sectional anonymous questionnaire survey. The European Commission Network on HIV Infection and Hepatitis in Prison.

Abstract: Objectives: (a) To determine both the frequency of injecting inside prison and use of sterilising tablets to clean needles in the previous four weeks; (b) to assess the efficiency of random mandatory drugs testing at detecting prisoners who inject heroin inside prison; (c) to determine the percentage of prisoners who had been offered vaccination against hepatitis B. Design: Cross sectional willing anonymous salivary HIV surveillance linked to a self completion risk factor questionnaire. Setting: Lowmoss prison, Glasgow, and Aberdeen prison on 11 and 30 October 1996. Subjects: 293 (94%) of all 312 inmates at Lowmoss and 146 (93%) of all 157 at Aberdeen, resulting in 286 and 143 valid questionnaires. Main outcome measures: Frequency of injecting inside prison in the previous four weeks by injector inmates who had been in prison for at least four weeks. Results: 116 (41%) Lowmoss and 53 (37%) Aberdeen prisoners had a history of injecting drug use but only 4% of inmates (17/395; 95% confidence interval 2% to 6%) had ever been offered vaccination against hepatitis B. 42 Lowmoss prisoners (estimated 207 injections and 258 uses of sterilising tablets) and 31 Aberdeen prisoners (229 injections, 221 uses) had injected inside prison in the previous four weeks. The prisons together held 112 injector inmates who had been in prison for more than four weeks, of whom 57 (51%; 42% to 60%) had injected in prison in the past four weeks; their estimated mean number of injections was 6.0 (SD 5.7). Prisoners injecting heroin six times in four weeks will test positive in random mandatory drugs testing on at most 18 days out of 28. Conclusions: Sterilising tablets and hepatitis B vaccination should be offered to all prisoners. Random mandatory drugs testing seriously underestimates injector inmates9 harm reduction needs. Key messages Half of injector inmates of two Scottish prisons who had been in prison for more than four weeks had injected in the previous four weeks—an average of six times Injector inmates used sterilising tablets to clean injecting equipment as often as they injected Only 4% of inmates had ever been offered vaccination against hepatitis B Vaccination against hepatitis B and sterilising tablets are prisoners9 rights Random mandatory drugs testing is likely to detect only one third to two thirds of heroin injectors in prison and so seriously underestimates injector inmates9 drug reduction needs

Self-mutilation and suicide attempt: distinguishing features in prisoners

Abstract: Nonlethal forms of self-injury are often discussed together with suicide attempts as though they belonged on a continuum of self-harm. Both types of self-injury are common in prisons, which have a predominantly male population; however, most studies of nonlethal self-injury have been done with female subjects. This exploratory study tested the hypothesis that prisoners who injured themselves without intending to die would differ clinically from prisoners who had attempted suicide. Inmates admitted to the prison unit of a public hospital for treatment of self-inflicted wounds or who had a history of previous self-injury were administered a standardized intake protocol by the first author, which included asking about their intent at the time they injured themselves. Patients were classified as self-mutilators or suicide attempters on the basis of intent. Fifteen patients reported that they had attempted to take their own lives, while 16 reported other reasons for harming themselves. Suicide attempt was associated with adult affective disorder 13/15 versus 2/16 mutilators); self-mutilation with a history of childhood hyperactivity (12/16 versus 1/15 suicide attempters) and a mixed dysthymia/anxiety syndrome that began in childhood or early adolescence (9/16). Prison self-mutilators and suicide attempters had very different clinical presentations and histories. The history of childhood hyperactivity in self-mutilators deserves further study in both correctional and noncorrectional populations.

Treating prison inmates with co-occurring disorders: an integrative review of existing programs

Abstract: The tremendous growth in state and federal correctional populations has focused greater attention on the needs of mentally ill and substance abusing inmates. Although an estimated 3-11% of prison inmates have co-occurring mental health (psychotic and major mood) disorders and substance abuse disorders, few treatment programs are described in the literature and there is little available information regarding effective treatment strategies for this population. The current study provides an integrative review of seven 'dual diagnosis' treatment programs that recently have been developed in state and federal prisons. Many of these have evolved from existing substance abuse treatment programs and approaches. Key program components include an extended assessment period, orientation/motivational activities, psychoeducational groups, cognitive-behavioral interventions such as restructuring of 'criminal thinking errors', self-help groups, medication monitoring, relapse prevention, and transition into institution or community-based aftercare facilities. Many programs use therapeutic community approaches that are modified to provide (a) greater individual counseling and support, (b) less confrontation, (c) smaller staff caseloads, and (d) cross-training of staff. Research is underway in three of the seven sites to examine the effectiveness of these new programs.

The quality of health care in prison: results of a year's programme of semistructured inspections.

Abstract: Objectives: To assess, as part of wider inspections by HM Inspectorate of Prisons, the extent and quality of health care in prisons in England and Wales. Design: Inspections based on a set of “expectations” derived mainly from existing healthcare quality standards published by the prison service and existing ethical guidelines; questionnaire survey of prisoners. Subjects: 19 prisons in England and Wales, 1996-7. Main outcome measures: Appraisals of needs assessment and the commissioning and delivery of health care against the inspectorate9s expectations. Results: The quality of health care varied greatly. A few prisons provided health care broadly equivalent to NHS care, but in many the health care was of low quality, some doctors were not adequately trained to do the work they faced, and some care failed to meet proper ethical standards. Little professional support was available to healthcare staff. Conclusions: The current policy for improving health care in prisons is not likely to achieve its objectives and is potentially wasteful. The prison service needs to recognise that expertise in the commissioning and delivery of health care is overwhelmingly based in the NHS. The current review of the provision of health care in prisons offers an opportunity to ensure that prisoners are not excluded from high quality health care. Key messages The standard of health care in prisons in England and Wales varies widely—a few provide a quality of care close to that in the NHS, but many provide low quality care The commissioning of health care and the monitoring of services in prisons are inadequate More exacting standards for appointing doctors, a mandatory system for continuing professional development, and better support for healthcare staff are needed A better ethical framework is essential The NHS should be more involved in both the commissioning and the provision of health care in prisons

The benefits of social support for mentally ill offenders: prison‐to‐community transitions

Abstract: This paper provides results of a longitudinal study of 27 mentally ill prison inmates who were released from Ohio state prisons in 1994-1996. The object of this paper is to test the hypothesis that subjects who receive better social support will experience more positive social adjustment, higher quality of life, and lower recidivism. Subjects, identified by prison staff, were interviewed and given independent psychological evaluations shortly before their release. They were then interviewed repeatedly during the first year after their release from prison about many aspects of social adjustment. Social support, provided both in and after release from prison, was associated with higher quality of life after release from prison. Social support provided in either context, however, was not significantly related to criminal recidivism or psychiatric hospitalization after release from prison.

Pitfalls of tuberculosis programmes in prisons.

Abstract: Among its other activities, the International Committee of the Red Cross visits prisoners in countries all over the world, essentially in countries at war or affected by conflict. As part of its work aimed at ensuring that prisoners receive adequate care, it has had to deal with the issue of tuberculosis. Recent experience in countries of the former Soviet Union has given us an insight into how complicated the treatment of tuberculosis can be in prisons. There are pitfalls that must be avoided if the disease is to be treated in accordance with the directly observed treatment, short course (DOTS) strategy drawn up by the World Health Organisation and the International Union against Tuberculosis and Lung Disease.1 Directly observed therapy is designed to ensure, by means of direct observation, that patients actually take their full course of treatment. Prisons are, however, particularly difficult environments for applying such a strategy. Prevalencies five to ten times the national average are not uncommon and can be up to 50 times the reported national average.2 3 Tuberculosis may be a, or even the, major cause of death in prisons in developing countries, with mortality rates as high as 24%.4 In the case of tuberculosis, it is better to do nothing than to do something badly—and failure to complete courses of treatment can have disastrous results, leading to the development of multidrug resistant strains of Mycobacterium tuberculosis . The problems described here apply essentially to countries where problems of low income are accompanied by a high prevalence of the disease. Prisons are full beyond capacity, with prisoners from impoverished unhealthy backgrounds living in an even unhealthier environment. Prison health services suffer serious shortcomings, and the internal violence of prisons also has its influence. The setting is perfect for tuberculosis to develop and …

Sex Offender Sentencing in Washington State

Abstract: prison; the remainder received either a jail sentence or probation. For those who were imprisoned, the average length of stay was just over five years.1 For sex offenders determined by the court to be "sexual psychopaths," civil commitment was available. Approximately 200 sex offenders received inpatient treatment at a state mental hospital, which lasted about two years. The hospital staff made continual decisions regarding the offender's progress in treatment. Only about 20 percent of those offenders sent to the hospital were successfully discharged; the remainder were returned to court and sentenced to prison terms.2 In 1981, the Legislature embarked on sentencing reform and appointed a Sentencing Guidelines Commission to recommend the first sentencing guidelines.3 The Commission completed its initial work in 1983. However, at that time the group requested another year to determine if and how to incorporate treatment options for sex offenders. The Commission's report noted that both advocates of sexual assault victims and specialists in the treatment of sex offenders were concerned about the ramifica tions of presumptive sentencing on treatment opportunities for sex offenders.4 Under the indeter minate sentencing scheme, the offender was offered treatment as part of a probation sentence. If the offender did not succeed or failed to cooperate, the court could impose a jail or prison term later. Since determinate sentencing is an "up-front" system, however, accommodating treatment meant carving out special rules for sex offenses. During 1982, Commission members met with prosecutors, defense attorneys, victim and sex offender treatment professionals and received letters from many citizen groups and individuals. In addition, they reviewed scientific research and contacted national experts in the field of sex offender treatment. In the Commission's deliberations, the victim's response to sex crimes was an important consideration. The Commission learned that many victims and their families want the offender to receive treatment rather than be incarcerated, particularly in cases involving child sexual abuse by relatives. Without the cooperation of victims and their families, the criminal justice system could not effectively respond to sexual abuse. With incarcera tion as the sole options, victims and other family members aware of sexual abuse might not be willing to report the offender. The Commission also considered the offender's incentives to cooperate with treatment. Offenders are usually aware that undergoing treatment, especially if the professional is well-qualified and effective, will not be easy: the inquiry will be very intrusive. By contrast, doing time in jail or prison may be boring, frightening, or oppressive, but the level of intrusive ness will not be nearly so high. Therefore, the Commission saw the need to structure a system with incentives for the offender, since public safety is enhanced when treatment reduces re-offending. Ultimately, the Commission chose to craft a special treatment option for certain sex offenders that allowed them to receive treatment in lieu of incar

Substance use in remand prisoners: a consecutive case study

Abstract: Objectives: To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. Design: A consecutive case study of remand prisoners screened at reception for substance misuse and treatment needs and comparison of findings with those of prison reception screening and treatment provision. Setting: A large adult male remand prison (Durham). Subjects: 548 men aged 21 and over awaiting trial. Main outcome measures: Prevalence of substance misuse; treatment needs of substance misusers; effectiveness of prison reception screening for substance misuse; provision of detoxification programmes. Results: Before remand 312 (57%) men were using illicit drugs and 181 (33%) met DSM-IV drug misuse or dependence criteria; 177 (32%) men met misuse or dependence criteria for alcohol. 391 (71%) men were judged to require help directed at their drug or alcohol use and 197 (36%) were judged to require a detoxification programme. The prison reception screen identified recent illicit drug use in 131 (24%) of 536 men and problem drinking in 103 (19%). Drug use was more likely to be identified by prison screening if an inmate was using multiple substances, using opiates, or had a diagnosis of abuse or dependence. 47 (9%) of 536 inmates were prescribed treatment to ease the symptoms of substance withdrawal. Conclusions: The prevalence of substance misuse in newly remanded prisoners is high. Prison reception health screening consistently underestimates drug and alcohol use. In many cases in which substance use is identified the quantities and numbers of different substances being used are underestimated. Initial management of inmates identified by prison screening as having problems with dependence producing substances is poor. Few receive a detoxification programme, so that many are left with the option of continuing to use drugs in prison or facing untreated withdrawal. Key messages In screening for substance use in remand prisoners a positive finding must be considered the norm rather than the exception Present prison reception procedures fail to identify the extent to which substances are used and misused by people newly remanded to prison Provision of detoxification programmes for prisoners identified by reception screening as having serious drug and alcohol related problems is inadequate Prisoners who need help but think that asking for this is more likely to result in punishment than treatment are not likely be truthful about their substance use More consideration needs to be given to reducing substance misuse in prisons by improving assessment at reception and providing better treatment for misusers rather than using random urine screening to detect and punish offenders

Solution-Focused Therapy in Prison

Abstract: This is a report on a combined therapy and research project conducted with a seriously criminal population in Swedish prisons and using a Solution-Focused Brief Therapy approach with a focus on networks. Recidivism was significantly lower and less serious among experimental group participants. A case study is included.