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Showing papers on "Prison published in 2017"


Journal ArticleDOI
TL;DR: How mass incarceration shapes inequality in health is examined, which raises concerns that excessive incarceration could harm entire communities and thus might partly underlie health disparities both in the USA and between theUSA and other developed countries.

489 citations


Journal ArticleDOI
TL;DR: This article develops state-level estimates based on demographic life tables and extends previous national estimates of the number of people with felony convictions to 2010 and discusses the far-reaching consequences of the spatial concentration and immense growth of these groups since 1980.
Abstract: The steep rise in U.S. criminal punishment in recent decades has spurred scholarship on the collateral consequences of imprisonment for individuals, families, and communities. Several excellent studies have estimated the number of people who have been incarcerated and the collateral consequences they face, but far less is known about the size and scope of the total U.S. population with felony convictions beyond prison walls, including those who serve their sentences on probation or in jail. This article develops state-level estimates based on demographic life tables and extends previous national estimates of the number of people with felony convictions to 2010. We estimate that 3 % of the total U.S. adult population and 15 % of the African American adult male population has ever been to prison; people with felony convictions account for 8 % of all adults and 33 % of the African American adult male population. We discuss the far-reaching consequences of the spatial concentration and immense growth of these groups since 1980.

158 citations


Journal ArticleDOI
TL;DR: The paper concludes that the rise in synthetic cannabinoid use in custody and the size of the drug market are posing significant challenges to the management of offenders; including healthcare, appropriate detection techniques, license recall and sanctions for both use and supply.

154 citations


Journal ArticleDOI
TL;DR: In this article, the authors used meta-regression to test associations with general population suicide rates, incarceration rates, and prison-related factors (overcrowding, ratio of prisoners to prison officers or health care staff or education staff, daily spend, turnover, and imprisonment duration).

153 citations


Journal ArticleDOI
01 Jun 2017

133 citations


Book ChapterDOI
08 Sep 2017
TL;DR: The decision to give up crime is generally triggered by a shock of some sort, by a delayed deterrence process, or both as discussed by the authors, and it can be explained by a gradual disenchantment with the criminal life in its totality: the inability to trust people; the frequent harassment by the police; the effects on wives and children when the offender is in prison.
Abstract: The decision to give up crime is generally triggered by a shock of some sort, by a delayed deterrence process, or both. Offenders give up crime almost as often as they get into it. The impetus to think seriously about retirement from crime altogether seemed to come in many cases from a gradual disenchantment with the criminal life in its totality: the inability to trust people; the frequent harassment by the police; the effects on wives and children when the offender is in prison. Sometimes a new crime is committed when the ex-prisoner is idle, bored, and despondent. Travis Hirschi and Michael Gottfredson convincingly made the point that there is a direct connection between age and crime. In the case of those individuals who stop committing crimes at the end of adolescence, one can speak of normal maturation. The study of the abandonment of crime calls for recapitulation of the genesis of criminal habits in reverse.

127 citations


Journal ArticleDOI
TL;DR: Prevalence rates for mental illnesses and related comorbidities among all inmates in a state prison system in Iowa showed a substantial burden of mental illness among inmates, coupled with a general delay in diagnosis and treatment.
Abstract: The United States has the highest incarceration rate in the world which has created a public health crisis. Correctional facilities have become a front line for mental health care. Public health research in this setting could inform criminal justice reform. We determined prevalence rates for mental illnesses and related comorbidities among all inmates in a state prison system. Cross-sectional study using the Iowa Corrections Offender Network which contains health records of all inmates in Iowa. The point prevalence of both ICD-9 and DSM-IV codes for mental illnesses, timing of diagnosis and interval between incarceration and mental illness diagnosis were determined. The average inmate (N = 8574) age was 36.7 ± 12.4 years; 17% were ≥50 years. The majority of inmates were men (91%) and white (65%).Obesity was prevalent in 38% of inmates, and 51% had a history of smoking. Almost half of inmates were diagnosed with a mental illness (48%), of whom, 29% had a serious mental illness (41% of all females and 27% of all males), and 26% had a history of a substance use disorder. Females had higher odds of having both a mental illness and substance use disorder. Almost all mental illness diagnoses were first made during incarceration (99%). The mean interval to diagnosis of depression, anxiety, PTSD and personality disorders were 26, 24, 21 and 29 months respectively. Almost 90% of mental illnesses were recognized by the 6th year of incarceration. The mean interval from incarceration to first diagnosis (recognition) of a substance abuse history was 11 months. There is a substantial burden of mental illness among inmates. Racial, age and gender disparities in mental health care are coupled with a general delay in diagnosis and treatment. A large part of understanding the mental health problem in this country starts at prisons.

119 citations


Journal ArticleDOI
TL;DR: There is disproportionate incarceration, mistreatment, harsh punishment, and sexual victimization of sexual minority inmates, which calls for special public policy and health interventions.
Abstract: Objectives. To report characteristics of sexual minority US inmates.Methods. We drew our data from the National Inmate Survey, 2011–2012, a probability sample of inmates in US prisons and jails. We determined weighted proportions and odds ratios with 95% confidence intervals to estimate differences between sexual minority and heterosexual inmates.Results. Sexual minorities (those who self-identify as lesbian, gay, or bisexual or report a same-sex sexual experience before arrival at the facility) were disproportionately incarcerated: 9.3% of men in prison, 6.2% of men in jail, 42.1% of women in prison, and 35.7% of women in jail were sexual minorities. The incarceration rate of self-identified lesbian, gay, or bisexual persons was 1882 per 100 000, more than 3 times that of the US adult population. Compared with straight inmates, sexual minorities were more likely to have been sexually victimized as children, to have been sexually victimized while incarcerated, to have experienced solitary confinement and ...

115 citations


Journal ArticleDOI
TL;DR: Although there were positive outcomes associated with prison visits, it was not possible to draw strong conclusions for the outcomes of interest due to a lack of research, methodological discrepancies, and variability in outcome measures and results.
Abstract: The effect of family visits on prisoner well-being and future behavior is an important consideration in the development of prison policy. This review systematically examines current research findings that explore the impact of prison visits from family members on three specific offender outcomes: prisoners' well-being, rule breaking within the prison, and recidivism. The review focuses on visits by family and does not duplicate earlier reviews but rather extends them into current literature, through identification of empirical studies conducted post 1989, published since 1991. Ten studies met the stipulated inclusion criteria. All are case-control and cohort studies. The review of studies used a standardized quality assessment tool. Results show considerable variation in study quality, methods, and findings. However, studies consistently reported positive effects of prisoners receiving visits. Prison visits reduced depressive symptoms in women and adolescent prisoners. There was some evidence of reduction in rule-breaking behavior. One high-quality study suggested that visits reduced recidivism and increased survival in the community. Although there were positive outcomes associated with prison visits, it was not possible to draw strong conclusions for the outcomes of interest due to a lack of research, methodological discrepancies, and variability in outcome measures and results. The discussion considers the implications of the findings for policy, practice, and research.

98 citations


Journal ArticleDOI
TL;DR: The authors found that being released to a county with higher low-skilled wages significantly decreases the risk of recidivism for both black offenders and first-time offenders, and in sectors that report being more willing to hire ex-offenders.

88 citations


Journal ArticleDOI
TL;DR: This mixed-methods case study extends theoretical insights of classic prison ethnographies, adds quantifiable results capable of future replication, and points to a growing population of older inmates as important for contemporary prison social organization.
Abstract: Research of inmate social order is a once-vibrant area that receded just as American incarceration rates climbed and the country's carceral contexts dramatically changed This study reengages inmate society with an abductive mixed methods investigation of informal status within a contemporary men's prison unit The authors collect narrative and social network data from 133 male inmates housed in a unit of a Pennsylvania medium-security prison Analyses of inmate narratives suggest that unit "old heads" provide collective goods in the form of mentoring and role modeling that foster a positive and stable peer environment This hypothesis is then tested with Exponential Random Graph Models (ERGMs) of peer nomination data The ERGM results complement the qualitative analysis and suggest that older inmates and those who have been on the unit longer are perceived by their peers as powerful and influential Both analytical strategies point to the maturity of aging and the acquisition of local knowledge as important for attaining informal status in the unit In sum, this mixed methods case study extends theoretical insights of classic prison ethnographies, adds quantifiable results capable of future replication, and points to a growing population of older inmates as important for contemporary prison social organization

Journal ArticleDOI
TL;DR: Neither referral by correctional partners nor early engagement was significantly associated with recidivism, and the findings suggest that health equity for this vulnerable population could be achieved through improved coordination between correctional and community health care systems.
Abstract: Low-income and minority communities are disproportionately affected by incarceration, which exacerbates health disparities. Through enhanced primary care, the Transitions Clinic Network (TCN) seeks to improve the health of people with chronic conditions who return to their communities from prison. Using TCN data, we assessed the impact of early engagement in primary care and referral from correctional systems to TCN on the use of acute care (emergency department visits and hospitalizations) and recidivism. Of 751 patients, 29.8 percent were referred by correctional partners, and 52.7 percent were engaged in TCN care within one month after release. In the twelve months after release, patients referred by correctional partners had fewer acute care visits, compared to those referred by community-based partners, while early engagement was associated with more acute care visits. Neither referral by correctional partners nor early engagement was significantly associated with recidivism. Our findings suggest tha...

Journal ArticleDOI
TL;DR: These rates of mental ill-health and their similarity in remand and sentenced prisoners indicate that diversion of people with mental health problems from the prison arm of the criminal justice system remains inadequate, with serious consequences for well-being and recidivism.
Abstract: High levels of psychiatric morbidity in prisoners have important implications for services. Assessing Needs for Psychiatric Treatment in Prisoners is an evaluation of representative samples of prisoners in a male and a female prison in London. This paper reports on the prevalence of mental disorders. In a companion paper, we describe how this translates into mental health treatment needs and the extent to which they have been met. Prisoners were randomly sampled in a sequential procedure based on the Local Inmate Data System. We interviewed roughly equal numbers from the following groups: male remand; male sentenced prisoners (Pentonville prison); and female remand; female sentenced prisoners (Holloway prison). Structured assessments were made of psychosis, common mental disorders, PTSD, personality disorder and substance abuse. We interviewed 197 male and 171 female prisoners. Psychiatric morbidity in male and female, sentenced and remand prisoners far exceeded in prevalence and severity than in equivalent general population surveys. In particular, 12% met criteria for psychosis; 53.8% for depressive disorders; 26.8% for anxiety disorders; 33.1% were dependent on alcohol and 57.1% on illegal drugs; 34.2% had some form of personality disorder; and 69.1% had two disorders or more. Moreover, in the year before imprisonment, 25.3% had used mental health services. These rates of mental ill-health and their similarity in remand and sentenced prisoners indicate that diversion of people with mental health problems from the prison arm of the criminal justice system remains inadequate, with serious consequences for well-being and recidivism.

Journal ArticleDOI
TL;DR: In this article, a theory of penal consciousness is used to analyze formerly incarcerated women's narratives about prison food, and women describe both concrete and symbolic punishments associated with food, including deprivation of adequate food and rationing of humane attentions.
Abstract: Women’s perceptions of the prison experience and the punishing dimensions of their confinement are under-examined. To expand knowledge in this area, Sexton’s theory of penal consciousness is used to analyze formerly incarcerated women’s narratives about prison food. This analysis builds understanding about the lived experience of incarceration by explicating one dimension of prisoners’ understandings and perceptions of punishment. Women’s narratives describe both concrete and symbolic punishments associated with food. Participants spoke about poorly designed, sloppy food systems that left them feeling uncared for, ignored, frustrated, and humiliated. Women articulate experiences of hunger that reflect both a deprivation of adequate food and a rationing of humane attentions. These punishing perceptions may inhibit the efforts of social service and health providers to engage incarcerated and formerly incarcerated women in care. In contrast, exceptional participant narratives about positive, non-punishing fo...

Journal ArticleDOI
TL;DR: In this paper, the authors use 16 characterizations of crews, codes, and contexts to determine if offender subcultures (code of the street, convict code, street and prison gangs) converge, complement, or are independent of one another.
Abstract: We use 16 characterizations of crews, codes, and contexts to determine if offender subcultures (code of the street, convict code, street and prison gangs) converge, complement, or are independent of one another. We find extensive overlap across offender subcultures with “belief” subcultures in street and prison settings mirroring the “group” subcultures in those respective settings. Findings generate a call for comparative research on the convergences and divergences across subcultures on the street and in prisons with a specific emphasis on the impact that importation, deprivation, and exportation have on policy and programming importation for both the street and prison settings.

Journal ArticleDOI
TL;DR: For example, this paper found that completing vocational training and apprenticeship programs, GEDs, or college classes at any point during incarceration coincided with lower rates of prison returns within 3 years after release and none of these benefits accrued to inmates who started but did not complete these programs/classes.
Abstract: Research Summary Participants and nonparticipants in Ohio prison education programs were compared in rates of misconduct during incarceration and prison returns after release Propensity score matching was used to compare male nonparticipants with males who completed or started but did not complete GEDs, vocational training/apprenticeship programs, and college classes (each education group examined separately) More than 92,000 males were eligible for study, reflecting all men admitted to Ohio prisons between January 2008 and June 2012 Inmates who earned GEDs or completed college classes were less likely than nonprogram inmates to engage in violence during incarceration, whereas completing vocational training and apprenticeship programs had no such effect on any type of inmate misconduct examined On the other hand, completing vocational training and apprenticeship programs, GEDs, or college classes at any point during incarceration coincided with lower rates of prison returns within 3 years after release None of these benefits accrued to inmates who started but did not complete these programs/classes Policy Implications The provision of GED programs and college classes to prison inmates may help to reduce levels of violence during incarceration, thus, providing safer facility environments for both inmates and staff GED programs, college classes, and vocational training/apprenticeship programs may also help offenders to refrain from returning to prison, perhaps by providing knowledge and skills that enhance their employability in desirable jobs after release The absence of comparable findings for inmates who started but did not complete these activities, however, underscores the importance of completion, providing incentive for state policy makers and correctional administrators to encourage inmates to complete these pursuits

Journal ArticleDOI
TL;DR: Analysis of studies of the causes and correlates of prisoner victimization published between 1980 and 2014 revealed that predictor variables reflecting inmates’ background characteristics, their institutional routines and experiences, and prison characteristics all influence victimization.
Abstract: A considerable amount of research has been directed at understanding the sources of inmate misconduct (offending within prison), whereas few studies have focused on identifying the causes and correlates of prisoner victimization. The sources of inmate victimization should be distinguished from those of offending, however, because the policy implications of each focus differ to some extent. In order to determine the predictors of inmate victimization and stimulate further research on the topic, we systematically reviewed studies of the causes/correlates of prisoner victimization published between 1980 and 2014. Our findings revealed that predictor variables reflecting inmates' background characteristics (e.g., history of victimization), their institutional routines and experiences (e.g., history of misconduct), and prison characteristics (e.g., population size) all influence victimization.

Journal ArticleDOI
TL;DR: Mental illness among adult, juvenile, male, female, jail, and prison inmates is examined and the way in which mental health diagnoses impact offending and violent behavior is explored.
Abstract: This article examines mental illness among adult, juvenile, male, female, jail, and prison inmates. It also explores the way in which mental health diagnoses impact offending and violent behavior. A review of literature pertaining to differences between the genders and age of offenders suggests that psychiatric disorders are more common among criminal offenders than the population at large. Furthermore, it appears that many mentally ill offenders do not receive sufficient treatment during their incarcerations and that barriers inherent to incarceration prevent adequate treatment of mental illnesses.

Journal ArticleDOI
TL;DR: The results suggest the association between incarceration and mental health may vary substantially across facilities and highlight the importance of expanding research in this area beyond studies of prisons.
Abstract: Previous studies provide insight into the mental health of jail and prison inmates, but this research does not compare the two groups of inmates. Using data from the Fragile Families and Child Wellbeing Study, this article examines how the association between incarceration and self-reported mental health varies by facility type, net of an array of demographic and socioeconomic characteristics. Both jail and prison inmates report high rates of depression, life dissatisfaction, heavy drinking, and illicit drug use. In adjusted logistic regression models, those incarcerated in jails, compared with those not incarcerated, have higher odds of depression (odds ratio [ OR] = 5.06, 90% confidence interval [CI; 1.96, 13.11]), life dissatisfaction ( OR = 3.59, 90% CI [1.40, 9.24]), and recent illicit drug use ( OR = 4.03, 90% CI [1.49, 10.58]). Those incarcerated in prisons have higher odds of life dissatisfaction ( OR = 3.88, 90% CI [2.16, 6.94]) and lower odds of recent heavy drinking ( OR = 0.32, 90% CI [0.13, 0.81]) compared with those not incarcerated. Furthermore, jail inmates report significantly more depression, heavy drinking, and illicit drug use than prison inmates. These results suggest the association between incarceration and mental health may vary substantially across facilities and highlight the importance of expanding research in this area beyond studies of prisons. The results also indicate that public health professionals in the correctional system should be especially attuned to the disproportionately high levels of poor mental health outcomes among jail inmates.

Journal ArticleDOI
TL;DR: For instance, the authors found that older, Black, and who have been incarcerated more frequently experience less visitation. But, they also found that those who come from areas with higher incarceration rates and higher levels of social altruism experience more visits, while sentence length and economic disadvantage are not associated with visitation.
Abstract: Scholarship has shown that visitation helps individuals maintain social ties during imprisonment, which, in turn, can improve inmate behavior and reduce recidivism. Not being visited can result in collateral consequences and inequality in punishment. Few studies, however, have explored the factors associated with visitation. This study uses data on Florida inmates to identify individual- and community-level factors that may affect visitation. Consistent with expectations derived from prior theory and research, the study finds that inmates who are older, Black, and who have been incarcerated more frequently experience less visitation. In addition, inmates who come from areas with higher incarceration rates and higher levels of social altruism experience more visits. Unexpectedly, however, sentence length and economic disadvantage are not associated with visitation. Implications of these findings are discussed.

Journal ArticleDOI
TL;DR: It is concluded that under the right conditions self-organizing inmate society can foster social integration reminiscent of other social settings, and prisons are capable of successfully building peer associations.

Journal ArticleDOI
TL;DR: The current findings underscore the importance of both vulnerability factors and prison-specific stressors for suicidal ideation in prisoners, and hence the need for a multi-faceted approach to suicide prevention in custodial settings.

Journal ArticleDOI
TL;DR: The question has been posed whether current developments in American penal policy toward reducing prison populations and sentences for low-level, nonviolent offenses might reflect the end of the ma... as discussed by the authors.
Abstract: The question has been posed whether current developments in American penal policy toward reducing prison populations and sentences for low level, nonviolent offenses might reflect the end of the ma...

Journal ArticleDOI
TL;DR: In this article, the authors report on the effects of vicarious nature experiences (nature videos) provided to maximum-security prison inmates for one year, and compared their emotions and behaviors to inmates who were not offered such videos.
Abstract: An estimated 5.3 million Americans live or work in nature-deprived venues such as prisons, homeless shelters, and mental hospitals. Such removal from nature can result in an “extinction of experience” that can further lead to disinterest or disaffection toward natural settings, or even biophobia (fear of the natural environment). People who infrequently – or never – spend time in nature will be deprived of the numerous physical and emotional benefits that contact with nature affords. We report on the effects of vicarious nature experiences (nature videos) provided to maximum-security prison inmates for one year, and compared their emotions and behaviors to inmates who were not offered such videos. Inmates who watched nature videos reported feeling significantly calmer, less irritable, and more empathetic, and committed 26% fewer violent infractions as compared to those who did not watch the videos. Prison staff corroborated these findings. This research reinforces the value of nature exposure as a powerful tool not only for corrections administrators, but also for urban planners and policy makers, to promote socially desirable behaviors.

Journal ArticleDOI
TL;DR: It is shown that more stringent postprison parole supervision (relative to probation supervision) increases imprisonment through the detection and punishment of low-level offending or violation behavior, which would not otherwise result in imprisonment for someone who had not already been to prison or who was not on parole.
Abstract: A substantial contributor to prison admissions is the return of individuals recently released from prison, which has come to be known as prison's "revolving door." However, it is unclear whether being sentenced to prison itself has a causal effect on the probability of a subsequent return to prison or on criminal behavior. To examine the causal effect of being sentenced to prison on subsequent offending and reimprisonment, we leverage a natural experiment using the random assignment of judges with different propensities for sentencing offenders to prison. Drawing on data on all individuals sentenced for a felony in Michigan between 2003 and 2006, we compare individuals sentenced to prison to those sentenced to probation, taking into account sentence lengths and stratifying our analysis by race. Results show that being sentenced to prison rather than probation increases the probability of imprisonment in the first 3 years after release from prison by 18 percentage points among nonwhites and 19 percentage points among whites. Further results show that such effects are driven primarily by imprisonment for technical violations of community supervision rather than new felony convictions. This suggests that more stringent postprison parole supervision (relative to probation supervision) increases imprisonment through the detection and punishment of low-level offending or violation behavior. Such behavior would not otherwise result in imprisonment for someone who had not already been to prison or who was not on parole. These results demonstrate that the revolving door of prison is in part an effect of the nature of postprison supervision.

Journal ArticleDOI
TL;DR: In this paper, Latent class analysis and hierarchical generalized linear models were used to identify both supportive and unsupportive visitors in the Arizona Prison Visitation Project, which includes information on 687 visitors nested within 227 inmates.

Journal ArticleDOI
TL;DR: The authors studied the trajectories of foreign-national offenders in the UK and found that imprisonment and detention coalesce within the deportation regime as a double punishment, one that is highly racialised and gendered.
Abstract: The United Kingdom has taken an increasingly punitive stance towards ‘foreign criminals’ using law and policy to pave the way for their expulsion from the country. Imprisonment, then, becomes the first stage in a complex process intertwining identity, belonging and punishment. We draw here on research data from two projects to understand the carceral trajectories of foreign-national offenders in the UK. We consider the lived experiences of male foreign-nationals in two sites: prison and immigration detention. The narratives presented show how imprisonment and detention coalesce within the deportation regime as a ‘double punishment’, one that is highly racialised and gendered. We argue that the UK’s increasingly punitive response to foreign-national offenders challenges the traditional purposes of punishment by sidestepping prisoners’ rehabilitative efforts and denying ‘second chances’ while enacting permanent exclusion through bans on re-entry.

Journal ArticleDOI
TL;DR: Unmet needs for mental health treatment and care were common in the two prisons in London and have adverse consequences both for individual prisoners and for the effective functioning of the criminal justice system.
Abstract: In a companion paper, we established high levels of psychiatric morbidity in prisoners (Bebbington et al. Soc Psychiatry Psychiatr Epidemiol, 2016). In the current report, we evaluate how this morbidity translates into specific needs for treatment and the consequent implications for services. Mental health treatment needs and the extent to which they had been met were assessed in a representative sample of prisoners in a male and a female prison in London (Pentonville and Holloway). Prisoners were sampled at random in a sequential procedure based on the Local Inmate Data System. We targeted equal numbers of male remand, male sentenced, female remand, and female sentenced prisoners. Following structured assessment of psychosis, common mental disorders, PTSD, personality disorders and disorders of abuse, we used the MRC Needs for Care Assessment (NFCAS) to establish whether potential needs for care in ten areas of mental health functioning were met, unmet, or incapable of being met by services. Data on treatment experience were provided by 360 inmates. Eighty percent of females and 70% of males had at least one need for treatment. Over half (53.7%) of the needs of female prisoners were met, but only one third (36.5%) in males. Needs for medication were unmet in 32% of cases, while those for psychological treatment were unmet in 51%. Unmet needs for mental health treatment and care were common in the two prisons. This has adverse consequences both for individual prisoners and for the effective functioning of the criminal justice system.

Journal ArticleDOI
TL;DR: It is argued that it is feasible to screen for intellectual disabilities in prisons and, given the inequalities to which prisoners with intellectual disabilities are subject in prison, it is time for such screening to be rolled out to all prisons.
Abstract: Background Prisoners with intellectual disabilities are known to be disadvantaged in prisons and to be more susceptible to bullying, segregation, depression and anxiety than other prisoners. Method In this study, nearly 3000 new prisoners entering three English prisons were offered screening for intellectual disabilities, using the LDSQ. Results On average, 75% of all new prisoners entering prison were offered screening, and only 14% refused screening. Overall, just less than 7% were screened positive on the LDSQ and prisons made some reasonable adjustments as a result. Conclusions It is argued that it is feasible to screen for intellectual disabilities in prisons and, given the inequalities to which prisoners with intellectual disabilities are subject in prison, it is time for such screening to be rolled out to all prisons.

Journal ArticleDOI
TL;DR: Following release from prison, one in 15 ex-prisoners presented to an emergency department due to self-harm, within an average of 2.6 years of release, and such presentations could provide opportunities for suicide prevention in this population.
Abstract: Objective:Prisoners are at increased risk of both self-harm and suicide compared with the general population, and the risk of suicide after release from prison is three times greater than for those still incarcerated. However, surprisingly little is known about the incidence of self-harm following release from prison. We aimed to determine the incidence of, identify risk factors for and characterise emergency department presentations resulting from self-harm in adults after release from prison.Method:Cohort study of 1325 adults interviewed prior to release from prison, linked prospectively with State correctional and emergency department records. Data from all emergency department presentations resulting from self-harm were secondarily coded to characterise these presentations. We used negative binomial regression to identify independent predictors of such presentations.Results:During 3192 person-years of follow-up (median 2.6 years per participant), there were 3755 emergency department presentations. In ...