Standards for Prison Health Care: US and British Approaches
Diane C. Hatton, Anastasia A. Fisher, Andrew Coyle in Women Prisoners and Health Justice, 2018
One approach to improving health care for prisoners has been to hire outside providers, such as public health departments, non-profit organizations, university health centers, or private, for-profit corporations. Some states have a mix of service providers. The use of outside service providers presents additional challenges for prison health care standards and accreditation. Private correctional health care vendors provide $3 billion of health care services annually to inmates in US correctional facilities.12 Correctional Medical Services (CMS) currently serves over 250 000 prisoners at facilities in 24 states.13 Monitoring private prison health care has proven to be even more difficult than monitoring the public system because the private firms have more freedom to provide their services without close scrutiny.
Older people and the criminal justice system
John C. Gunn, Pamela J. Taylor in Forensic Psychiatry, 2014
If, as described above, 5% of older prisoners have a psychotic illness, then, using 2004 figures, at any one time about 70–80 of sentenced male prisoners aged 60 or over in England and Wales would be psychotic, almost all with a depressive psychosis. Most clinicians and prison staff would agree that these men should be transferred to a hospital – whether secure or not – for treatment. In addition, according to similar calculations, around 400 older inmates there would be suffering from a major but non-psychotic clinical depression. It may be that most of these could be treated appropriately within the prison setting, but there must be substantial improvements in prison healthcare for this to happen. In a study of such older men, only 14% of all depressed prisoners (n=60) reported being treated with anti-depressants, although three-quarters of this sample were being prescribed medication and being seen by prison doctors for their physical health needs (Fazel et al., 2004). Similar problems with likely under-treatment of psychiatric illness have been found in the USA, where, in one study (Koenig et al., 1995), 13 of 16 older prisoners with active psychiatric disorders received no treatment.
Legal Aspects of Atopic Dermatitis
Donald Rudikoff, Steven R. Cohen, Noah Scheinfeld in Atopic Dermatitis and Eczematous Disorders, 2014
Atopic dermatitis is sometimes a subject of complaint in prisoner pro se petitions seeking a civil rights action under 42 USC section 1983 for deliberate indifference to medical conditions. Under this statute prisoners will accuse prison authorities, and occasionally but less commonly physicians, of violating their Eighth Amendment right to be free from cruel and unusual punishment by not properly addressing their atopic dermatitis (Sledge v Kooi 2007, Jackson v Clowers 2003). Most such cases fail, both because they are typically factually deficient and because the level of care required to meet the ‘deliberate indifference’ standard is not especially high. An issue that engenders grievances in prisons is the lack of access to specialist care and restricted drug formularies. In some states, court-appointed monitors have their prison healthcare being administered under a court-appointed monitor. It is overseen prison healthcare.
Exploring Mental Health and Substance use Treatment Needs of Commercially Sexually Exploited Youth Participating in a Specialty Juvenile Court
Published in Behavioral Medicine, 2018
Mekeila C. Cook, Elizabeth Barnert, Roya Ijadi-Maghsoodi, Kayleen Ports, Eraka Bath
Our study has implications for the delivery of health care to CSE youth in custody. Federal law mandates that all youth in juvenile detention centers have access to health care.34 However, the availability and quality of health services available to detained youth vary widely based on differences in state laws as well as local practices.35 Juvenile detention centers conduct initial health screenings, but the level of subsequent evaluation and follow-up varies. Although, the National Commission on Correctional Health Care sets standards for the delivery of health care within correctional settings, accreditation is voluntary. For mentally ill youth in custody in California, by law, an initial health intake is conducted. However, mental health screening is only conducted when initial intake screening points to potential mental health problems requiring attention or posing a risk to safety.36 Though many counties in California, including Los Angeles County, administer the Massachusetts Youth Screening Instrument (MAYSI-2),37 to assess youth for mental health symptoms,36,37 more needs to be done to ensure youth can access the care they need. Ensuring regulations are followed is of paramount importance to address the health needs of all justice involved youth and in particular, CSE youth. Trauma-informed care and SBIRT are two approaches that if comprehensively implemented as standard care, could potentially expand access to mental health and substance use treatment among justice involved CSE youth.
Medications for opioid use disorder in state prisons: Perspectives of formerly incarcerated persons
Published in Substance Abuse, 2022
Peter C. Treitler, Michael Enich, Donald Reeves, Stephen Crystal
This study describes the experiences with MOUD of recently incarcerated persons both while incarcerated and upon community reentry. Study findings illuminate key areas for correctional health care providers to focus patient education, such as risks of post-release overdose and the role of MOUD in mitigating this risk. Conversely, efforts to reduce MOUD stigma and address over-confidence in one’s ability to maintain recovery after release could increase patient engagement. Development of decision or education aid tools to be used by providers could facilitate this process, as well as clearly present the various medication options available to patients. Broadly, given participants’ positive experiences with MOUD, correctional facilities should implement supportive policies for incarcerated individuals to access a variety of MOUD treatment modalities while incarcerated. Future research could investigate strategies to increase engagement in medication treatment (e.g., education, patient decision aids), and which aspects of carceral MOUD programs support initiation and post-release retention, such as patients’ role in decision-making, medication dosing and regimen, and strategies used to link patients to community-based care.
Differences in triage and medical confidentiality between prisons of Belgium and the Netherlands
Published in Acta Clinica Belgica, 2021
Jan Matthys, Mathieu Hallyn, Anneleen Miclotte, Georges Van Maele, Dirk Avonts
In Belgium, the majority of prison doctors experience more time pressure during their consultations in prison, compared to their private medical work outside. In the Netherlands, the opposite is observed. In the Netherlands, compared to Belgium, there is easy access to psychiatric care and psychological support. Interpreter facilities are available for doctors and prisoners in the Netherlands, but not in Belgium. Prison doctors in both countries agree that the possibility for a strictly personal encounter with the patient (without the presence of other medical staff) can be very useful. This study contributes to the debate on prison healthcare, more specifically the notion of ‘equivalence of care’ with that of the community (1, 10).
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