The Rikers Island Hot Spotters: Defining the Needs of the Most Frequently Incarcerated

We used "hot spotting" to characterize the persons most frequently admitted to the New York City jail system in 2013.

We used our Correctional Health Services electronic health record to identify 800 patients admitted in 2013 who returned most since November 2008. We compared them to a randomly selected control group of 800 others admitted in 2013, by using descriptive statistics and cross-tabulations, including data through December 2014.

The frequently incarcerated individuals had a median of 21 incarcerations (median duration 11 days), representing 18 713 admissions and $129 million in custody and health costs versus $38 million for the controls. The frequently incarcerated were: 

• significantly older (42 vs 35 years), 
• and more likely to have serious mental illness (19% vs 8.5%) 
• and homelessness (51.5% vs 14.7%) in their record. 
• Significant substance use was highly prevalent (96.9% vs 55.6%). 
• Most top criminal charges (88.7%) for the frequently incarcerated were misdemeanors; assault charges were less common (2.8% vs 10.4%). 

Frequently incarcerated persons have chronic mental health and substance use problems, their charges are generally minor, and incarceration is costly. Tailored supportive housing is likely to be less costly and improve outcomes.

Via: http://ht.ly/SB6Xh Purchase full article at: http://goo.gl/tg5GQO

By: MacDonald R1, Kaba F1, Rosner Z1, Vise A1, Weiss D1, Brittner M1, Skerker M1, Dickey N1, Venters H1.

• 1All of the authors are with the New York City Department of Health and Mental Hygiene, Bureau of Correctional Health Services, Queens, NY.

More at:  https://twitter.com/hiv_insight

County-Level Heat Maps of Prison Capacity and Latino Inmate County of Origin

Via:  http://ht.ly/SvtwN MT https://twitter.com/LSEUSAblog

Percentage of inmates visited by distance and race/ethnicity

Via:  http://ht.ly/SvtwN MT https://twitter.com/LSEUSAblog

Predicted Likelihood of Prison Visitation by Economic Disadvantage

Via:  http://ht.ly/SvtwN MT https://twitter.com/LSEUSAblog

U.S. Adult Community Supervision Rate, 1980-2013

Via: http://ht.ly/SpNam

Association Between Number of Psychiatric Disorders and Violent Reoffending in Male Released Prisoners

Error bars are 95% CIs.

Read more at: http://ht.ly/S88T2

By: Chang Z1, Larsson H2, Lichtenstein P2, Fazel S3.

• 1Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 3Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.

Probability of Violent Reoffending by Sex, Time After Release, and Psychiatric Disorder Status

Error bars are 95% CIs.

Read more at: http://ht.ly/S88T2

By: Chang Z1, Larsson H2, Lichtenstein P2, Fazel S3.

• 1Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 3Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.

Psychiatric Disorders & Violent Reoffending: A National Cohort Study of Convicted Prisoners in Sweden

Reoffending and presence of psychiatric disorders are common in prisoners worldwide. However, whether psychiatric disorders are risk factors for reoffending is still unknown. We aimed to examine the association between psychiatric disorders, including substance use disorder, and violent reoffending.

We did a longitudinal cohort study of 47 326 prisoners who were imprisoned since Jan 1, 2000, and released before Dec 31, 2009, in Sweden. We obtained data for diagnosed psychiatric disorders from both inpatient and outpatient registers, and sociodemographic and criminological factors from other population-based registers...

Diagnosed psychiatric disorders were associated with an increased hazard of violent reoffending in male and female prisoners, and these associations were independent of measured sociodemographic and criminological factors, and, in men, remained substantial after adjustment for unmeasured familial factors. However, findings differed between individual diagnoses and sex. We found some evidence of stronger effects on violent reoffending of alcohol and drug use disorders and bipolar disorder than of other psychiatric disorders. Alcohol use disorder seemed to have a greater effect in women than in men. The overall effects of psychiatric disorders did not differ with severity of crime. The hazard of violent reoffending increased in a stepwise way with the number of diagnosed psychiatric disorders. Assuming causality, up to 20% of violent reoffending in men and 40% in women was attributable to the diagnosed psychiatric disorders that we investigated.

Certain psychiatric disorders are associated with a substantially increased hazard of violent reoffending. Because these disorders are prevalent and mostly treatable, improvements to prison mental health services could counteract the cycle of reoffending and improve both public health and safety. National violence prevention strategies should consider the role of prison health.

Read more at: http://ht.ly/S88T2

By: Chang Z1, Larsson H2, Lichtenstein P2, Fazel S3.

• 1Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 2Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
• 3Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.

Recidivism among Licensed-Released Prisoners Who Participated in the EM Program in Israel

Toward the end of 2006, a pilot program was launched in Israel wherein licensed-released prisoners were put under electronic monitoring (EM). In addition to EM, the pilot program, operated by the Prisoners' Rehabilitation Authority, provides programs of occupational supervision and personal therapy and is designed to allow for early release of those prisoners who, without increased supervision, would have been found unsuitable for early release. 

The aim of this study was to ascertain whether participation in the EM program among licensed-released prisoners in Israel might bring about lessened recidivism. For that matter, rates of arrests and incarceration were examined during a follow-up period of up to 4 years, among the entirety of licensed-released prisoners participating in the EM program between the years 2007 and 2009 (n = 155). 

To compare recidivism rates, a control group was assembled from among the entirety of released prisoners who were found unsuitable for early release in judicial conditions, and had therefore served the full term of their incarceration, to be released between the years 2005 and 2006 (a period of time during which an EM program was not yet operated among licensed-released prisoners in Israel). 

Study findings clearly show that while among the control group, 42% of released prisoners were re-incarcerated, at the end of a 4-year follow-up period, only 15% among the study group had returned to prison. 

These findings can be explained by combining the Social Control theory and the Self-Control theory which consider the period of time under EM program and the occupational and familial integration tools for reducing criminal connections and enhancing pro-social behavior.

Via: http://ht.ly/S78hx

By: Shoham E1, Yehosha-Stern S2, Efodi R3.

• 1Ashkelon Academic College, Israel 
• 2Ashkelon Academic College, Israel.
• 3Prisoners Rehabilitation Authority, Jerusalem, Israel.

Symptomatic Exposures among California Inmates 2011-2013

Prisoners have a high prevalence of substance misuse and abuse, but few studies have examined symptomatic exposures among incarcerated populations. We sought to further characterize the nature of these exposures among this population using the California Poison Control System data. Keyword searches identified inmate cases in 2011-2013 for patients 20+ years old exposed to a single substance and taken to hospital from jail, prison, or police custody. 

Comparisons were made with non-inmate cases during the same period, using similar limitations. Body stuffers and body packers were analyzed as a subgroup. Seven hundred four inmate cases were compared to 106,260 non-inmate cases. Inmates were more likely to be younger, male, and to have engaged in drug misuse or abuse. They most commonly ingested methamphetamine, heroin, acetaminophen, and anticonvulsants. Inmates were more likely to receive activated charcoal, whole bowel irrigation, undergo endotracheal intubation, and to experience a major clinical outcome or death. 

When body stuffers and packers were removed, clinical findings were similar, though the odds of a major outcome or death became statistically non-significant. Body stuffers and body packers primarily used methamphetamine and heroin, and compared with other inmates had significantly higher odds of both adverse clinical effects and poor outcome. 

This large series provides a profile of symptomatic exposures among inmates, a little-studied population. The potential for high morbidity among body stuffers and packers suggests that a high index of suspicion of such ingestions be maintained when evaluating patients prior to incarceration.

Via:  http://ht.ly/S6INw

By: Butterfield M1, Al-Abri S, Huntington S, Carlson T, Geller RJ, Olson KR.
1Department of Internal Medicine, Tulane University Medical Center, New Orleans, LA, USA

Local Jail Inmates, 1980 - 2013

Via: http://ht.ly/S43NF

State and Federal Prisoners: 1980 - 2013

Via: http://ht.ly/S42ug

Total Correctional Population in U.S.

Via: http://ht.ly/S42a3

Sources of Guns to Dangerous People: What We Learn By Asking Them

Gun violence exacts a lethal toll on public health. This paper focuses on reducing access to firearms by dangerous offenders, contributing original empirical data on the gun transactions that arm offenders in Chicago. Conducted in the fall of 2013, analysis of an open-ended survey of 99 inmates of Cook County Jail focuses on a subset of violence-prone individuals with the goal of improving law enforcement actions. 

Among our principal findings: 

• Our respondents (adult offenders living in Chicago or nearby) obtain most of their guns from their social network of personal connections. Rarely is the proximate source either direct purchase from a gun store, or theft. 
• Only about 60% of guns in the possession of respondents were obtained by purchase or trade. Other common arrangements include sharing guns and holding guns for others. 
• About one in seven respondents report selling guns, but in only a few cases as a regular source of income.
• Gangs continue to play some role in Chicago in organizing gun buys and in distributing guns to members as needed.
• The Chicago Police Department has a considerable effect on the workings of the underground gun market through deterrence. 
• Transactions with strangers and less-trusted associates are limited by concerns over arrest risk (if the buyer should happen to be an undercover officer or a snitch), and about being caught with a "dirty" gun (one that has been fired in a crime).

Via: http://ht.ly/S1bY6

By: Cook PJ1, Parker ST2, Pollack HA3.

• 1Duke University and NBER, USA..
• 2University of Chicago Crime Lab, USA.
• 3University of Chicago, USA.

Intensive Vipassana Meditation Practice: An Intervention with Promise for Traumatized Prisoners

The United States has the highest rate of incarceration in the world. According to the Bureau of Justice Statistics, 2,266,800 adults were incarcerated in U.S. federal and state prisons and county jails at year-end 2010 – about 0.7% of the resident adult population. Childhood trauma increases the likelihood of criminal justice involvement in adulthood (Wolf & Shi, 2010). A high percentage of prisoners are survivors of childhood abuse and other traumas before they are imprisoned (Wallace, Connor, & Dass-Brailsford, 2011), and prisons are notoriously violent and traumatic places for inmates. In a survey of inmates in Midwestern prisons, 54% of men and 28% of women reported having been raped in their current facility (Struckman-Johnson & Struckman-Johnson, 2000). In short, prisons are veritable warehouses of traumatized adults.

Read full document at (PDF): http://ht.ly/S1btX HT https://twitter.com/TheJusticeDept

Examining Recidivism among Foreign-Born Jail Inmates: Does Immigration Status Make a Difference Over the Long Term?

The topic of ‘illegal’ immigration is currently the focus of intense ideological and policy debate in the United States. A common assertion is that those without legal immigration status are disproportionately involved in criminal offending relative to other foreign-born populations. 

The current study examines the long-term recidivism patterns of a group of male removable aliens compared to those foreign-born with legal authorisation to be present in the United States. The sample includes 1297 foreign-born males released from the Los Angeles County Jail during a 1-month period in 2002, and the follow-up period extends through 2011. 

Using three measures of rearrest and a rigorous counterfactual modelling approach, we find no statistically significant differences between the two groups in likelihood, frequency, or timing of first rearrest over 9 years. The findings do not lend support to arguments that removable aliens pose a disproportionate risk of repeat involvement in local criminal justice systems.

Via:  http://ht.ly/RXS5e

By: Jennifer S. Wong, Laura J. Hickman, Marika Suttorp-Booth

• ^a School of Criminology, Simon Fraser University, Burnaby, BC, Canada
• ^b Criminology and Criminal Justice Division, Portland State University, Portland, OR, USA
• ^c Quantitative Analyst, RAND, Santa Monica, CA, USA

Patterns of Inhalant Use among Incarcerated Youth

Below: Plot of Polyinhalant Use Classes.

Note. (1) Airplane or model glue; (2) Anesthetic gases; (3) Freon; (4) Gas from whipping cream cans; (5) Butane; (6) "White-out" or another correction fluid; (7) Air Freshener; (8) Nail polish; (9) Nail polish remover; (10) Whippets; (11) Spray paint; (12) Gases from computer "duster" sprays; (13) Permanent markers; (14) Gasoline.

Inhalant use is especially prevalent among antisocial youth and can have serious health consequences. However, the extant literature has not investigated how use of various inhalants may co-occur among incarcerated youth. This study begins to address this gap in the literature by using latent class analyses to form distinct typologies of inhalant use. Study participants were residents (N = 723) of 27 Missouri Division of Youth Services facilities. Interviews assessed psychiatric symptoms, antisocial traits, delinquency, trauma, suicidality, and substance use behaviors. The mean age of the mostly male, ethnically diverse sample was 15.5 (S.D. = 1.2) years old. The study revealed the following classes of inhalant use: (1) severe polyinhalant use; (2) moderate polyinhalant use; (3) gas and permanent marker use; and (4) low-use. Compared to the low-use class, members of the severe polyinhalant use class had experienced more than double the rate of head injuries, the highest rates of traumatic experiences, and the highest rates of mental illness diagnoses. The gas and markers class had the highest rate of reporting hearing voices, followed by the severe polyinhalant use class, and the moderate polyinhalant use class. Results of this study underscore the need to address the high rate of head injuries and mental health diagnoses that contribute to severe polyinhalant use.

Read more at: http://goo.gl/k7i7W9 HT https://twitter.com/georgiastateu

No Escaping Medical Co-Payments, Even in Prison

Via: http://ht.ly/RrDHJ HT https://twitter.com/independentmail

Personality Disorders Do Not Affect Treatment Outcomes for Chronic HCV Infection in Spanish Prisoners: The Perseo Study

Below:  Treatment discontinuation in prisoners with and without personality disorders, stratified by cause of treatment interruption. *Release and/or transfer between prisons. PD: personality disorder; NS: not significant

Results

The sample included 236 patients (mean age: 40.3 years, 92.8 % male, 79.2 % intravenous drug users, and 26.3 % HIV-coinfected). The prevalence of PD was 72.5 %. 32.2 % of patients discontinued treatment; this percentage was higher in patients with HCV genotypes 1/4 (AOR = 3.55; CI:1.76–7.18) and those without PD (AOR = 2.51; 1.23–5.11). Treatment discontinuation was mainly for penitentiary reasons (40.3 %): release or transfer between prisons.

The rate of sustained viral response (SVR) was 52.1 % by ITT and 76.9 % by observed treatment (OT). SVR was higher among patients with genotype 2 or 3, and those with low baseline HCV-RNA. We did not observe any differences between individuals with and without PD in term of SVR, HCV genotype or HIV infection.

Conclusions

Our results support the safety and clinical effectiveness of the treatment of chronic HCV infection in correctional facilities, both in prisoners with PD and those without. Our data support non-discrimination between patients with and without PD when offering treatment for HCV infection to prison inmates.

Read more at:   http://ht.ly/R4RFF MT @BMC_series 

Suicide after release from prison - A population-based cohort study from Sweden

Below:  Number of suicides (total N=127) among released prisoners in Sweden 2005-2009 by month of release. The fifth year is not shown since no suicide occurred.

We identified 38,995 releases among 26,953 prisoners (7.6% females) during 2005-2009. Overall, 127 suicides occurred, accounting for 14% of all deaths after release (n=920). The mean suicide rate was 204 per 100,000 person years yielding an incidence rate ratio of 18.2 (95% CI 13.9-23.8) compared with general population controls. Previous substance use disorder (Hazard Ratio [HR]=2.1, 1.4-3.2), suicide attempt (HR=2.5, 1.7-3.7), and being born in Sweden vs. abroad (HR=2.1, 1.2-3.6) were independent risk factors for suicide after release.

Released prisoners are at high suicide risk and with a slightly different pattern of psychiatric risk factors for suicide compared with the general population. Results suggest appropriate allocation of resources to facilitate transition to life outside prison and increased attention to prisoners with both a previous suicide attempt and substance use disorder.

Via:   http://ht.ly/QrQ6o HT @karolinskainst