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Baccon WC, Salci MA, Carreira L, Gallo AM, Marques FRDM, Laranjeira C. "Feeling Trapped in Prison" Due to the COVID-19 Pandemic: Perceptions and Practices among Healthcare Workers and Prison Staff from a Brazilian Maximum Security Unit. Healthcare (Basel) 2023; 11:2451. [PMID: 37685485 PMCID: PMC10487085 DOI: 10.3390/healthcare11172451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
The COVID-19 pandemic had several repercussions on prison staff, but the currently available evidence has mainly ignored these effects. This qualitative study aimed to understand the impact of COVID-19 on the prison system through the narratives of health and security professionals, using the methodological framework of the constructivist grounded theory proposed by Charmaz. The sample included 10 healthcare workers and 10 security professionals. Data collection took place between October and November 2022 through individual in-depth interviews. The data were analyzed using the MaxQDA software. Three categories of interrelated data emerged: (1) "Confrontation and disruption" caused by the COVID-19 pandemic in the prison system; (2) "Between disinfodemic and solicitude" referring to the tension between information management and the practice of care centered on the needs of inmates; and, finally, (3) "Reorganization and mitigation strategies during the fight against COVID-19". Continuous education and the development of specific skills are essential to enable professionals to face the challenges and complex demands that arise in prison contexts. The daily routines professionals had previously taken for granted were disrupted by COVID-19. Thus, investing in adequate training and emotional support programs is crucial to promote the resilience and well-being of these professionals, ensuring an efficient and quality response to critical events.
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Affiliation(s)
- Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Francielle Renata Danielli Martins Marques
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá 87020-900, PR, Brazil; (W.C.B.); (M.A.S.); (L.C.); (A.M.G.); (F.R.D.M.M.)
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Campus 5, Polytechnic University of Leiria, Rua de Santo André-66-68, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Koch M, Dvorak A, Hobersdorfer M, Yeghiazaryan L, Rabl U, Komorowski A. The impact of the COVID-19 pandemic on the psychosocial rehabilitation of forensic psychiatric patients in Austria. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 88:101889. [PMID: 37121203 PMCID: PMC10110938 DOI: 10.1016/j.ijlp.2023.101889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/28/2023] [Accepted: 04/15/2023] [Indexed: 05/04/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic led to increased psychological distress and far-reaching restrictions of freedom. In March 2020, Austrian penal authorities enacted various safety and protection measures to mitigate the propagation of COVID-19. While infection rates in penal institutions were low, restrictive conditions of detention limited the forensic care of offenders. This retrospective longitudinal observational study aimed to evaluate the impact of the pandemic on the psychosocial rehabilitation in forensic psychiatry. Administrative and clinical data obtained from 97 males treated at an inpatient forensic mental health institution were compared before (January 2019 - mid-March 2020) and after (mid-March 2020 - May 2021) the enactment of pandemic-related restrictive measures. The study outcomes related to rehabilitative activities, social contacts, psychopathological stability, and compliance with institutional regulations. During the pandemic, a decrease in individual one-day temporary releases (64 vs. 3, p < .001) and one-day group excursions (103 vs. 10, p < .001) was observed. Likewise, visits by relatives (1440 vs. 429, p < .001) and legal guardians (286 vs. 130, p = .009) decreased. Regarding compliance with institutional regulations, illegal activities decreased from 27 to 8 after enactment of restrictive measures (p = .024). In contrast, long-term temporary releases (122 vs. 188 weeks, p = .131) and admissions to the acute ward (141 vs. 143, p = .712) remained unchanged. Overall, this study demonstrates the substantial impact of COVID-19 on the psychosocial care of forensic psychiatric patients and implies the necessity for guidelines to uphold an appropriate standard of forensic rehabilitation during future pandemics.
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Affiliation(s)
- Marlene Koch
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria
| | | | | | - Lusine Yeghiazaryan
- Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Ulrich Rabl
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria
| | - Arkadiusz Komorowski
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Vienna, Austria.
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Dahiya S, Simpson PL, Butler T. Rethinking standards on prison cell size in a (post)pandemic world: a scoping review. BMJ Open 2023; 13:e069952. [PMID: 37015783 PMCID: PMC10083520 DOI: 10.1136/bmjopen-2022-069952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVE To describe the current international, regional and national standards on prison cell spatial density and the evidence for the association between COVID-19 transmission and prison crowding measures to provide recommendations on prison cell spatial density standards for a (post) pandemic world. DESIGN Scoping review. DATA SOURCES PubMed, ProQuest, Informit, Criminal Justice Abstracts, Cochrane, Web of Science, Scopus, EMBASE, Google Scholar and Google were searched up to November 2021. ELIGIBILITY CRITERIA Guidelines were included provided they described standards of prison accommodation with respect to prison cells. Studies were included provided they examined an association between COVID-19 cases and a crowding measure. DATA EXTRACTION AND SYNTHESIS Data were extracted by one reviewer and cross-checked by another. Quantitative and qualitative data on prison cell standards and characteristics of studies examining an association between COVID-19 and prison crowding were collected.Findings were synthesised qualitatively. RESULTS Seventeen reports and six studies met eligibility criteria. International and regional standards on cell spatial density were mostly qualitative, with two quantifiable international standards located (3.4 m2 and 3.5 m2 per person for multiple occupancy cells), and two quantifiable regional standards located (4 m2 per person (Europe) and 5.75 m2 or 4 m2 per person (Australia and New Zealand)). Country-based standards varied substantially, ranging from 1.25 m2 per person (Pakistan) to 10 m2 per person (Netherlands). Consideration of airborne transmission of disease in prisons were mostly overlooked or absent to rationalise standards. There was consistent evidence that prison crowding measures were associated with COVID-19 transmission/cases. CONCLUSION Considering the physics of respiratory emissions, we recommend prison cell spatial density standards be updated to reflect graded levels of risk that consider other factors that combine to inform airborne transmission risk. Decarceration strategies should be considered and become vital if standards are not met.
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Affiliation(s)
- Simran Dahiya
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Paul Leslie Simpson
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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Butsang T, McLuhan A, Keown LA, Fung K, Matheson FI. Sex differences in pre-incarceration mental illness, substance use, injury and sexually transmitted infections and health service utilization: a longitudinal linkage study of people serving federal sentences in Ontario. HEALTH & JUSTICE 2023; 11:19. [PMID: 37004620 PMCID: PMC10067244 DOI: 10.1186/s40352-023-00218-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND People who experience incarceration have poorer health than the general population. Yet, we know little about the health and health service utilization of people during the critical period prior to their incarceration, relative to during incarceration and post-release. In this study, we conducted a longitudinal cohort study of 39,498 adults in Ontario, Canada between January 1, 2002, and December 31, 2011 using linked administrative health and correctional data to describe mental illness, substance use, injury, sexually transmitted infections and health service utilization of men and women in federal prisons in the 3 years prior to their incarceration, compared to a matched group. RESULTS We found that, in the 3-year period prior to their incarceration, men (n = 6,134) and women (n = 449) experiencing their first federal sentence had poorer health across all indicators examined (e.g., psychosis, drug/alcohol use, and self-harm) and higher outpatient psychiatric and emergency department visits, compared with the matched group. Women in the pre-incarceration group exhibited a higher prevalence of self-harm and substance use, relative to women in the matched comparison group and higher relative prevalence to that of men in the pre-incarceration group, compared to their matched counterparts. CONCLUSIONS Disparities in health and health service utilization are gendered and exist prior to incarceration. The gendered nature of these findings, specifically the significantly higher prevalence of poor health among women across several indicators, necessitates a focus on the social and systemic factors that contribute to these disparities. Gender-responsive and trauma-informed primary, secondary, and tertiary prevention strategies, alongside transformative approaches to justice should be considered in addressing the health needs of men and women who experience incarceration.
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Affiliation(s)
- Tenzin Butsang
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Arthur McLuhan
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Leslie A Keown
- Research Branch, Correctional Service of Canada, Ottawa, ON, Canada
| | | | - Flora I Matheson
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.
- ICES, Toronto, ON, Canada.
- Centre for Criminology and Socio-Legal Studies, University of Toronto, Toronto, ON, Canada.
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Forrester A, Aboaja A, Beigel L, Mundt AP, Rivera G, Torales J. Mental health in prisons in Latin America: The effects of COVID-19. MEDICINE, SCIENCE, AND THE LAW 2023; 63:89-92. [PMID: 36628418 PMCID: PMC9836837 DOI: 10.1177/00258024221149932] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
| | | | | | - Adrian P. Mundt
- Universidad de Chile, Chile
- Universidad Diego Portales, Chile
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Liu YE, LeBoa C, Rodriguez M, Sherif B, Trinidad C, del Rosario M, Allen S, Clifford C, Redding J, Chen WT, Rosas LG, Morales C, Chyorny A, Andrews JR. COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms. Front Public Health 2022; 10:854343. [PMID: 35774562 PMCID: PMC9237366 DOI: 10.3389/fpubh.2022.854343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Carceral facilities are high-risk settings for COVID-19 transmission. Little is known about the hidden burden of infection or practical barriers to infection control in these settings, especially in jails. There is also limited research on the mental health impacts of the pandemic among people living and working in carceral facilities. Methods Between July 8, 2020 and April 30, 2021, we performed SARS-CoV-2 rapid antibody testing and administered a questionnaire among residents and staff of four Northern California jails. We utilized multivariable logistic regression, adjusting for demographic and carceral characteristics, to analyze factors associated with prior infection, including perceived likelihood of prior infection and access to new masks. We additionally assessed the implementation of, perceptions toward, and impacts of COVID-19 policies in practice. We engaged stakeholder representatives, including incarcerated individuals, to guide study design, procedures, and results interpretation. Results We enrolled 788 jail residents and 380 jail staff. Nearly half of residents and two-thirds of staff who were antibody-positive had not previously tested positive for COVID-19. Among residents without a prior COVID-19 diagnosis, antibody positivity was significantly associated with perceived likelihood of prior infection (adjusted OR = 8.9; 95% CI, 3.6–22.0). Residents who had flu-like illness in jail cited inadequate responses to reported illness and deterrents to symptom reporting, including fears of medical isolation and perceptions of medical neglect. Residents also disclosed deficient access to face masks, which was associated with antibody positivity (adjusted OR = 13.8, 95% CI, 1.8–107.0). Worsened mental health was pervasive among residents, attributed not only to fear of COVID-19 and unsanitary jail conditions but also to intensified isolation and deprivation due to pandemic restrictions on in-person visitation, programs, and recreation time. Conclusion Carceral settings present significant challenges to maintaining infection control and human rights. Custody officials should work diligently to transform the conditions of medical isolation, which could mitigate deterrents to symptom reporting. Furthermore, they should minimize use of restrictive measures like lockdowns and suspension of visitation that exacerbate the mental health harms of incarceration. Instead, custody officials should ensure comprehensive implementation of other preventive strategies like masking, testing, and vaccination, in conjunction with multisector efforts to advance decarceration.
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Affiliation(s)
- Yiran E. Liu
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford, CA, United States
- Cancer Biology Graduate Program, Stanford University School of Medicine, Stanford, CA, United States
- *Correspondence: Yiran E. Liu
| | - Christopher LeBoa
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford, CA, United States
| | - Marcela Rodriguez
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Beruk Sherif
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Chrisele Trinidad
- Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Michael del Rosario
- Division of Correctional Health Services, San Mateo County Health, Redwood City, CA, United States
| | - Sophie Allen
- Stanford Law School, Stanford, CA, United States
- Department of Sociology, Stanford School of Humanities and Sciences, Stanford, CA, United States
| | | | - Jennifer Redding
- Santa Clara County Office of the Public Defender, San Jose, CA, United States
| | - Wei-ting Chen
- Office of Community Engagement, Stanford University School of Medicine, Stanford, CA, United States
| | - Lisa G. Rosas
- Office of Community Engagement, Stanford University School of Medicine, Stanford, CA, United States
| | - Carlos Morales
- Division of Correctional Health Services, San Mateo County Health, Redwood City, CA, United States
| | - Alexander Chyorny
- Division of Custody Health, Department of Medicine, Santa Clara Valley Health and Hospital System, San Jose, CA, United States
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford, CA, United States
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Esposito M, Salerno M, Di Nunno N, Ministeri F, Liberto A, Sessa F. The Risk of COVID-19 Infection in Prisons and Prevention Strategies: A Systematic Review and a New Strategic Protocol of Prevention. Healthcare (Basel) 2022; 10:270. [PMID: 35206884 PMCID: PMC8872582 DOI: 10.3390/healthcare10020270] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/14/2022] Open
Abstract
Health risks within prisons are well known and have worsened with the 2019 coronavirus pandemic (COVID-19), becoming a public health emergency. To date, there are more than 10 million inmates in the world; in most cases, conditions are bad and health care is scarce. A SARS-CoV-2 outbreak inside a prison is extremely rapid. The aim of this systematic review was to analyze all possible prevention techniques to reduce the risk of COVID-19 related infection within prisons. A systematic review of the literature was performed according to the PRISMA guidelines. Scopus, Web of Science, PubMed, and Google Scholar were used as search engines from 1 January 2020 to 1 November 2021 to evaluate the prevention of COVID-19 in prisoners. A total of 1757 articles were collected. Of them, 486 duplicates were removed. A total of 1250 articles did not meet the inclusion criteria. In conclusion, 21 articles were included in the present systematic review. From this analysis, it emerged that the most common COVID-19 prevention methods were the screening of the entire population (prisoners and workers) inside the prison through swab analysis and the reduction in overcrowding in prisons. Few studies concerned the prevention of COVID-19 infection through vaccination and the implementation of quarantine. To our knowledge, this is the first systematic review that evaluates the prevention of COVID-19 within jails and the real effectiveness of all possible methods used and published in the literature. Finally, a very useful strategic protocol is provided to reduce the incidence of infection and to control and manage COVID-19 in prisons.
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Affiliation(s)
- Massimiliano Esposito
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (F.M.); (A.L.)
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (F.M.); (A.L.)
| | - Nunzio Di Nunno
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy;
| | - Federica Ministeri
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (F.M.); (A.L.)
| | - Aldo Liberto
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (F.M.); (A.L.)
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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