Best practice guidelines for evaluating patients in custody in the emergency department

Patients in custody due to arrest or incarceration are a vulnerable population that present a unique ethical and logistical challenge for emergency physicians (EPs). People incarcerated in the United States have a constitutional right to health care. When caring for these patients, EPs must balance their ethical obligations to the patient with security and safety concerns. They should refer to their institutional policy for guidance and their local, state, and federal laws, when applicable. Hospital legal counsel and risk management also can be helpful resources. EPs should communicate early and openly with law enforcement personnel to ensure security and emergency department staff safety is maintained while meeting the patient's medical needs. Physicians should consider the least restrictive restraints necessary to ensure security while allowing for medical evaluation and treatment. They should also protect patient privacy as much as possible within departmental constraints, promote the patient's autonomous medical decision-making, and be mindful of ways that medical information could interact with the legal system.

Racism and violence in policing: Perspectives from a juvenile prison

Following recent events involving racism and violence in policing, the current study sought to understand factors associated with support for related social movements and worries about personal, family, and peer safety. Data were from 78 currently incarcerated young people (M = 16.5 years; 31% Black) and 20 juvenile prison staff (M = 40.3 years; 72% Black) via online surveys. A comparable proportion of young people (47.3%) and staff (47.4%) reported participating in the Black Lives Matter movement. Among young people, prior experiences with police were significantly associated with support for social movements and worries about safety concerning racism and violence in policing. Among staff, race, ethnicity, sexual orientation, and racial and ethnic identity were significantly associated with social movement support and worries about safety. Civic education and interventions to promote racial and ethnic identity may promote support for systemic change and buffer against worries about racism and violence in policing.

Infection Prevention and Control in Correctional Settings

Correctional facilities house millions of residents in communities throughout the United States. Such congregate settings are critical for national infection prevention and control (IPC) efforts. Carceral settings can be sites where infectious diseases are detected in patient populations who may not otherwise have access to health care services, and as highlighted by the COVID-19 pandemic, where outbreaks of infectious diseases may result in spread to residents, correctional staff, and the community at large. Correctional IPC, while sharing commonalities with IPC in other settings, is unique programmatically and operationally. In this article, we identify common challenges with correctional IPC program implementation and recommend action steps for advancing correctional IPC as a national public health priority.

Transgender Incarceration and Law Enforcement as a Source of Harm: Upstream and Primordial Prevention Perspectives

In the United States (US), transgender individuals are more likely to experience violence and sexual assault in jails and prisons compared with cisgender peers. Harms of incarceration on transgender individuals include limited access to medical care and hormone therapy, as well as being housed in facilities based on biological sex instead of gender identity. However, there has been insufficient research on addressing factors that lead to transgender individuals being incarcerated in the first place. In this article, we argue the need to focus on law enforcement interactions with transgender individuals in the US to reduce incarceration-related harms. Using the perspectives of primordial prevention and focusing on upstream factors that create health-related harms, we assert that focusing on law enforcement is a necessary component in addressing how the criminal justice system harms transgender individuals.

From Cognitive Behavioral Therapy to Mindfulness-Based Interventions

The U.S. Department of Justice indicates that 83% of individuals released from state prisons in 2005 were arrested at least once during a 9-year follow-up period. With only 17% of released individuals not rearrested, it could be argued that correctional facilities fail to provide the necessary resources that individuals need for proper rehabilitation and reintegration. Thus, there is a need for alternative jail and prison programming. This article reviews the leading program, cognitive behavioral therapy, and advocates for the integration and use of mindfulness-based interventions (MBIs) in carceral settings. Specifically, this article reviews the literature on MBIs and their significance in corrections.