Improving Social Climate In Youth Detention

Ongoing concerns have been expressed about the poor rehabilitative climate of youth detention centers, with a number of government inquiries examining the nature of the centers and how to improve their rehabilitative culture. Emerging research points to staff training and support as mechanisms to improve institutional climate. This study examines the impact on institutional climate of training and coaching staff in effective practice skills. Staff and young people, across three Australian detention centers, were administered a validated social climate measure prior to and 3 to 6 months following training and coaching. The social climate improved at a statistically significant level for staff. For young people the social climate improved but the improvement was not statistically significant. The measure was also administered at two control sites for staff where minimal changes in social climate were seen, suggesting that the staff improvements flowed from the training and coaching rather than from other organizational factors. It is concluded that training and coaching improved detention center social climate for staff although the study does not provide evidence that it improved significantly for young people.

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.

Prevalence of psilocybin use in vaping and associated factors: a study among amphetamine-type stimulants (ATS) use disorder in Malaysia

BACKGROUND

The emergence of New Psychoactive Substances (NPS), including synthetic psilocybin, has raised concern among health experts due to the numerous health and socioeconomic consequences. The current trend is shifting to the hazardous use of synthetic psilocybin in vaping, and little is known about the prevalence of use, specifically among amphetamine-type stimulants (ATS) users.

METHODS

Interviewer-administered questionnaires were conducted in drug detention centers between March and October 2022. The study was conducted using ASSIST 3.0 and obtained information on the respondents' socio-demographic characteristics and clinical profiles. N = 355 ATS users were enrolled in this study.

RESULTS

The results show a high prevalence of psilocybin vaping among ATS users (182/355, 53.1%). Most of the respondents were males (85.1%) and unmarried (69.3%), with a mean age of 29.2 (SD = 7.3). Across all respondents, five factors were associated with psilocybin vaping: tobacco smoking, aOR =5.790 (95% CI: 1.723, 8.183); cannabis uses, aOR= 9.152 (95% CI: 2.693, 10.396); and alcohol use, aOR= 3.137 (95% CI: 1.461, 5.817). Respondents of the Malay race had higher odds of being involved in psilocybin vaping compared to other races, with aOR= 1.638 (0.043, 2.459). Meanwhile, a reduction in age by 1.9 will increase the likelihood of involvement in psilocybin vaping with aOR = 1.897 (95% CI: 0.857, 1.938).

CONCLUSION

Psilocybin in vaping is growing among ATS users and across all populations. Unfortunately, knowledge regarding the long-term effects on health is limited. Further studies should highlight the harmful effects of psilocybin and the potential risk of psilocybin vaping among the younger population.

Pandemic detention: life with COVID-19 behind bars in Maryland

Background

People incarcerated during the COVID-19 pandemic face higher vulnerability to infection due to structural and social factors in carceral settings. Additionally, due to the higher prevalence of chronic health conditions among carceral populations, they are also at risk for more severe COVID-19 disease. This study was designed to explore the experiences of people incarcerated in prisons and jails in Maryland during the height of the pandemic.

Methods

We conducted semi-structured phone interviews between January 2021 and April 2022 with ten individuals incarcerated in Maryland carceral facilities during the height of the U.S. COVID-19 pandemic and were subsequently released from prison or jail. We transcribed the interviews, coded them, and engaged in content analysis, an inductive analytical approach to developing themes and meaning from qualitative data.

Results

Four themes emerged from participants' descriptions of their experiences: (1) distress from fear, vulnerability, and lack of knowledge about COVID-19 and how to protect themselves, (2) shortcomings of prison and jail administrators and other personnel through lack of transparency and arbitrary and punitive enforcement of COVID-19 protocols, (3) lack of access to programming and communication with others, and (4) absence of preparation for release and access to usual re-entry services.

Conclusion

Participants responded that the prison and jails' response during the COVID-19 pandemic was ill-prepared, inconsistent, and without appropriate measures to mitigate restrictions on liberty and prepare them for release. The lack of information sharing amplified their sense of fear and vulnerability unique to their incarceration status. Study findings have several institutional implications, such as requiring carceral facilities to establish public health preparedness procedures and making plans publicly available.

Psychosocial Risk Factors Associated with Lifetime Amphetamine-Type Stimulants (ATS) Dependence in Drug Detention Centres: Perspectives from the Multiethnicity Study

ATS dependence in Malaysia is growing tremendously across multiracial Malaysian groups, increasing concerns among public health experts and the community. This study highlighted the chronicity of ATS dependence and factors associated with ATS use. Interviewer-administered questionnaires were administered using ASSIST 3.0. A total of N = 327 multiracial people who use ATS were enrolled in this study. The study findings show that 190/327 (58.1%) respondents were ATS dependent. Malays reported the highest number of ATS-dependent (55.8%), followed by Bajau (21.6%) and Kadazan-Dusun (16.8%) ethnic. Across all races, three factors were significantly associated with the ATS dependence: respondents who had a lifetime history of needle sharing aOR = 0.023 (95% CI: 0.003, 0.183) and a lifetime history of heroin use aOR = 0.192 (95% CI: 0.093, 0.396) were at a reduced odd of ATS dependent. Meanwhile, being married reduced the likelihood of becoming dependent on ATS with aOR = 0.378 (95% CI: 0.206, 0.693) compared to being single or divorced. This study revealed that the use of ATS among multiracial Malaysians is alarmingly high, including those in detention centers. Comprehensive harm reduction strategies are urgently needed to prevent the spreading of infectious diseases and other negative health consequences associated with ATS use.

Jail Health Care in the Southeastern United States From Entry to Release

Policy Points As a consequence of mass incarceration and related social inequities in the United States, jails annually incarcerate millions of people who have profound and expensive health care needs. Resources allocated for jail health care are scarce, likely resulting in treatment delays, limited access to care, lower-quality care, unnecessary use of emergency medical services (EMS) and emergency departments (EDs), and limited services to support continuity of care upon release. Potential policy solutions include alternative models for jail health care oversight and financing, and providing alternatives to incarceration, particularly for those with mental illness and substance use disorders.

CONTEXT

Millions of people are incarcerated in US jails annually. These individuals commonly have ongoing medical needs, and most are released back to their communities within days or weeks. Jails are required to provide health care but have substantial discretion in how they provide care, and a thorough overview of jail health care is lacking. In response, we sought to generate a comprehensive description of jails' health care structures, resources, and delivery across the entire incarceration experience from jail entry to release.

METHODS

We conducted in-depth interviews with jail personnel in five southeastern states from August 2018 to February 2019. We purposefully targeted recruitment from 34 jails reflecting a diversity of sizes, rurality, and locations, and we interviewed personnel most knowledgeable about health care delivery within each facility. We coded transcripts for salient themes and summarized content by and across participants. Domains included staffing, prebooking clearance, intake screening and care initiation, withdrawal management, history and physicals, sick calls, urgent care, external health care resources, and transitional care at release.

FINDINGS

Ninety percent of jails contracted with private companies to provide health care. We identified two broad staffing models and four variations of the medical intake process. Detention officers often had medical duties, and jails routinely used community resources (e.g., emergency departments) to fill gaps in on-site care. Reentry transitional services were uncommon.

CONCLUSIONS

Jails' strategies for delivering health care were often influenced by a scarcity of on-site resources, particularly in the smaller facilities. Some strategies (e.g., officers performing medical duties) have not been well documented previously and raise immediate questions about safety and effectiveness, and broader questions about the adequacy of jail funding and impact of contracting with private health care companies. Beyond these findings, our description of jail health care newly provides researchers and policymakers a common foundation from which to understand and study the delivery of jail health care.

Implementation of Dietary Reference Intake Standards in Prison Menus in Poland

Adequate nutrition in prisons should constantly be monitored due to the limited possibilities of external control as well as the low catering budget for prison meals and poorly defined requirements in this regard. The aim of the study was to assess the nutritional value of meals served in Polish prisons. Using a computer program, 14-day regular and bland diets from 30 prisons were analyzed. The energy value of the meals and the percentage of energy provided by protein, fat, and carbohydrate contained therein were found to meet the recommendations of the Polish National Food and Nutrition Institute. The amount of minerals supplied with the diet did not cover the recommended dietary allowance (RDA) in the case of calcium and magnesium. Particularly disturbing was the excessive supply of sodium in the regular and bland diets, which covered 537% and 311% of the dietary reference intake (DRI), respectively, as well as phosphorus (194 and 192% of RDA). The largest vitamin deficiencies were recorded for vitamins D and C and folate. An especially excessive supply was observed for vitamins A and B₁₂. The type of diet significantly differentiated the average content of over half of the analyzed components, whereas the season of the year turned out to be statistically insignificant. The results of the present investigations indicate a need for development of more accurate legal provisions to regulate the nutrition in Polish prisons in terms of not only the energy value and macronutrient supply but also the intake of minerals and vitamins.

Damaging the Future: The Health Rights of Children and the Issue of Short-Termism; Issues Facing Australian Bioethicists

This article considers recent ethical topics in Australia relating to the health rights of children in the contexts of (1) detention centers, (2) vaccination, and (3) procreative liberty, within a wider framework of discussion of the competing rights of society, parents, the child, and future generations.