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Drug use in prisoners : epidemiology, implications, and policy responses
\"In most countries, problematic drug use is dealt with primarily as a criminal justice issue, rather than a health issue. Accordingly, a large proportion of people in prison have a history of alcohol, tobacco and/or illicit drug use and, despite the best efforts of correctional authorities, some continue to use these substances in prison, often in very risky ways. After release from prison, many relapse to risky substance use, and are at high risk of poor health outcomes, preventable death, or reincarceration.In this edited volume, for the first time we bring together 40 contributors from 10 countries to review what is known about alcohol, tobacco and illicit drug use in people who cycle through prisons, and the harms associated with use of these substances. We consider some evidence-based responses to these harms - both in prison and after return to the community - and discuss their implications for policy reform.This book is international in scope and multi-disciplinary in character. It brings together and integrates the perspectives of public health and addictions researchers, criminologists and correctional leaders, epidemiologists, physicians, and human rights lawyers. Our contributors are unified in their commitment to evidence-informed policy - that is, doing what we know works. An overarching theme pervading all of the chapters is that people who cycle through prisons come from the community, and almost always return to the community. Their health problems are therefore our health problems; in other words, 'prisoner health is public health'\"--Provided by publisher.
Book
Substance Use and Recidivism Outcomes for Prison-Based Drug and Alcohol Interventions
We conducted a systematic review to examine the substance use and recidivism outcomes of prison-based substance use interventions. We searched public health, criminology, and psychology databases, and conducted forward and backward snowballing methods to identify additional studies. Studies were included if they were published between January 1, 2000 and June 30, 2017; were published in English; and reported substance use and/or recidivism outcomes of prison-based substance use interventions. Studies were reviewed for methodological rigor using the Effective Public Health Practice Project’s Quality Assessment Tool for Quantitative Studies. Our search returned 49 studies: 6 were methodologically strong, 20 were moderate, and 23 were weak. Results suggest therapeutic communities are effective in reducing recidivism and, to a lesser extent substance use after release. There is also evidence to suggest that opioid maintenance treatment is effective in reducing the risk of drug use after release from prison for opioid users. Furthermore, care after release from prison appears to enhance treatment effects for both types of interventions. Results provide evidence that policymakers can use to make informed decisions on best-practice approaches when addressing prisoner substance dependence and improving long-term outcomes. This comprehensive review highlights the difficulties of conducting quality research in the prison setting and suggests innovative study design for future research.
Journal Article
Psychosocial determinants of recidivism risk among incarcerated individuals with a history of substance use: A systematic review
The prevalence of recidivism among individuals with a history of substance use and incarceration remains a significant concern for criminal justice systems worldwide. With significant social and economic ramifications, preventing people with a history of substance use from reoffending is a substantial issue. It is imperative to comprehend the complex connections between psychological and social factors to continue developing successful therapies. To better understand this complexity, this review provides a comprehensive analysis of how psychological vulnerabilities and social barriers combine to influence reoffending. Our search strategies in major databases, including Scopus, Web of Science (WoS), ScienceDirect, PubMed, and PubMed Central (PMC), yielded 34,766 results, which decreased to 858 articles after eliminating ineligible records, duplicates, and records unrelated to the language. Finally, 30 articles qualified to be included in the systematic review following PRISMA guidelines. In addition to social determinants, including family support, community impact, stigma, and peer influence, the review concentrated on psychological issues like drug abuse, dual diagnoses, and early-life adversity. The review highlights the importance of social support, with strong family and community relationships associated with reduced recidivism risk. Mental health issues, particularly those co-occurring with substance use, impede reintegration, with emotional dysregulation and poor decision-making contributing to continued criminal conduct. Other significant risk factors include involvement in a gang, trauma exposure, and a lack of rehabilitative assistance. The results highlight that recidivism is a fundamentally psychological and societal problem rather than just an individual one. Breaking reoffending cycles requires addressing these elements through comprehensive, long-term interventions. Given possible gender disparities in recidivism pathways, future systematic reviews should consider doing separate syntheses for men and women to provide more focused insights.
Journal Article
The Effects of Prison Visits From Family Members on Prisoners’ Well-Being, Prison Rule Breaking, and Recidivism
The effect of family visits on prisoner well-being and future behavior is an important consideration in the development of prison policy. This review systematically examines current research findings that explore the impact of prison visits from family members on three specific offender outcomes: prisoners’ well-being, rule breaking within the prison, and recidivism. The review focuses on visits by family and does not duplicate earlier reviews but rather extends them into current literature, through identification of empirical studies conducted post 1989, published since 1991. Ten studies met the stipulated inclusion criteria. All are case–control and cohort studies. The review of studies used a standardized quality assessment tool. Results show considerable variation in study quality, methods, and findings. However, studies consistently reported positive effects of prisoners receiving visits. Prison visits reduced depressive symptoms in women and adolescent prisoners. There was some evidence of reduction in rule-breaking behavior. One high-quality study suggested that visits reduced recidivism and increased survival in the community. Although there were positive outcomes associated with prison visits, it was not possible to draw strong conclusions for the outcomes of interest due to a lack of research, methodological discrepancies, and variability in outcome measures and results. The discussion considers the implications of the findings for policy, practice, and research.
Journal Article
Dark and bright personality dimensions as predictors of criminal behavior and recidivism
A growing body of research highlights the continuum between dark and bright personality traits impacting individual prosocial or antisocial tendencies. However, the interplay between personality dimensions and actual criminal behavior and its reoccurrence is not fully elucidated. We aimed to explore the cumulative predictive value of the bright and dark core of personality for criminal history in differentiating a general community sample (
N
= 282) from a large sample of inmates (
N
= 296), with (
n
= 129) or without (
n
= 167) criminal history while controlling for age, sex and impression management. Predictors of first-time offending were higher levels of Neuroticism, Openness, Dark Factor, Sadism, and Deceitfulness. Criminal recidivism was predicted by high Neuroticism and Deceitfulness. Finally, higher levels of Extraversion were negatively related to criminal behavior and history, highlighting a potential protective effect of displaying assertive and sociable tendencies. The findings highlight the relevance of considering the dark personality core complementary to the typical personality dimensions in the risk assessment, prediction, and reduction of criminal behavior.
Journal Article
Dynamic risk and protective factors in mentally disordered offenders: forensic psychiatry treatment monitoring, prison release and length of stay
Background
The reduction of violence risk and crime recidivism is the core marker of progress in forensic psychiatry treatment for mentally disordered offenders, and commonly used to decide upon discharge from prison-based security clinics. While dynamic risk is expected to relate to treatment progress, static risk is expected to predict discharge from prison-based treatments. Integrated risk-protection assessment is thought to facilitate prediction of treatment outcome.
Methods
In a two-year prospective observational cohort study using a repeated measures design, we monitored treatment as usual induced changes in violence and protective factors, in 117 offenders of a medium-security forensic clinic in Switzerland. Mixed-effects and multinomial logistic regression models were used to predict longitudinal risk and protection evolution, length of stay, and discharge locations.
Results
Forensic psychiatry treatment was indeed associated with decrease in dynamic risk and enhanced protection, contrary to static risk. After 18–24 months of treatment, protective factors counterbalanced risk factors. For risk, both a numeric scale and a structured professional judgement approach equally showed significant improvement over time. For protection and integrated risk-protection, structured professional judgement ratings failed to show significant treatment-related change. Discharge to low-security psychiatry wards was predicted only by favorable baseline risk, protection, and integrated risk-protection, but not by their treatment-related evolution. Longer length of stay was predicted by higher baseline total risk only.
Conclusions
Study results confirm the need to distinguish dynamic from static risk in forensic psychiatric treatment monitoring, and to include integrated risk-protection measures. Treatment length and discharge are predicted by the offenders’ baseline risk profile, but not by the evolution of risk and protection factors. A structured professional judgment approach in risk and protection assessment leads to different longitudinal results than the use of numeric scale scores.
Journal Article
Prediction of recidivism in a long-term follow-up of forensic psychiatric patients: Incremental effects of neuroimaging data
One of the primary objectives in forensic psychiatry, distinguishing it from other psychiatric disciplines, is risk management. Assessments of the risk of criminal recidivism are performed on a routine basis, as a baseline for risk management for populations involved in the criminal justice system. However, the risk assessment tools available to clinical practice are limited in their ability to predict recidivism. Recently, the prospect of incorporating neuroimaging data to improve the prediction of criminal behavior has received increased attention. In this study we investigated the feasibility of including neuroimaging data in the prediction of recidivism by studying whether the inclusion of resting-state regional cerebral blood flow measurements leads to an incremental increase in predictive performance over traditional risk factors. A subsample (N = 44) from a cohort of forensic psychiatric patients who underwent single-photon emission computed tomography neuroimaging and clinical psychiatric assessment during their court-ordered forensic psychiatric investigation were included in a long-term (ten year average time at risk) follow-up. A Baseline model with eight empirically established risk factors, and an Extended model which also included resting-state regional cerebral blood flow measurements from eight brain regions were estimated using random forest classification and compared using several predictive performance metrics. Including neuroimaging data in the Extended model increased the area under the receiver operating characteristic curve (AUC) from .69 to .81, increased accuracy from .64 to .82 and increased the scaled Brier score from .08 to .25, supporting the feasibility of including neuroimaging data in the prediction of recidivism in forensic psychiatric patients. Although our results hint at potential benefits in the domain of risk assessment, several limitations and ethical challenges are discussed. Further studies with larger, carefully characterized clinical samples utilizing higher-resolution neuroimaging techniques are warranted.
Journal Article
Predicting risk of recidivism in Spanish young offenders: Comparative analysis of the SAVRY and YLS/CMI
This study offers a comparative analysis of evidence for the predictive validity of SAVRY and YLS/CMI scores in predicting risk of recidivism in a group of young people who received a Juvenile Justice order.
The sample was made up of 594 youths aged between 14 and 18 (M=15.63, SD=1.08) at the time they committed an offense.
Both instruments showed high accuracy in predicting recidivism, with the greatest accuracy observed in the SAVRY and YLS/CMI total scores, as well as in the Individual domain of the SAVRY. Comparative analysis of the AUCs of both instruments indicated no statistically significant differences between total scores from the two instruments. Results showed statistically significant differences in comparisons of means and AUCs between the groups of young reoffenders and non-reoffenders in all cases. Our results did not support the hypothesis that dynamic risk factors are a better predictors of recidivism in young offenders.
This study offers empirical evidence of the predictive capacity and differential functioning of the SAVRY and YLS/CMI instruments in the Spanish context.
Journal Article
Reincarceration Risk Among Men with Mental Illnesses Leaving Prison: A Risk Environment Analysis
Reentry interventions for persons with mental illness leaving prison have consisted primarily of linkage to mental health services and have produced mixed results on psychiatric and criminal recidivism. These interventions primarily focus on intra-individual risk factors. However, social and environmental factors may also increase risk of reincarceration by constraining choices and pro-social opportunities for community reintegration upon release from prison. In order to add to the knowledge base on understanding reincarceration risk for men with mental illnesses leaving prison, we examined interpersonal and environmental factors that exposed men to heightened risk for reincarceration. As part of a larger study examining the effectiveness of Critical Time Intervention for men with mental illness leaving prison, in-depth interviews were conducted with 28 men within 6 months of release from prison. Policies and practices at local and state levels, community conditions, and interpersonal obligation and conflict were identified as increasing risk for reincarceration.
Journal Article
The Relationship Between Severe Mental Disorders and Recidivism in a Sample of Women Released from Prison
Women are one of the fastest growing sectors of the prison population, and have different pathways into prison and differing needs during the reentry process when compared to men (Cloyes et al. J Forensic Nurs; 6:3-14, 2010b; Herrschaft et al. J Offender Rehabil; 48:463-482, 2009). Women report higher levels of mental health problems overall, and report more severe symptomatology (Cloyes et al. J Forensic Nurs; 6:3-14, 2010a; Hyde 2012; Lynch et al. 2014). The current study focuses on the role of severe mental disorders for women released from prison. Data collected from the North Carolina Division of Adult Correction and Juvenile Justice were used to analyze the specific role of severe mental disorders in women’s recidivism at eight years post-release (n = 2311). Approximately 20% of women in this sample met the criteria for diagnosis with a severe mental disorder (SMD). Logistic regression analysis indicated that there was an association between SMDs and recidivism for this sample only (p = .11). Cox regression analyses indicated that women diagnosed with SMDs were 16% more likely to have recidivated at eight years post-release compared with women who were not diagnosed with an SMD (p < .05). Implications for the recognition, role, and treatment of SMDs during reentry are discussed.
Journal Article