Search Results (64)

This study aimed to map the literature on the clinical role of pharmacists in the care of incarcerated people at correctional facilities and to identify gaps in this field. A scoping review was conducted on 30 July 2024, using the PubMed, Scopus, and LILACS databases. Gray literature was searched via Google Scholar, and references of included studies were manually reviewed. Primary studies of any design reporting pharmacists’ clinical services and/or activities for incarcerated individuals were eligible. Study selection and data extraction were performed independently by two reviewers, with a third resolving disagreements. The search yielded 894 records, from which 27 studies were included. Most studies were conducted in the United States (n = 16; 59%) and France (n = 7; 26%). Eleven (41%) focused exclusively on male populations, and one (4%) on female inmates. Most studies addressed pharmacists’ clinical roles in mental health conditions and substance use disorders (n = 9; 33%), infectious diseases (n = 5; 19%), and diabetes (n = 4; 15%). Clinical services and/or activities related to direct patient care were the most frequently reported (n = 18; 67%). Process measures were reported in 18 studies (67%), and clinical outcomes were the most common type of outcome (n = 13; 48%). This review highlights the pharmacist’s clinical role in treating mental health conditions and substance abuse, infectious diseases, and diabetes in incarcerated care. It underscores the need for further research in low- and middle-income countries, on women’s health, and on other prevalent conditions. Full article

Background: Incarcerated individuals often experience poor oral health due to limited access to care and socioeconomic disadvantages. Objective: This study assessed the dental health status of incarcerated individuals in Silesia over a five-year period using the Decayed, Missing, and Filled Teeth (DMFT) index and compared their outcomes to a matched control group from the general population. Methods: We conducted a retrospective observational case-control study at the University Centre for Dentistry in Bytom, reviewing records of 136 incarcerated patients (mean age 36.8 ± 7.9 years; 9.4% women) and a matched control group between 2019 and 2024. Results: Incarcerated individuals had a higher mean DMFT score (14.4 ± 5.7) compared to controls (11.5 ± 6.5; mean difference = 2.95, 95% CI: 1.53 to 4.37; Cohen’s d = 0.49), with more decayed (4.9 ± 3.2 vs. 3.4 ± 2.4) and missing teeth (4.3 ± 3.2 vs. 3.5 ± 2.6). Most incarcerated patients (65.5%) required oral surgical treatment, most commonly for retained roots (25.9%) and impacted teeth (24.5%). No significant DMFT differences were observed based on age or sex, although disparities were most pronounced in older female prisoners (mean DMFT 17.8 vs. 9.8 in controls aged 40+). Conclusions: Incarcerated individuals in Silesia demonstrated a significantly higher burden of untreated dental disease and greater tooth loss compared to non-incarcerated controls over the five-year period. The predominance of advanced dental conditions requiring surgical intervention highlights missed opportunities for early and preventive care in this vulnerable population. Full article

Sexual minority women (SMW) are a resilient yet vulnerable population who may experience poor psychosocial outcomes due to minority stress associated with their marginalized status and traumatic experiences resulting from interpersonal and structural violence. When SMW are incarcerated, the trauma of this experience can exacerbate existing mental health challenges. Self-concept is a key measure of mental health that is associated with increased self-efficacy and positive psychosocial outcomes. This analysis explores the ways in which incarceration impacts the self-concept of SMW. Secondary data analysis of three qualitative interviews with formerly incarcerated SMW was conducted. Specifically, Gilligan’s Listening Guide was used to create “I poems” that articulate the participants’ narratives and contrapuntal voices. These poems were then analyzed to build knowledge about participants’ self-concept. This analysis informs our understandings of self-concept among SMW, violence against women, the vulnerability of binary constructs, and the ways in which people negotiate past, present and future selves. The findings can inform interventions that seek to mitigate the psychosocial risks faced by SMW and formerly incarcerated people and improve outcomes for these populations. Full article

Despite the increase in the study of women and crimes committed by them, investigations continue to be scarce. Self-control and psychopathy have been widely studied in incarcerated populations, though more frequently in males than females. This study examines these psychological variables related to substance use history and violent crime in a sample of 94 incarcerated women in Portugal. Participants completed a sociodemographic questionnaire, the Self-Control Scale, and Levenson’s Self-Report Psychopathy Scale—VP. We found average self-control levels, with lower scores among participants with substance use. Significant differences in self-control emerged between women who committed homicide and those who did not. Psychopathy scores were above average, with significant differences in Factor 2 (impulsivity) between those who committed homicide and those who did not. Self-control and psychopathy were negatively associated, and psychopathy predicted self-control. These findings, which are not entirely consistent with the literature, challenge common assumptions about self-control, psychopathy, and crime, particularly in incarcerated women, and suggest that different mechanisms may drive violent and non-violent crimes in women. These results reinforce the need to consider gender-specific pathways to crime, highlighting the urgency of continuing to investigate the manifestation, in women, of widely studied variables in male samples. Full article

Background: Cardiovascular disease (CVD) is the leading cause of death worldwide and is exacerbated by poor dietary habits, particularly in settings such as women’s prisons. Incarcerated women are often exposed to ultra-processed foods, limited nutritional education, and restricted living conditions that increase their risk of CVD. Objectives: This study aimed to explore the challenges perceived by professionals in a Portuguese women’s prison regarding the prevention of CVD, particularly through dietary interventions. Methods: A qualitative, exploratory and descriptive study was conducted using a focus group with six professionals. Data were collected in July 2024 and analysed using thematic content analysis. Results: Three thematic categories emerged: (1) contextual challenges of the prison system (e.g., sedentary lifestyle, limited food options); (2) socio-cultural resistance to behavioural change (e.g., low adherence to health programmes, use of food as a coping mechanism); and (3) the need for sustainable and interdisciplinary intervention strategies. Conclusions: The findings highlight the complexity of promoting cardiovascular health in female prisoners. Interventions need to take into account mental health support, prisoner autonomy and institutional constraints. Future research should develop and test targeted, context-specific nutrition programmes in similar settings. Full article

The vast majority of people in U.S. women’s prisons are survivors of interpersonal violence, a pattern that organizers and advocates have referred to as the abuse-to-prison pipeline. This article critically examines criminal prosecution from the perspectives of survivors of interpersonal violence who faced long prison sentences in California. In-depth interviews and group discussions were generated through a participatory process at a gathering to launch the University of California Sentencing Project, a partnership with the community-based organization California Coalition for Women Prisoners. The twenty-two formerly incarcerated participants had collectively spent more than 300 years imprisoned. Drawing on their lived experiences spanning several decades and multiple jurisdictions, this article offers an unyielding account of tactics of isolation, intimidation, narrative manipulation, and confinement as definitional to prosecutorial practice and culture. This criminalized survivor-centered analysis of prosecution shows how one of the most robustly funded public interventions for interpersonal violence is not merely failing to protect victims but is protracting patterns of abuse and coercive control. Implications are discussed in terms of social care work and collective defense rooted in abolition feminism. Full article

Background: Oral health is crucial to overall well-being but is significantly neglected among incarcerated women, who face higher rates of dental caries, periodontal disease, and edentulism due to systemic barriers, behavioral risks, and socio-demographic vulnerabilities. Objective: This review evaluates the oral health status of incarcerated women, identifying key determinants and assessing intervention effectiveness. Methods: A systematic search of PubMed, Scopus, Embase, and Cochrane Library databases was conducted as per PRISMA 2020 guidelines. Studies published in English in the last 15 years on adult incarcerated women were included. Data on oral health outcomes, risk factors, and interventions were extracted and analyzed. Results: Ten studies revealed significantly higher rates of oral diseases among incarcerated women compared to the general population. Behavioral factors such as smoking and poor diet, combined with inadequate access to care, are major contributors. Pregnant inmates face compounded risks, with poor oral health linked to adverse maternal and infant outcomes. Conclusions: Incarcerated women experience severe oral health disparities requiring gender-responsive, interdisciplinary interventions, including preventive care, education, and integrated correctional policies. Future research should focus on longitudinal studies and effective intervention strategies. Full article

The carceral apparatus in the U.S. can be understood as mechanisms of policing, criminalizing, and incarcerating through the criminal justice system in its traditional sense but also encompassing mechanisms of social control, surveillance, and violence exerted through other systems such as family policing organizations, social service agencies, and helping professions. As we are witnessing the impacts of the toxic drug supply crisis and continued reliance on the “war on drugs” policies, these carceral functions are deeply felt among people who use drugs and have substance use disorders. This qualitative study uses the Foucauldian lens of biopolitics and biopower to examine how power operates in carceral systems and impacts women who use substances. By conducting and analyzing in-depth interviews with four women who identify as systems-involved in the U.S., this study highlights that power operates in a multitude of ways. The findings highlight the gendered experience these individuals face navigating these systems of circularity, including the minimization of bodily autonomy, the destruction of social reproduction, and coercive performances to the patriarchal gaze. The findings also amplify the women’s perspective on systemic change and offer alternatives to current carceral approaches. This research provides insights for social service professionals in all fields for more liberatory approaches to working with women in carceral settings and proposes a radical departure from current trajectories of social control and criminalization. Full article

Incarcerated women report extremely high rates of lifetime sexual violence victimization. Survivors Healing from Abuse: Recovery through Exposure (SHARE) is an exposure-based group therapy specifically designed for incarcerated women survivors of sexual violence. SHARE has been continuously delivered in a women’s prison for more than 12 years. However, like many prisons during the COVID-19 pandemic, the prison ceased all in-person programming between March 2020 and July 2021. In response, the SHARE treatment team pivoted to a hybrid telehealth delivery model (i.e., group participants gathering in a facility group room and therapists joining via video, displayed on a computer screen within the group room). Given the lack of evidence for hybrid telehealth in carceral settings, and specifically for group therapy for sexual trauma, the current study compared ratings on internalizing symptoms (Brief Symptom Inventory-18 or BSI-18), posttraumatic stress symptoms (Posttraumatic Checklist-5 or PCL-5), and group cohesion ratings (Inclusion of Self in Other scale, or IOS) for participants who received SHARE in person (n = 21) or through hybrid telehealth (n = 19). The results demonstrated that participants of in-person and hybrid telehealth SHARE groups reported similar significant reductions in BSI-18 (15.21 in person vs. 16.00 in hybrid telehealth) and PCL-5 (30.78 in person vs. 26.40 in hybrid telehealth) scores pre- to post-treatment and comparable IOS ratings (5.06 in person vs. 5.31 in hybrid telehealth). The findings suggest hybrid telehealth is an effective and feasible treatment modality for meeting the need for trauma-focused therapy in prisons. Future studies examining the effectiveness and implementation of trauma-focused hybrid telehealth groups in prisons are warranted. Full article

From both a social and epidemiological perspective, incarcerated individuals in Latin America face a series of accumulated disadvantages in different areas, one of them being the deterioration in their mental health linked to confinement and the negative effects of incarceration. However, since mental health evaluations at the intake phase are virtually non-existent for incarcerated populations in Chile, the diagnosis of, monitoring of, and intervention initiatives on mental health issues are very limited, thus limiting the possibilities of causal relationship analysis and evidence-based interventions. Thus, the first step to making the topic of mental health more visible to public policy is to gather more evidence about it in prison settings. This article analyzed—using a screening approach—the presence, suspicion, or absence of psychopathology using the GHQ-12 instrument among a sample of 1159 incarcerated individuals grouped in 20 prisons throughout Chile. Our main results show that there are about 22.3% of Chilean inmates with presence of some form of psychopathology, plus an additional 51.8% with the criteria for suspected psychopathology; we also found significant, bivariate relationships between various mental health items and gender, the type of prison, and age, so that incarcerated women, younger inmates, and those housed in public prisons reporting more problems than their counterparts. Finally, we discuss the implications of our findings for the improvement of prison life in Chile and the possibility of social reintegration for incarcerated people. Full article

Trauma, mental illnesses, and substance use disorders (SUD) are well-documented contributors leading to women’s incarceration; however, less is known about how these factors also influence women’s pathways through prison once incarcerated. To address this gap, we examined (1) women’s pathways to and through prison-based mental health services, (2) summarized their sociodemographic and diagnostic profiles, and (3) examined how mental health and addiction relate to indicators of within-prison functioning, intervention receipt, and recidivism. Data derived from routine administrative and treatment records of women incarcerated between January 2015 and December 2023 in the Washington Corrections Center for Women (WCCW). The full sample comprised 5775 women who entered WCCW during the study period. The majority (53.2%) of women admitted to prison in the study period had at least one mental health diagnosis requiring at least moderate mental health intervention. Substance use (62.73%), trauma-related (61.11%), and mood (47.71%) disorders were most common. Individuals with at least a diagnosis of psychosis, neurocognitive disorders, and personality disorders had greater rates of close observation stays, crisis events, and non-suicidal self-injury risk assessments. Psychosis was associated with the highest rate of crisis events, while personality disorders were associated with the highest rate of non-suicidal self-injury risk assessments. Three-year recidivism rates were highest amongst those with a diagnosis of psychosis or ADHD. Trauma-focused and substance use treatments were associated with lower rates of crisis interventions and other critical incidents in their post-treatment period, but no relationship was observed for reductions in post-release recidivism. Overwhelmingly, women enter prison with significant mental health care needs and require a high-level of care that is largely reflective of the nearly ubiquitous nature of trauma, psychological distress, and addiction. The level of care needed, in response to the varied and complicated diagnostic profile of incarcerated women (e.g., ADHD, psychosis, trauma), as well as the number of critical incidents stemming from symptoms, reflects the need for more clinical staff to expand reach along with training in a wide range of modalities. Full article

Women in jail experience high rates of exposure to interpersonal violence and PTSD. However, programming to address women’s trauma-related treatment needs in corrections facilities is limited and this population remains underserved. Research identifying treatment targets to reduce PTSD symptoms and to support recovery is needed. Prior research suggests trauma-related shame and coping self-efficacy are associated with PTSD symptoms in the general population. The present study aimed to expand upon the current literature by using structural equation modeling to evaluate the associations among cumulative interpersonal violence exposures, trauma coping self-efficacy (TCSE), trauma-related shame, and current PTSD symptoms in a sample of randomly selected women in jail (n = 150). Over half the sample (55%) reported clinically significant PTSD symptoms. Shame (β = 0.372, p = 0.001) and TCSE (β = −0.375, p < 0 000) significantly predicted PTSD symptoms, explaining 50% of the variance in PTSD. These findings provide preliminary direction for identification and implementation of evidence-based treatments addressing trauma-related shame and TCSE to reduce PTSD symptoms in incarcerated women. Full article

Women are the fastest-growing segment of the incarcerated population and experience high rates of cumulative trauma exposure, mental illness, and PTSD. The aim of this study is to assess the implementation of a peer-led Seeking Safety (an evidence-based intervention for addressing trauma and addiction) pilot program for women in jail. Guided by principles from community-based participatory research and cooperative inquiry, participant surveys were analyzed (secondary data) using descriptive methods (n = 60), and qualitative interviews with program facilitators were conducted and analyzed using a general inductive approach (n = 7). Peer-led Seeking Safety is feasible, acceptable, and appropriate for women in jail, with high levels of participant satisfaction. We describe several “lessons learned” related to the jail context, including structure and security processes and vicarious and retraumatization experiences among facilitators. Preventing facilitator burnout is necessary for the sustainability of the program. Future implementations of Seeking Safety in jails should consider the lessons learned in this study. Full article

Background: Although cervical cancer (CC) is highly preventable through appropriate screening methods like the Papanicolaou (Pap) test, which enables early detection of malignant and precancerous lesions, access to such screening has not been equitable across social groups. Sex workers and people with records of incarceration are among the most under-screened populations in Ontario. Little is known about the acceptability and feasibility of HPV self-sampling (HPV-SS) as an alternative cervical cancer screening method for these groups. This online, community-based mixed-methods pilot study aimed to address this knowledge gap. Methods: Eighty-four under- and never-screened sex workers and ex-prisoners aged 25–69 years and residing in the Greater Toronto Area, were recruited by community peer associates. Participants completed an online survey and viewed short videos about CC and screening with Pap and HPV-SS. Those who opted for HPV-SS conducted the test at one of two collaborating organizations. Results: The median age of participants was 36.5 years. Most had limited knowledge about CC and screening. Approximately 13% identified as non-binary, and 5% as two-spirit or trans men, with the majority having completed secondary education. Of the participants, 88% chose HPV-SS, and one-third tested positive for high-risk HPV types. The ability to self-sample without judgment from healthcare providers was noted as a key advantage. However, there was a need for training on proper HPV-SS techniques. Conclusions: To improve cervical cancer screening among sex workers, increasing awareness through participatory community co-creation of sexual health education is essential. Additionally, offering HPV-SS as a screening option is crucial, given its demonstrated acceptability and feasibility within this population, many of whom lack a primary care provider and face discriminatory attitudes in healthcare settings. Full article

Aims: This research examined the incarceration experiences of adult women with histories of drug addiction, aiming to fill knowledge gaps regarding how these women subjectively interpret their incarceration experiences. Methodology: In-depth interviews were conducted with 22 formerly incarcerated women from the Northeast and Midwest United States. A phenomenological approach was used to explore the meaning of incarceration for the participants, with the deprivation model of imprisonment guiding the analysis. Findings: Women with drug addiction reported being treated differently while incarcerated because of their addiction. They experienced a lack of physical and psychosocial security, limited autonomy in health-related decisions, and diminished freedom to act and express themselves, often as a result of their mental health and drug addiction issues. Additionally, they experienced a loss of identity, stigma, and internalized stigma due to the way they were treated in prison. Conclusions: Incarceration is a critical life event that deprives women of many basic human needs, shaping their health, self-perception, and understanding of the criminal justice system. Further research is necessary to explore how the experience of incarceration impacts women’s mental health, drug addiction recovery, and overall well-being. Full article