Inmate Perceptions of Mental Health Services.

With the increasing rise in the U.S. prison population, meeting the mental health needs of inmates before, during, and after incarceration remains an obstacle. What are the mental health experiences of inmates? For what types of problems are inmates willing to seek help, and what are the barriers to their service utilization? This study investigated inmates' attitudes and perceptions toward mental health services and examined whether these attitudes and perceptions vary with respect to ethnic group membership or among inmates of differing security levels. Implications of these findings for psychologists, including psychologists not employed in correctional settings, are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors predicting levels of female inmates’ use of psychological services.

The number of female inmates in state and federal correctional institutions has increased dramatically over the past several years. In addition to this overall increase in number, women have greater levels of mental health service use than men, both in the community and during incarceration. It is important to understand what factors are associated with varying amounts of mental health service use as this population continues to grow. This study explores the influence of female inmate characteristics, including demographic variables and mental health service use before incarceration, on a continuous dependent measure of overall psychological services use during incarceration. Results indicate that for a sample of female inmates within the federal prison system, U.S. citizenship, prior community-based receipt of mental health services, and history of substance abuse were the strongest predictors of increased service use while incarcerated. Findings concerning routine versus volitional services suggest that female inmates with less severe mental health problems are among those who volitionally seek mental health services during incarceration. Recommendations for correctional mental health services training, practice, and research are made. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A national survey of group psychotherapy services in correctional facilities.

Facilitating group psychotherapy in correctional settings presents dilemmas and concerns that are unmatched in other environments, often leaving clinicians grasping for therapeutic advantages. This article provides information regarding national practices of group psychotherapy services for male inmates in state correctional facilities (n?=?79) as reported by correctional mental health providers (n?=?162). The general findings of this study will be of interest to group psychotherapy providers employed in correctional facilities; however, of particular importance for doctoral-level psychologists is their potential role in fulfilling a need for the active development and evaluation of group psychotherapy programs in correctional settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Advancing psychology services through telehealth in the Federal Bureau of Prisons.

This article describes a collaborative pilot project between the Federal Bureau of Prisons and the Joint (Departments of Justice and Defense) Program Steering Group that seeks to determine the benefit of telehealth in a corrections environment. This pilot project is currently being conducted between a hub site in Lexington, Kentucky, and remote sites in Allenwood and Lewisburg, Pennsylvania. Results to date are consistent with previous literature and suggest a high level of patient acceptance of this technology and mode of service delivery. The particular advantages of telehealth for correctional settings, including increased access to the full range of psychology services for inmates, the maintenance of institutional security, increased access to the inmate population for research purposes, and professional consultation for correctional psychologists are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of DSM-IV substance abuse and dependence disorders among prison inmates

The study examined the 30-day and lifetime prevalence of DSM-IV alcohol and drug disorders among state prison inmates. A sample of 400 inmates consecutively admitted to a state prison reception center were assessed for alcohol and drug disorders using the Structured Clinical Interview for DSM-IV (SCID-IV). Test-retest reliabilities were calculated for the SCID-IV. Lifetime substance abuse or dependence disorders were detected among 74% of inmates, including over half who were dependent on alcohol or drugs. For the 30 days prior to incarceration, over half of the sample were diagnosed as having substance abuse or dependence disorders, including 46% who were dependent on alcohol or drugs. Black inmates were significantly less likely to be diagnosed as alcohol dependent than whites or Hispanics. The high rates of substance use disorders are consistent with previous findings from other studies conducted in correctional settings and reflect the need to expand treatment capacity in prisons.     

Evaluating response set styles on the MMPI with prisoners: Faking good adjustment and maladjustment.

Told 24 prison inmates (mean age = 23 yr) to fake good adjustment and maladjustment on the MMPI. Results were compared with Ss' normal or "honest" MMPI profiles. Ss were easily able to fake maladjustment and, contrary to theory, were also able to fake good adjustment. The adequacy of various indices of faking were compared and recommendations are made for the applied use of some of these indices for the detection of faked responses in correctional settings. Previous role-playing vs "real-life" studies are contrasted and the inmates' results are compared with previous findings. (French summary) (27 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computerized offender assessment: Validation study.

Evaluated the validity of a computer-based test interpretation (CBTI) system for mental health screening in correctional settings. First, 100 adult male felons were administered a brief mental status interview and a series of psychological tests, including the Minnesota Multiphasic Personality Inventory (MMPI), the revised Beta IQ Examination, and the Buss-Durkee Hostility Inventory. Psychiatric diagnoses and CBTI ratings of victimization, violence, suicide, and substance abuse potentials were compared with clinicians' evaluations. Second, CBTI diagnoses of 109 inmates were compared with Diagnostic Interview Schedule (DIS) diagnoses. Last, CBTI risk ratings were compared with institutional infraction records of 1,718 inmates. Agreement with CBTI and clinicians' risk ratings was fair. CBTI agreement with clinicians' and DIS diagnoses ranged from 60–93%. Ways of improving CBTI algorithms and the value of this approach in correctional screening are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth in the Federal Bureau of Prisons: Inmates' perceptions.

Nationally, correctional psychologists are being asked to use behavioral telehealth interventions with mentally ill inmates. Beyond anecdotal stories, no information is available on which inmates might be best suited for such interventions. This article examines 75 inmates satisfaction with telehealth consultations, reporting initial satisfaction with the consultation process, more comfort with the process over time, and a willingness to return for follow-up. Inmates with thought disorders and inmates with mood disorders were satisfied with telehealth, but difficulties were noted when inmates became frustrated and angry. These difficulties may be accommodated by technological upgrades and spending more time preparing inmates for consultation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-systems approach to evidence-based practice for children and adolescents.

Improving outcomes for children and adolescents with mental health needs demands a broad meta-systemic orientation to overcome persistent problems in current service systems. Improving outcomes necessitates inclusion of current and emerging evidence about effective practices for the diverse population of youth and their families. Key components of the meta-system for children with emotional or behavioral needs include families, cultural norms and values, and service sectors such as schools, pediatric health centers, specialty mental health systems, juvenile justice systems, child protection services, and substance use treatment systems. We describe each component of the meta-system, noting challenges to the provision of evidence-based practice (EBP) and highlighting ways to optimize outcomes. Our focus is on the inclusion of evidence-based assessment and interventions, including prevention, within a developmentally driven and culturally responsive contextual model. Recommendations for addressing disparities in research funding and essential steps to foster communication and coordination of EBP across settings are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Restructuring public mental health and substance abuse service systems

The authors originally circulated the concepts in this proposal during May 1995. The purpose was to support an open, public dialogue regarding the restructuring of the mental health and substance abuse services in Illinois in anticipation of Medicaid funding changes. Restructuring mental health and substance abuse service systems should follow certain key principles. These principles are applicable to other states, particularly those large in territory and population. The authors propose the temporary use of multiple managed care companies serving as administrative services only (ASO) organizations, each of whom would have responsibility for a given geographic portion of a state. The role of the ASOs would be to organize providers into networks on a regional basis and transfer managed care expertise in financing and clinical management to the relevant state departments and provider groups. Changes in the service delivery system would be phased in over time with reorganization of key components of the system during each phase. Where the provision of mental health, substance abuse, and social services is split among multiple state agencies, these agencies would be merged to achieve unified funding and administrative efficiency. Patients and advocacy organizations would play a key role in overseeing and shaping system restructuring at all levels, including a governmental board reporting to the governor, overseeing ASO organizations' operations and assuring quality and access at the provider level. The authors propose funding of public behavioral health services through use of a tiered, integrated funding model.     

Impact of Time in Prison and Security Level on Inmates' Sexual Attitude, Behavior, and Identity.

The aim of the present study was to develop an understanding of changes in inmates' sexual identity and the role these changes play in inmates' sexual attitudes and behaviors while incarcerated. Participants in this study consisted of 185 inmates from minimum and maximum security correctional facilities in a midwestern state. Results revealed that the higher the security level was and the longer inmates spent in a correctional facility, the greater was the probability that inmates would begin to endorse some preference for same-sex sexual behavior. This is in contrast to the finding that inmates less readily changed their sexual identity from heterosexual to homosexual regardless of the security level or the length of time spent in prison. Furthermore, inmates generally reported engaging in consensual same-sex sexual activities for reasons that are consistent with those of nonincarcerated persons (love and pleasure). Implications and future studies are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Military youth and the deployment cycle: Emotional health consequences and recommendations for intervention.

The United States military force includes over 2.2 million volunteer service members. Three out of five service members who are deployed or are preparing for deployment have spouses and/or children. Stressors associated with the deployment cycle can lead to depression, anxiety, and behavior problems in children, as well as psychological distress in the military spouse. Further, the emotional and behavioral health of family members can affect the psychological functioning of the military service member during the deployment and reintegration periods. Despite widespread acknowledgment of the need for emotional and behavioral health services for youth from military families, many professionals in a position to serve them struggle with how to best respond and select appropriate interventions. The purpose of this paper is to provide an empirically based and theoretically informed review to guide service provision and the development of evidence based treatments for military youth in particular. This review includes an overview of stressors associated with the deployment cycle, emotional and behavioral health consequences of deployment on youth and their caretaking parent, and existing preventative and treatment services for youth from military families. It concludes with treatment recommendations for older children and adolescents experiencing emotional and behavioral health symptoms associated with the deployment cycle. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Provision of mental health services in women's health centers

Women's health centers are often associated with a comprehensive model of health care that treats the "whole woman." Using data from a nationwide study of 467 women's health centers, we explored how the ideal of comprehensive care was implemented with respect to mental health services. Specifically, we examined the rates of screening and treatment for a subset of mental health and behavioral and social problems in women's health centers and the structural, staffing, philosophical, and patient factors associated with the provision of services. Across 12 services, the overall rates of provision ranged from 7.7% for screening for dementing disorders to 27.6% for smoking cessation counseling and treatment. In a series of logistic regressions, center type (primary care) and having a mental health staff person were consistently associated with service provision; other important variables were having a high percentage of women using the center as their usual source of care and having a belief in women-centered care. Findings indicate that the majority of women using women's health centers do not receive services in a comprehensive care environment that includes key mental health services.     

Failure of erythropoietin treatment in a case with primary autonomic failure

All prisons provide healthcare services which aim to meet the needs of prisoners. The goal of the service is to give prisoners access to the same quality and range of health care as the NHS gives the general public. However, within the prison environment priorities centre around order, control and discipline and therefore an ethos of health care needs to be developed. Custody reduces the prisoner's opportunity for self-care and independent action as inmates have to consult nursing or medical staff for even the most simple remedies. Nursing staff in the prison service can play a significant part in primary health care, mental disorder and health promotion. Nurses have the knowledge, skills and attitudes needed to deal with this diverse and vulnerable prison population and to promote a positive interface between custody and care.     

Hepatocyte growth factor expression in the developing myocardium: evidence for a role in the regulation of the mesenchymal cell phenotype and urokinase expression

BACKGROUND: No previous studies have examined the extent to which correctional facilities in the United States screen for and treat hepatitis C (HCV) infection. METHODS: Medical directors of state correctional facilities responded to a survey assessing the degree to which prisons screen for and treat hepatitis C. To estimate numbers of inmates eligible for interferon treatment and to examine costs associated with HCV management, we constructed a feasibility model that incorporated screening criteria used in California and Rhode Island. RESULTS: Thirty-six states and Washington, DC, responded, resulting in a survey response rate of 73%, representing 77% of all inmates in state facilities nationwide. Colorado alone reported routine screening. Only California reported conducting a systematic seroprevalence study, which found that 39.4% of male inmates were hepatitis C antibody positive in 1994. Seventy-three percent of the respondents sometimes consider treating with interferon. Four states follow a standard protocol. The feasibility model suggests that treating suitably screened inmates is a reasonable expenditure for correctional systems. CONCLUSION: Prison may be an appropriate setting for treatment of hepatitis C. If accompanying substance abuse issues are addressed, instituting HCV treatment for certain eligible incarcerated individuals may be a worthy target for public health dollars.     

Response to "All That Glitters Is Not Always Gold: Medical Offset Effects and Managed Behavioral Health Care".

Comments on an article by J. S. Fraser (see record 1996-00461-003) regarding managed behavior health care offset effects in marketing managed behavioral care services. Previous criticism of medical cost offset, problems in Fraser's study and report, and the relationship of research to public accusations against Medco (Fraser's funding source) are discussed. The present author concludes that Fraser's article does not address the stated goal of clarifying unrealistic expectations that led to the Wall Street Journal exposé. All of Biodyne's contractual failures alleged in the Wall Street Journal article remain unchallenged by Fraser's examination of medical cost offset. It is argued that because the published article contains numerous errors, questions must also be raised about the accurate collection and interpretation of raw data. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stay safe! Stay healthy! Surviving old age in prison

Although elderly inmates form a small minority in the U.S. prison population (6.6%), this number is expected to increase by 2005. Elderly prisoners consist of first-time offenders, habitual offenders, and those who have "aged in place" (received very long sentences at a young age). Violence is an identified stressor affecting the elderly prisoner. This enduring stressor can add to physical deterioration, particularly in the inmate with chronic illness. Violence in prison falls into three categories: prisoner-prisoner, staff-prisoner, or prisoner-staff (Clear & Cole, 1994). Prisoner-prisoner incidents account for the majority of violence within prison systems. The convict in today's prison will use extremes of violence to combat threats to his or her reputation or self-concept of "machismo," or if the inmate feels "disrespected." The aging prisoner may have chronic, pervasive stress levels disguised under a tough veneer, although he or she may no longer be strong enough physically or emotionally to fend off potential attackers. Interventions with elderly prisoners include thorough physical and cognitive assessment, including signs and symptoms of depression or stress related to environmental disturbances. Educational training for correctional staff about age-specific developmental changes is necessary. Building partnerships with community, state, and national organizations can assist elderly inmates in their adjustment to prison and foster successful community release programs. Special care units may be considered for frail elderly inmates or those with chronic health problems.     

Development of a correctional-clinical psychology program.

Describes the development of a graduate training program in correctional-clinical psychology at the University of Alabama. Since 1971, the Department of Psychology has combined academic instruction, field consultation, research, and social activism in this program. An organizational component within the department, the Center for Correctional Psychology, has served the primary coordination role and has been the primary training vehicle. The center's involvement includes not only correctional settings and offenders, but also hospitals, patients, law enforcement systems, police, and courts. Major areas of activity are briefly described, including consultation with criminal justice agencies, the training of criminal justice personnel, provision for a clearinghouse for correctional information, and the preparation and presentation of expert testimony in court. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community Health Centers: Exciting Opportunities for the 21st Century.

What are important and increasingly available settings for psychologists interested in practicing primary behavioral health care? Community health centers (CHCs) represent the medical "safety net" for millions of uninsured and medically underserved Americans. The recent push to expand mental health services at CHCs creates the need for psychologists and other mental health providers, particularly those familiar with primary behavioral health care approaches. Federal funding to recruit and retain psychologists at CHCs has increased along with opportunities for multidisciplinary service approaches and training. The potential ways in which psychologists can respond to demonstrated societal needs and develop new clinical skills and methods at CHCs are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developing visiting surgical services for rural and remote Australian communities

The University Department of Surgery at Queen Elizabeth II Medical Centre (Perth, Western Australia) has undertaken a pilot project to provide surgical services to country communities where no such service exists. Three surgeons undertake a regular schedule of appointments, and are accompanied by final-year medical students to give them experience with common conditions rarely managed in teaching hospitals. The service is supported by a central administrative office and coordinated by a general practitioner, who negotiates with the regional healthcare providers. Patients are referred by their general practitioner, who may work with the surgeon as anaesthetist or surgical assistant.