COVID-19 and the reimaging of compassionate release.

PURPOSE: The purpose of this paper is to provide a historical overview of compassionate release policies in the USA and describe how these policies have been used during the COVID-19 pandemic. The authors then describe how these programs have been shaped by COVID-19 and could be reimagined to address the structural conditions that make prisons potentially life limiting for older adults and those with chronic illness. DESIGN/METHODOLOGY/APPROACH: This paper is primarily descriptive, offering an overview of the history of compassionate release policies before and during the COVID-19 pandemic. The authors augmented this description by surveying state Departments of Corrections about their utilization of compassionate release during 2019 and 2020. The findings from this survey were combined with data collected via Freedom of Information Act Requests sent to state Departments of Corrections about the same topic. FINDINGS: The findings demonstrate that while the US federal prison system saw a multifold increase in the number of individuals released under compassionate release policies in 2020 compared to 2019, most US states had modest change, with many states maintaining the same number, or even fewer, releases in 2020 compared with 2019. ORIGINALITY/VALUE: This paper provides both new data and new insight into compassionate release utilization during the COVID-19 pandemic and offers new possibilities for how compassionate release might be considered in the future.

Older incarcerated persons' mental health before and during the COVID-19 pandemic

Purpose: Older incarcerated persons are an especially vulnerable segment of the prison population, with high rates of multimorbidity. This study aims to determine the impact of the COVID-19 pandemic on older incarcerated persons' mental and physical health. Design/methodology/approach: Participants were 157 currently-incarcerated persons age >=50 years who were enrolled in an ongoing longitudinal study before the pandemic. Anxiety symptoms (seven-item generalized anxiety disorder questionnaire), depressive symptoms (eight-item patient health questionnaire) and self-rated health (SRH) were assessed during in-person interviews completed before the pandemic and via mailed surveys during the pandemic (August-September 2020). A mediation model evaluated the relationship among anxiety, depression and SRH. Findings: Participants were 96% male, racially diverse (41% White, 41% Black, 18% Hispanic/Other), with average age 56.0(+/-5.8) years. From before to during the pandemic, anxiety symptoms increased (worsened) (from 6.4 +/- 5.7 to 7.8 +/- 6.6;p < 0.001), depressive symptoms increased (worsened) (from 5.5 +/- 6.0 to 8.1 +/- 6.5;p < 0.001) and SRH decreased (worsened) (from 3.0 +/- 0.2 to 2.6 +/- 0.2;p < 0.001). The total effect of worsening anxiety symptoms on worsening SRH (-0.043;p < 0.001) occurs entirely because of worsening depressive symptoms, i.e. the direct effect was statistically non-significant -0.030 (p = 0.068). Practical implications: Older incarcerated persons experienced worsening mental health during the COVID-19 pandemic which was associated with worsening SRH. These findings have implications for health-care costs and services needed to care for this vulnerable group. Originality/value: This is the first study to evaluate change in older incarcerated persons' mental health from before the COVID-19 pandemic to during the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Age and COVID-19 mortality in the United States: a comparison of the prison and general population.

PURPOSE: The USA has a rapidly aging prison population that, combined with their poorer health and living conditions, is at extreme risk for COVID-19. The purpose of this paper is to compare COVID-19 mortality trends in the US prison population and the general population to see how mortality risk changed over the course of the pandemic. The authors first provide a national overview of trends in COVID-19 mortality; then, the authors assess COVID-19 deaths among older populations using more detailed data from one US state. DESIGN/METHODOLOGY/APPROACH: The authors used multiple publicly available data sets (e.g. Centers for Disease Control and prevention, COVID Prison Project) and indirect and direct standardization to estimate standardized mortality rates covering the period from April 2020 to June 2021 for the US and for the State of Texas. FINDINGS: While 921 COVID-19-related deaths among people in US prisons were expected as of June 5, 2021, 2,664 were observed, corresponding to a standardized mortality ratio of 2.89 (95%CI 2.78, 3.00). The observed number of COVID-19-related deaths exceeded the expected number of COVID-19-related deaths among people in prison for most of the pandemic, with a substantially widening gap leading to a plateau about four weeks after the COVID-19 vaccine was introduced in the USA. In the state population, the older population in prison is dying at younger ages compared with the general population, with the highest percentage of deaths among people aged 50-64 years. RESEARCH LIMITATIONS/IMPLICATIONS: People who are incarcerated are dying of COVID-19 at a rate that far outpaces the general population and are dying at younger ages. ORIGINALITY/VALUE: This descriptive analysis serves as a first step in understanding the dynamic trends in COVID-19 mortality and the association between age and COVID-19 death in US prisons.

"Prison life is very hard and it's made harder if you're isolated": COVID-19 risk mitigation strategies and the mental health of incarcerated women in California.

PURPOSE: This study aims to describe the COVID-19 risk mitigation strategies implemented in California prisons and the impact of these policies on the mental health of incarcerated women. DESIGN/METHODOLOGY/APPROACH: The authors conducted semi-structured qualitative interviews with ten women who were over the age of 50 and/or had a chronic illness and had been incarcerated in California prisons during the COVID-19 pandemic. The authors also interviewed ten health-care providers working in California jails or prisons during the pandemic. Interviews were analyzed using a grounded theory coding framework and triangulated with fieldnotes from ethnographic observations of medical and legal advocacy efforts during the pandemic. FINDINGS: Participants described being locked in their cells for 23 hours per day or more, often for days, weeks or even months at a time in an effort to reduce the spread of COVID-19. For many participants, these lockdowns and the resulting isolation from loved ones both inside and outside of the prison were detrimental to both their physical and mental health. Participants reported that access to mental health care for those in the general population was limited prior to the pandemic, and that COVID-19 risk mitigation strategies, including the cessation of group programs and shift to cell-front mental health services, created further barriers. ORIGINALITY/VALUE: There has been little qualitative research on the mental health effects of the COVID-19 pandemic on incarcerated populations. This paper provides insight into the mental health effects of both the COVID-19 pandemic and COVID-19 risk mitigation strategies for the structurally vulnerable older women incarcerated in California prisons.

Older incarcerated persons' mental health before and during the COVID-19 pandemic

Purpose: Older incarcerated persons are an especially vulnerable segment of the prison population, with high rates of multimorbidity. This study aims to determine the impact of the COVID-19 pandemic on older incarcerated persons' mental and physical health. Design/methodology/approach: Participants were 157 currently-incarcerated persons age >=50 years who were enrolled in an ongoing longitudinal study before the pandemic. Anxiety symptoms (seven-item generalized anxiety disorder questionnaire), depressive symptoms (eight-item patient health questionnaire) and self-rated health (SRH) were assessed during in-person interviews completed before the pandemic and via mailed surveys during the pandemic (August-September 2020). A mediation model evaluated the relationship among anxiety, depression and SRH. Findings: Participants were 96% male, racially diverse (41% White, 41% Black, 18% Hispanic/Other), with average age 56.0(+/-5.8) years. From before to during the pandemic, anxiety symptoms increased (worsened) (from 6.4 +/- 5.7 to 7.8 +/- 6.6;p < 0.001), depressive symptoms increased (worsened) (from 5.5 +/- 6.0 to 8.1 +/- 6.5;p < 0.001) and SRH decreased (worsened) (from 3.0 +/- 0.2 to 2.6 +/- 0.2;p < 0.001). The total effect of worsening anxiety symptoms on worsening SRH (-0.043;p < 0.001) occurs entirely because of worsening depressive symptoms, i.e. the direct effect was statistically non-significant -0.030 (p = 0.068). Practical implications: Older incarcerated persons experienced worsening mental health during the COVID-19 pandemic which was associated with worsening SRH. These findings have implications for health-care costs and services needed to care for this vulnerable group. Originality/value: This is the first study to evaluate change in older incarcerated persons' mental health from before the COVID-19 pandemic to during the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Older incarcerated persons' mental health before and during the COVID-19 pandemic.

PURPOSE: Older incarcerated persons are an especially vulnerable segment of the prison population, with high rates of multimorbidity. This study aims to determine the impact of the COVID-19 pandemic on older incarcerated persons' mental and physical health. DESIGN/METHODOLOGY/APPROACH: Participants were 157 currently-incarcerated persons age ≥50 years who were enrolled in an ongoing longitudinal study before the pandemic. Anxiety symptoms (seven-item generalized anxiety disorder questionnaire), depressive symptoms (eight-item patient health questionnaire) and self-rated health (SRH) were assessed during in-person interviews completed before the pandemic and via mailed surveys during the pandemic (August-September 2020). A mediation model evaluated the relationship among anxiety, depression and SRH. FINDINGS: Participants were 96% male, racially diverse (41% White, 41% Black, 18% Hispanic/Other), with average age 56.0(±5.8) years. From before to during the pandemic, anxiety symptoms increased (worsened) (from 6.4 ± 5.7 to 7.8 ± 6.6; p < 0.001), depressive symptoms increased (worsened) (from 5.5 ± 6.0 to 8.1 ± 6.5; p < 0.001) and SRH decreased (worsened) (from 3.0 ± 0.2 to 2.6 ± 0.2; p < 0.001). The total effect of worsening anxiety symptoms on worsening SRH (-0.043; p < 0.001) occurs entirely because of worsening depressive symptoms, i.e. the direct effect was statistically non-significant -0.030 (p = 0.068). PRACTICAL IMPLICATIONS: Older incarcerated persons experienced worsening mental health during the COVID-19 pandemic which was associated with worsening SRH. These findings have implications for health-care costs and services needed to care for this vulnerable group. ORIGINALITY/VALUE: This is the first study to evaluate change in older incarcerated persons' mental health from before the COVID-19 pandemic to during the pandemic.

COVID-19 and incarcerated older adults: a commentary on risk, care and early release in Australia.

PURPOSE: The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight key matters for better risk management and care of this population during this and future infectious disease pan/epidemics. DESIGN/METHODOLOGY/APPROACH: The present commentary draws on current policies, practices and literature regarding the health, needs and management of older incarcerated adults in Australia to discuss risk, care and early release for this population during the COVID-19 pandemic. FINDINGS: Incarcerated persons experience poorer health and accelerated age-related decline compared to those in the general community. The present situation offers the opportunity to fill knowledge and practice gaps, including policies for staff training, identification of dementia and cognitive decline, assessment of mobility issues, addressing barriers to health-seeking, possibilities of medical or compassionate release, risk assessment and release protocols and post-release needs. PRACTICAL IMPLICATIONS: While Australian prisons have acknowledged the vulnerability of older persons, more focused adaptation of COVID-19-related policies to consider adults as young as 45 years are needed. Appropriate ethical identification and management of cases in this population is needed, as is discussion on issues of decarceration and medical release. Re-conceptualisation of incarcerated adults as "citizens in need of care", rather than as "offenders to be secured", will be beneficial. Robust, local evidence is needed to assist decision-making. ORIGINALITY/VALUE: This is a comprehensive, focused review of relevant evidence, policies and practices for a growing subpopulation of prisoners worldwide with complex needs and particular vulnerability to the COVID-19.