Mood and Emotions among Inmates after COVID-19 Pandemic.

BACKGROUND: During imprisonment, inmates face many difficulties in adapting to life behind bars. The aim of the study was to find out (a) how challenging for inmates were the selected COVID-19 pandemic-related changes and stressors, (b) what moods and emotions are most commonly experienced by prisoners just after the difficult period of the COVID-19 pandemic, and (c) which of the selected factors determine the positive and negative mood of inmates. METHODS: The research was conducted in July 2022 in six randomly selected Polish prisons. Prisoners (N = 250) were invited to participate. Comparative and regression analyses were carried out. Two scales measuring moods: the General Mood Scale and the Mood Scale (positive and negative), the Emotions Questionnaire by B. Wojciszke and W. Baryla, and a proprietary questionnaire were used. RESULTS: Sanitary restrictions implemented in prisons resulted in a moderate experience of discomfort among prisoners, mainly in terms of not being able to have direct contact with family and friends, limitation in their personal freedoms to do their jobs, self-development, and deterioration of mental and physical health. A depressed mood predominated among the prisoners, making them feel unhappy, discouraged, tense, and uptight. They reported dominant feelings of alienation, distress, anxiety, and worry at the time of the survey. The mood of inmates was changing from more positive to more negative; on average, it was described as moderate. Based on the regression coefficients, the significant predictors of inmates' positive mood were perceived happiness (for those who got sick with COVID-19 during their prison sentence) and joy, angst, and contentment (for the healthy ones). In the group of SARS-CoV-2-infected prisoners, unhappiness, age, concern, cheerfulness, and rage were found to be predictors of their negative mood. The feeling of joy appeared to be a significant predictor of negative mood for those inmates who had no personal experience with COVID-19. CONCLUSIONS: It is necessary to provide convicts with continuous psychological care and to monitor their mood. Such measures should be the foundation for restorative interventions.

"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.

The manipulation of minds:reckoning with the legacy of the american post 9/11 torture program.

In this article, we argue that the government's post 9-11 torture program was a big lie, in that the designers, executors and enablers knew all along that torture does not elicit reliable information. We review the government's own research on the matter, and we discuss the ways in which methods known to be unreliable were implemented, most saliently at the detention facility at Guantánamo Bay. We review the secrecy and propaganda surrounding the scope and horror of the torture program at Guantánamo and black sites around the world, and the painful truth of how the government knowingly adopted the terror policies of the torture program, against their own knowledge, against international human rights, and against the law. On January 20, 2021, Joseph R. Biden, Jr. became the 46th President of the United States, following what might very well have been the most chaotic election in the recent history of the United States. The turmoil reached a peak on Jan 6, 2021, when Trump supporters stormed the Capitol in Washington, DC. At the center of this extended and ongoing political upheaval is what has been labeled "The Big Lie" - the completely disproven notion that Biden's win was based on fraudulent grounds, and that the election was stolen from Trump because of a corrupted voting process. President Biden has consistently rejected reality warping and presents himself on the national stage as a man of reason, and a strong supporter of science. He has proclaimed "Science is discovery. It's not fiction", as he announced that his team of scientific advisors would summon "science and truth" to combat climate change, the COVID-19 pandemic and other challenges facing his new administration, adding "The same laws apply, the same evidence holds true regardless of whether you accept them." President Biden can show his self-proclaimed commitment to truth by following through on his words with action. In particular, he can fulfil the task which his two predecessors, Trump and Obama, both failed to do: Closing the detention facility at Guantánamo Bay. The same United States law and international law apply; the same evidence, or lack thereof holds true for those remaining 38 prisoners being held within the confines of a US-run concentration camp in the Caribbean. The laws of science apply, the rules of evidence apply, and the rule of law applies. Science and truth cannot be situationally applied to suit political agendas, especially not within the confines of a facility once called a "Battle Lab" (Leopold, 2015), where the military touts phrases like "honor bound" and "defend freedom" at the entrance, yet the truths of what goes on inside are withheld from the public record, via the government's complex layers of secrecy, including classification, redactions, and obfuscations. There can be no justice without truth. The system has derailed every effort to bring the suspected 9/11 terrorists to justice before tribunals that have failed and have been derailed by torture. While President Biden can't remove the stain of the national torture policies, he can show that the Constitution endures; that the rule of law prevails, by illuminating the shadowland of the torture regime. Joe Biden needs to demonstrate that truth matters - even painful truths. In this article, we will describe that through a painstaking and laborious process of discovery, we now know that behind the gates of Guantánamo Bay and its related archipelago of black sites there were prisoners, often held on dubious grounds or no reasonable grounds at all. We know that these prisoners were submitted to treatments aimed squarely at generating complete psychological disintegration. As we will lay out in the article, prisoners captured during Operation Enduring Freedom and Operation Iraqi Freedom were subjected to physical violence, sexual violence, and an astonishing array of psychologically abusive tactics under the misnomer 'interrogation'. We also know that the torture program metastasized into a monster, as if lifted from the pages of the most absurd of postmodern fictions, and that the United States has never held anyone accountable, nor faced any reckoning for this disaster of human rights (Senate Select Committee Study of the Central Intelligence Agency Detention and Interrogation Program, 2014). And we know that the disaster that was the torture program was all based on lies, one big lie in particular - that torture worked to break through to truth. The chief argument, which we will defend below, is that the schemers behind the system of torture knew all along that this was bogus; that torture does nothing to produce truth, that what it breaks is a person's autonomy and very selfhood, rendering them compliant in the extreme. Indeed, the CIA and United States military, who both committed war crimes, knew all along that they propagated falsehoods - our main argument is that the historical record shows that the CIA itself has a long history of studying precisely the effect of techniques like those employed post 9/11. As we shall see, the so called architects had no interrogation experience, but were well-versed in communist-based methodologies known to produce false information.

Reasons for COVID-19 vaccine refusal among people incarcerated in Canadian federal prisons.

BACKGROUND: Vaccine uptake rates have been historically low in correctional settings. To better understand vaccine hesitancy in these high-risk settings, we explored reasons for COVID-19 vaccine refusal among people in federal prisons. METHODS: Three maximum security all-male federal prisons in British Columbia, Alberta, and Ontario (Canada) were chosen, representing prisons with the highest proportions of COVID-19 vaccine refusal. Using a qualitative descriptive design and purposive sampling, individual semi-structured interviews were conducted with incarcerated people who had previously refused at least one COVID-19 vaccine until data saturation was achieved. An inductive-deductive thematic analysis of audio-recorded interview transcripts was conducted using the Conceptual Model of Vaccine Hesitancy. RESULTS: Between May 19-July 8, 2021, 14 participants were interviewed (median age: 30 years; n = 7 Indigenous, n = 4 visible minority, n = 3 White). Individual-, interpersonal-, and system-level factors were identified. Three were particularly relevant to the correctional setting: 1) Risk perception: participants perceived that they were at lower risk of COVID-19 due to restricted visits and interactions; 2) Health care services in prison: participants reported feeling "punished" and stigmatized due to strict COVID-19 restrictions, and failed to identify personal benefits of vaccination due to the lack of incentives; 3) Universal distrust: participants expressed distrust in prison employees, including health care providers. INTERPRETATION: Reasons for vaccine refusal among people in prison are multifaceted. Educational interventions could seek to address COVID-19 risk misconceptions in prison settings. However, impact may be limited if trust is not fostered and if incentives are not considered in vaccine promotion.

Knowledge, attitudes, and behavior of incarcerated people regarding COVID-19 and related vaccination: a survey in Italy.

The cross-sectional study assessed knowledge, attitudes, and preventive practices toward COVID-19 disease of incarcerated people. A total of 685 subjects were surveyed. 94% were aware that respiratory droplets are involved in the transmission of COVID-19, and 77.2% that patients with chronic conditions are at risk of a more severe disease. Overall, 92.7% of respondents considered COVID-19 a more severe disease compared to influenza, and 85.4% believed that COVID-19 could cause serious consequences in their institution. Only 22.6% were self-confident about their ability to protect themselves from SARS-CoV-2 infection. This attitude was significantly higher in those who were involved in working activities in the institution, who did not report at least one common symptom compatible with COVID-19 in the previous 3 months, who did not show generalized anxiety symptoms, and did not need additional information. 63.9% of incarcerated people expressed willingness to receive COVID-19 vaccination. Older subjects, who knew that a COVID-19 vaccination is available, believed that COVID-19 is more serious than influenza, and were self-confident about their ability to protect themselves from SARS-CoV-2 infection, were significantly more willing to undergo COVID-19 vaccination. Public health response to COVID-19 in prisons should address vaccine hesitancy to increase vaccine confidence among incarcerated people.

Incarcerated individuals' experiences of COVID-19 in the United States.

PURPOSE: This study aims to examine steps taken by correctional staff to prevent COVID-19 from spreading through correctional facilities and explores strategies used by incarcerated individuals to reduce their own risk of contracting COVID-19 during confinement. DESIGN/METHODOLOGY/APPROACH: Data were drawn from interviews with 327 individuals incarcerated after March 16, 2020, in Midwest1, Midwest2 and Southeast state using a questionnaire developed for this purpose. All study participants were actively involved in a randomized controlled trial of a behavioral health reentry intervention and the human subjects board approved the supplement of this study on COVID-19; interviews were conducted from April 15 to November 19, 2020. FINDINGS: Overall, 9.89% of participants contracted COVID-19. Most (68.50%) individuals learned about COVID-19 from television compared to official correctional facility announcements (32.42%). Participants wore face masks (85.02%), washed hands (84.40%) and practiced physical distancing when possible (66.36%). Participants reported that facilities suspended visitation (89.60%) and volunteers (82.57%), provided face masks (83.18%), sanitized (68.20%), conducted temperature checks (55.35%) and released individuals early (7.34%). SOCIAL IMPLICATIONS: Longitudinal observational study on the implementation and effectiveness of public health guidelines in prisons and jails may identify best practices for containing the infectious disease. Maximizing transparent communications, as well as COVID-19 prevention and mitigation efforts, are critical to achieving universal best practices for virus containment and amplifying public health. ORIGINALITY/VALUE: Data presented indicate the early adoption of many Centers for Disease Control guidelines by individuals and correctional facilities, although broad variation existed. Data support the identification of containment strategies for feasible implementation in a range of correctional spaces.

Releasing prisoners during COVID-19: the impact of the support for the early release, perceived insecurity and political orientation on attitudes towards released prisoners in Portugal.

PURPOSE: This study aims to examine how prisoners' early release affects other citizens' perceived insecurity and their attitudes towards those released prisoners, and how citizens' political orientation influences these variables. DESIGN/METHODOLOGY/APPROACH: A total of 383 Portuguese participants were presented with a recommendation from the United Nations for the release of prisoners because of COVID-19 and then asked to fill in a questionnaire measuring their political orientation, support for the early release of prisoners, perceived insecurity regarding such measure and their attitudes towards the released prisoners. FINDINGS: Results showed that support for the release of prisoners during COVID-19 is associated with perceived insecurity and both, in turn, predicts inclusive attitudes regarding these prisoners, while only perceived insecurity is associated with an agreement with an intensification of social control measures. Right-wing participants were found to express the negative side. The more participants felt insecure, the more they believed released prisoners should not have the same rights as common citizens and the more they should be left out of the community. RESEARCH LIMITATIONS/IMPLICATIONS: The major limitation of this study concerns the sample: the authors collected answers from Portuguese participants exclusively, most of which held a university degree. PRACTICAL IMPLICATIONS: At least two major implications can be drawn from this study's results. These implications deal with prisoners' entrance in what can be considered a cycle of exclusion and the promotion of their social reintegration once they are released from prison. SOCIAL IMPLICATIONS: The findings point out the necessity to firstly put an effort in deconstructing the insecurity perception that results from the prospective of having prisoners back into society - that is to understand why it happens and how it can be reduced - promoting efficacy in the inclusion of these prisoners and preventing the emergence of controlling or protective approaches directed to these individuals in their return to society by enhancing people's awareness that the social reintegration of ex-prisoners will benefit the whole community. ORIGINALITY/VALUE: The authors present a different perspective of the impact that managing COVID-19 in prisons has on society.

"Fear can hold you, hope can set you free". Analysis of Italian prisoner narrative experience of the COVID-19 pandemic.

PURPOSE: This study aims to explore the psychological effects of lockdown during the early stages of the COVID-19 pandemic on people living in an Italian prison. The suspension of family visits and most activities, along with the difficulties in applying social distancing to this vulnerable population was associated with increased psychological distress. Riots broke out over two days in more than 22 prisons across Italy at the beginning of March 2020, highlighting the negative psychological impact of the pandemic and the country's emergency policies. DESIGN/METHODOLOGY/APPROACH: The research involves 17 men (Italians and foreigners) detained in a Lombardy prison from 1 March to 4 May 2020, corresponding to the lockdown phase in Italy. The qualitative content analysis (CA) of 27 posts, written by participants during that period and published on the blog "L'Oblò", were analysed. The analysis allowed the identification of topics and subtopics that are related to two major categories of content: cognitions and emotional connotations about the COVID-19 lockdown in prison. FINDINGS: Analysis showed that blog post content was predominately negative in terms of emotional connotations. The most frequent coded negative emotional connotations were: missing, worry, psychological pain and fear, whilst the most frequent coded positive emotional connotations were: hope and gratitude for the support they received from prison workers. The rest of the blog content was coded as "cognitions". Cognitions were coded as descriptions of lockdown effect on detention; prison during the COVID-19 emergency; the pandemic situation in general; and comparison between inside and outside prison. ORIGINALITY/VALUE: The current study is original as it describes through blog CA the psychological condition of prisoners during the first COVID-19 pandemic lockdown in the most affected region in Italy.

COVID-19 vaccine hesitancy among women leaving jails: A qualitative study.

In many correctional facilities across the United States, COVID-19 vaccine refusal rates are as high as 50%. Most women leaving jails have low SES, health literacy, and mistrust of governmental institutions, thus exacerbating existing health disparities and making women leaving jail vulnerable. Data from 25 interviews with recently released women suggest that interventions to promote vaccines to this population will have to address health education and mitigate mistrust, misinformation, and conspiracy theories.

Creative IDEA: Introducing a Statewide Art Therapy in Prisons Program.

Education is regarded as an avenue for success while the under-educated are disproportionately more likely to be incarcerated and remain within the correctional system. Current prison reforms have focused on increasing access to educational programming. However, these programs are not designed to address the lack of control, poor self-regulation, low emotional intelligence, inadequate social skills, or lack of internal motivation that hinder progress. Art therapy has been found effective in mitigating these impediments. Recognizing this, a partnership arose between a state Department of Corrections and a State University's graduate art therapy program out of which emerged an Art Therapy in Prisons Program, funded through the Individuals with Disabilities Education Act. Two art therapists provided services to youthful male and female offenders in four institutions to assuage these obstacles. This article explores the genesis and development of this program, and the flexible adjustments required to address the impending COVID-19. We conclude how those who participated did indeed demonstrate improvement.

Willingness to Receive a COVID-19 Vaccination Among Incarcerated or Detained Persons in Correctional and Detention Facilities - Four States, September-December 2020.

Incarcerated and detained persons are at increased risk for acquiring COVID-19. However, little is known about their willingness to receive a COVID-19 vaccination. During September-December 2020, residents in three prisons and 13 jails in four states were surveyed regarding their willingness to receive a COVID-19 vaccination and their reasons for COVID-19 vaccination hesitancy or refusal. Among 5,110 participants, 2,294 (44.9%) said they would receive a COVID-19 vaccination, 498 (9.8%) said they would hesitate to receive it, and 2,318 (45.4%) said they would refuse to receive it. Willingness to receive a COVID-19 vaccination was lowest among Black/African American (Black) (36.7%; 510 of 1,390) persons, participants aged 18-29 years (38.5%; 583 of 1,516), and those who lived in jails versus prisons (43.7%; 1,850 of 4,232). Common reasons reported for COVID-19 vaccine hesitancy were waiting for more information (54.8%) and efficacy or safety concerns (31.0%). The most common reason for COVID-19 vaccination refusal was distrust of health care, correctional, or government personnel or institutions (20.1%). Public health interventions to improve vaccine confidence and trust are needed to increase vaccination acceptance by incarcerated or detained persons.

Time out of cell and time in purposeful activity and adverse mental health outcomes amongst people in prison: a literature review.

PURPOSE: The purpose of this study is to synthesise the available peer-reviewed literature on the impact of time out of cell (TOOC) and time in purposeful activity (TIPA) on adverse mental outcomes amongst people in prison. DESIGN/METHODOLOGY/APPROACH: The outcomes of interest of this literature review were mental health, suicide, deliberate self-harm (DSH) and violence. Exposures of interest were TOOC, TIPA or a partial or indirect measure of either. In total, 14 studies were included. An abbreviated review methodology was used because of time constraints. FINDINGS: There was consistent evidence of an association between lower TOOC and TIPA and worse mental health and higher suicide risk. Limited evidence suggests a link between TOOC and DSH. No evidence was identified regarding the relationship between TOOC/TIPA and violence. RESEARCH LIMITATIONS/IMPLICATIONS: A lack of longitudinal studies prevents conclusions regarding causality. Significant heterogeneity of mental health outcomes limits the comparability of studies. PRACTICAL IMPLICATIONS: These findings highlight the importance of considering the impact of TOOC and TIPA on adverse mental outcomes for prisoners when designing prison regimes, including during urgent adaptation of such regimes in response to Covid-19. They are likely to be of interest to practitioners and policymakers concerned with prison regime design. ORIGINALITY/VALUE: This paper is the first to synthesise the existing literature on the impact of TOOC and TIPA on mental health outcomes.

Providing Ethical and Humane Care to Hospitalized, Incarcerated Patients With COVID-19.

The COVID-19 pandemic is devastating the health of hundreds of thousands of people who live and work in U.S. jails and prisons. Due to dozens of large outbreaks in correctional facilities, tens of thousands of seriously ill incarcerated people are receiving medical care in the community hospital setting. Yet community clinicians often have little knowledge of the basic rights and ethical principles governing care of seriously ill incarcerated patients. Such patients are legally entitled to make their own medical decisions just like non-incarcerated patients, and retain rights to appoint surrogate decision makers and make advance care plans. Wardens, correctional officers, and prison health care professionals should not make medical decisions for incarcerated patients and should not be asked to do so. Dying incarcerated patients should be offered goodbye visits with their loved ones, and patients from federal prisons are legally entitled to them. Community health care professionals may need to advocate for this medically vulnerable hospitalized patient population to receive ethically appropriate, humane care when under their care in community hospitals. If ethical care is being obstructed, community health care professionals should contact the prison's warden and medical director to explain their concerns and ask questions. If necessary, community clinicians should involve a hospital's ethics committee, leadership, and legal counsel. Correctional medicine experts and legal advocates for incarcerated people can also help community clinicians safeguard the rights of incarcerated patients.

[Mental health care in French correctional facilities during the Covid-19 pandemic]. / Prisons confinées : quelles conséquences pour les soins psychiatriques et la santé mentale des personnes détenues en France ?

OBJECTIVE: The impact of the Covid-19 pandemic on the 11 million people currently incarcerated worldwide is the subject of many concerns. Prisons and jails are filled with people suffering from many preexisting medical conditions increasing the risk of complications. Detainees' access to medical services is already limited and overcrowding poses a threat of massive contagion. Beyond the health impact of the crisis, the tightening of prison conditions worries. On March 16, 2020, in France, the lockdown measures have been accompanied by specific provisions for prisons: all facilities have suspended visitations, group activities and external interventions. Over 10,000 prisoners have been released to reduce the prison population and the risk of virus propagation. These adjustments had major consequences on the healthcare system in French prisons. The objectives of this article are to describe the reorganization of the three levels of psychiatric care for inmates in France in the context of Covid-19 pandemic and to have a look at the impact of lockdown measures and early releases on mental health of prisoners. METHODS: This work is based on a survey conducted in April 2020 in France among psychiatric healthcare providers working in 42 ambulatory units for inmates and in the 9 full-time inpatient psychiatric wards exclusively for inmates called "UHSAs" (which stands for "unités hospitalières spécialement aménagées", and can be translated as "specially equipped hospital units"). A review of the international literature on mental healthcare system for inmates during the Covid-19 epidemic has also been performed. RESULTS: The Covid-19 epidemic has been rather contained during the period of confinement in French prisons but the impact of confinement measures on the prison population is significant. The three levels of psychiatric care for inmates have implemented specific measures to ensure continuity of care, to support detainees during Coronavirus lockdown and to prevent an infection's spread. Among the most important are: limitation of medical consultations to serious and urgent cases, creation of "Covid units", cancellation of voluntary psychiatric hospitalizations, reinforcement of preventive hygiene measures and reshuffling of medical staff. Prolonged confinement has consequences on mental health of detainees. Currently, mental health workers are facing multiple clinical situations such as forced drug and substance withdrawal (linked to difficulties in supplying psychoactive substances), symptoms of anxiety (due to concerns for their own and their relatives' well-being) and decompensation among patients with severe psychiatric conditions. Early releases from prison may also raise some issues. People recently released from prison are identified as at high risk of death by suicide and drug overdose. The lack of time to provide the necessary link between health services within prisons and health structures outside could have serious consequences, emphasizing the well-known "revolving prison doors" effect. DISCUSSION: The current lockdown measures applied in French jails and prisons point out the disparities between psychiatric care for inmates and psychiatric care for general population. Giving the high vulnerability of prison population, public health authorities should pay more attention to health care in prisons.