Acesso ao direito à saúde no cárcere: entre o prescrito e o real / Access to health´s right in prison: between the prescription and the real

Objetivo: Conhecer como ocorre o acesso à saúde das pessoas privadas de liberdade. Métodos: Pesquisa qualitativa, realizada em um presídio no interior de Minas Gerais, com 19 pessoas privadas de liberdade. Os dados foram coletados mediante entrevista aberta orientada por roteiro semiestruturado no período de agosto a dezembro de 2017. Realizou-se Análise de Conteúdo de Bardin. Projeto aprovado no Comitê de Ética e Pesquisa com Seres Humanos. Resultados: Apesar do direito à saúde ser uma prerrogativa constitucional a ser garantida a todo cidadão, inclusive aos privados de liberdade, existem barreiras no cárcere que impedem esse acesso, como: dependência do agente penitenciário por meio de comunicação mediante bilhete, ausência de profissionais de saúde em tempo integral e falta de medicações, necessitando que a família atue como rede de cuidado. Conclusão: Evidencia-se a necessidade de melhor estruturar o acesso à saúde das pessoas privadas de liberdade, a fim de assegurar esse direito.(AU)

Objective: To establish how it occurs the access to health care for people deprived of liberty. Methods: Qualitative research, carried out in a prison Minas Gerais's inland, with 19 people deprived of liberty. Data were collected through open interviews guided by semi-structured rotation from August to December 2017. Bardin's Content Analysis was performed. Project approved by the Ethics and Research with Human Beings Committee. Results: Despite being a constitutional prerogative to be guaranteed to all citizens, including people deprived of liberty, there are prision obstacles that prevent this access, such as: dependence on the prison guard through communication by ticket, absence of a health professional full-time and lack of medication, making it necessary for the family to see itself as a care network. Conclusion: The need to structure the access to health care for people deprived of their liberty, in order to ensure their rights.(AU)

Objetivo: Conocer cómo se dá el acceso a la salud de las personas privó de su libertad. Métodos: Investigación cualitativa, realizada en una prisión del interior de Minas Gerais, con 19 personas privadas de libertad. Los datos fueron coleccionados atraves de una entrevista abierta orientado por un itinerario semi-estructurado. Se realizó el Análisis de Contenido de Bardin. Proyecto aprobado por el Comité de Ética e Investigación con Seres Humanos. Resultados: A pesar de que el derecho a la salud es una prerrogativa constitucional que debe garantizarse a todos los ciudadanos, incluidos los privados de libertad, existen barreras en la prisión que impiden este acceso, tales como: dependencia del guardia penitenciario mediante comunicación vía boleta, ausencia de salud profesionales de salud a tiempo completo y falta de medicación, lo que obliga a la familia a actuar como red asistencial. Conclusión: Se evidencia la necesidad de estructurar mejor el acceso a la salud de las personas privó de su libertad, a fin de garantizar este derecho.(AU)

From ED overcrowding to jail overcrowding: a cautionary tale of a Serial Inebriate Programme (SIP).

INTRODUCTION: Community-based programmes have been implemented to curtail ED use by individuals with chronic public intoxication. Among these programmes is the Serial Inebriate Programme (SIP), which aims to reduce use of ED and emergency medical services. We present the results of an evaluation of the SIP in Santa Cruz, California, including data on the participants' police and jail history, information not considered in prior analyses of SIPs. METHODS: In the present study, we used a retrospective cohort to evaluate the effectiveness of the SIP in Santa Cruz, California from 2013 to 2015. Specifically, we looked at the programme effects on participants' arrests, nights in jail, use of the local ED and ambulance services after programme adjudication. RESULTS: The median number of visits to the ED for participants before and after adjudication was reduced from 4 to 1, and participants showed a significant decrease in their number of jail bookings following adjudication (-4.5 bookings; p=0.004). However, the average number of nights in jail served by participants after adjudication was 2.1 times the average number of nights spent in jail spent before programme adjudication (58.5 vs 27.6 nights in jail for postadjudication and preadjudication groups, respectively; p=0.009). CONCLUSIONS: Our findings suggest that the Santa Cruz SIP had some impact in reducing participants' use of emergency services, but at the cost of increased jail time. The burdens of placing chronically intoxicated individuals in jail for extended periods of time are not trivial and should not be overlooked when designing and implementing a SIP.

Prisons: the psychiatric institution of last resort?

The World Health Organization declared in 1948 that the enjoyment of the highest individual attainment of health for any person is a fundamental human right. Australia, the U.K. and the United States all legally ratified this declaration as becoming signatories to their founding treatise with the United Nations. Despite this, there are many conspicuous examples of inequities of public health as found within these nations. One of the more disparate and outrageous examples of inequities in public health has been an insidious trend towards criminalizing mental illness, and the largely unjust treatment of many mentally ill persons. This change has resulted in untold numbers of mentally ill persons being over-represented within the criminal justice system, experiencing higher morbidity, co-morbidity and mortality rates, and having difficulty in surviving in a society frequently dealing with their illness in a persecutory manner. Questions must be raised: that although over the passage of time medical science and technology has changed, but has western societies' attitudes to health equity kept pace?

Droga y prisión: relaciones y contradicciones / Drug and prision: relationships and contradictions

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