Supporting Nurses in Provincial Corrections.

The Ministry of the Solicitor General is responsible for Ontario's 25 provincial prisons. On any given day, there are approximately 6,400 persons detained in provincial custody in Ontario, with many staying less than three days.

Does a Public Health Crisis Justify More Research with Incarcerated People?

Covid-19 has infected thousands and killed hundreds in prisons, jails, and immigration detention facilities across the United States. Responding to this crisis, leading medical researchers have called for expanding opportunities for people in prison to participate in vaccine trials. These calls, like current regulations, focus on individualized risk assessments around consent, coercion, and harm, while ignoring the unnaturalness of deprivation conditions in U.S. prisons. We need new frameworks of analysis that refocus on structural, rather than individual, risk assessments. Integrating structural perspectives-including skepticism of claims of scarcity, avoidance of representational distortions, and attention to institutional agency-into our existing, overly individualistic frameworks might permit the design of more ethical research projects involving people who are incarcerated. Still, the unnatural deprivations of incarceration might be so great that research subjects might need to be removed from prison entirely in order to ethically participate in research.

Participatory survey design of a workforce health needs assessment for correctional supervisors.

INTRODUCTION: The correctional workforce experiences persistent health problems, and interventions designed with worker participation show favorable outcomes. However, participatory intervention research often leaves workers out of the health needs assessment, the basis of interventions subsequently developed. This omission risks failure to detect factors contributing to the health and is less likely to result in primary prevention interventions. METHODS: Partnering with a correctional supervisors' union, we followed Schulz and colleagues' community-based participatory research (CBPR) methods for participatory survey design and used Healthy Workplace Participatory Program (HWPP) tools to develop a tailored survey to assess workforce health and contributing factors. Utilizing the HWPP Focus Group Guide, we generated key themes to adapt the HWPP All Employee Survey, a generic workforce health assessment, to become thorough and contextually-relevant for correctional supervisors. RESULTS: Content analysis of focus group data revealed 12 priority health concerns and contributors, including organizational culture, masculinity, work-family conflict, family support, trauma, positive job aspects, health literacy and efficacy, health/risk behaviors, sleep, obesity, and prioritizing work and income over health. Twenty-six measures were added to the generic survey, mainly health-related antecedents including knowledge, attitudes, norms, and motivation. CONCLUSION: Findings yielded new insights about supervisors' lived experiences of work and health, and resulted in a customized workforce survey. CBPR methods and HWPP tools allowed us to identify health issues that we would not have detected with conventional methods, and provide opportunities for interventions that address root causes of poor health. We share challenges faced and lessons learned using CBPR with the correctional workforce.

Facilitating Successful Reentry Among Justice-involved Veterans: The Role of Veteran and Offender Identity.

Reentry courts facilitate successful offender reintegration into the community following release from incarceration, and many justice-involved veterans may benefit from such services given their elevated risk for deleterious outcomes postrelease. However, effectively engaging court participants is a crucial foundation to achieve the goals of recidivism reduction and global psychosocial improvement. This conceptual article presents an overview of factors that may interfere with a veteran's engagement in reentry court through the lens of both veteran and offender identity. Recommendations for reentry court personnel based on justice-involved veterans' experiences, identity, and unique needs are presented. Careful consideration of these factors and associated practice adaptations may facilitate rapport between reentry court personnel and veteran participants, foster engagement, and ultimately improve outcomes among this unique, at-risk population.

Clinician Experiences of Care Provision in the Correctional Setting: A Scoping Review.

Little is known about the experiences of correctional health care providers and how their experiences impact the correctional health care system. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines, multiple databases were searched. Each abstract was read by two reviewers with a third for consensus as needed. Full-text articles were selected through a second round of review. Of 4,467 citations, 61 were selected for full-text evaluation and 23 were ultimately included. Major themes identified were the distinctive working environment, burnout, and the presence of ethical dilemmas, including the tension between security and clinical considerations. This scoping review identified a limited number of articles centered on the health care provider experience in the correctional setting.

The Complete Care Model and Glycemic Control in California State Prisons.

Since integrating the chronic care theory in 2008 and the complete care model (CCM) in 2015, the California Department of Corrections and Rehabilitation (CDCR) has seen steady improvement in health care-related mortality. However, comparing glycated hemoglobin (HbA1c) levels for the 2 years pre- and the 2 years post-CCM shows the glycemic control for diabetes patients has not significantly changed. Findings suggest that additional components of the theory will need to be incorporated into the CCM to achieve CDCR's progressive goal of 90% of their diabetes patients having HbA1c levels less than 8%. Authors recommend specific direction for further research and development of the CCM in order to reach patient care goals associated with the full adoption of the chronic care theory.

A Systematic Review of Literature: Alternative Offender Rehabilitation-Prison Yoga, Mindfulness, and Meditation.

For years, jails and prisons have been looking for ways to lower their health care costs. In addition, they have been looking for ways to reduce violence behind walls and reduce recidivism rates postrelease. Recently, criminological research has shined light on the use of alternative rehabilitation to help inmates cope with prison life, improve their overall health, and rehabilitate. Some of these techniques include yoga, mindfulness, and meditation. This article discusses the impact of these techniques in the criminal justice system, highlights the major findings, and identifies the gaps needed to be filled by future researchers.

The Emotional Burden of the Correctional Health Care Advanced Practice Nurse.

This state-of-the-science review highlights the unique experiences of the correctional health care advanced practice nurse and the risks involved with repeated exposure to violent behavior, verbal assaults, and other rigors of working within a correctional facility. This article also investigates the outcomes of these risks such as compassion fatigue, vicarious trauma, and burnout. As each of these terms is dissected, insight into the correctional health care advanced practice nurse's daily experience emerges. Very little literature exists on the topic of correctional nursing and the pitfalls of this field; however, all literature that examines these phenomena indicate that innate qualities such as resilience, along with efforts of education and awareness, will empower any advanced practice nurse to endure and overcome the high-risk field of correctional nursing.

Service Provision Study on the Implementation of Nurse-Led Clinic in the Irish Judicial System.

The exponential growth of the nurse-led clinic in the Republic of Ireland has proven to be effective in patients' care in the Irish community (National Council for Professional Development of Nursing and Midwifery, 2005). This initiative has been replicated in the penal environment and assumed to add value to the prison health care system. To date, this concept has never been explored. The main goal of this study was to examine this concept in this setting. It was hoped that the outcome of this inquiry will provide a better insight into the service, which can be used in the development of an evidence-based policy in the future.

Family Therapy in Corrections: Implications for Reentry Into the Community.

Prison life is often characterized by drug use, racial intolerance, and violence. This culture of criminality is juxtaposed to treatment efforts that address the criminogenic needs and risks that are associated with inmate institutional rule violations and reoffending in the community, thereby creating seemingly insurmountable challenges for treating clinicians. Rather than fighting a losing battle between treating staff and inmate peers, a more effective strategy may be to utilize family members as resources and allies in the process of change for incarcerated individuals. Challenges and solutions to family therapy prison program implementation are discussed.

The Relationship Among Secondary Trauma, Self-Efficacy, and Correctional Nurses.

Many of the nurses working in corrections suffer from secondary trauma as a result of taking care of a population that has had a high percentage of traumas in their lives. There is limited research in correctional nursing, and perhaps by identifying the relationship among secondary trauma, self-efficacy, and correctional nursing, there will be growth as a profession. A literature review was completed using PubMed, CIHAHL, and Google Scholar. If nurses apply self-efficacy and secondary traumatic growth into their profession, they will be removing negative emotions from secondary trauma and emergency medical crisis situations. With the correctional populations, it is important for correctional nurses to recognize the barriers in themselves to better take care of their patients. This might then lead to better care and have an impact on the violence in society upon release.

Occupational Therapists' Rehabilitation Orientation Toward People Who Are Incarcerated.

One hundred seventy-two occupational therapists in Alabama completed an online survey to identify factors associated with their orientation toward rehabilitating people who are incarcerated. The level of the respondents' rehabilitation orientation toward people who are incarcerated was assessed using the Rehabilitation Orientation Scale (ROS). Results indicated that the respondents' attitudes were favorable and comparable to those on the prison rehabilitation team. Respondents who considered working in prison settings had 2 times greater odds of favoring rehabilitation intervention than those who did not consider working in prison settings. None of the respondents' personal attributes and professional experience variables were significantly associated with the ROS score. Findings provide an initial direction indicating that resources should be placed on recruitment of occupational therapists to work in the correctional setting.

Developing policies for adult sexual minorities with mental health needs in secured settings.

Lesbian, Gay, Bisexual, and Transgender (LGBT) people are more likely to be disproportionally placed in a secured setting such jails, prisons, and forensic hospitals. These settings can be traumatizing, hostile, and dangerous-especially for those who are suffering from mental illness. Administrators are encouraged to develop institutional policies that undoubtedly include that LGBT residents should be free of discrimination, victimization, and abuse. LGBT residents should have equal access to safe housing, vocational programs, rehabilitation services, as well as medical and mental health treatments. Several organizations provide guidelines to ensure that LGBT residents are protected. This article provides a general roadmap for developing LGBT policies in secured settings synergizing the recommendations of some of these organizations with emphasis on policy guidelines for transgender people that are not only standards for good care but also very cost-effective interventions that can help reduce symptoms of mental illness for this population.

Futurelessness, Risk Perceptions, and Commitment to Institutional Rules Among a Sample of Incarcerated Men and Women.

Using self-reported surveys of a sample of 2,927 incarcerated men and women from correctional facilities of varying security levels in the United States, this study explores the interrelationship of futurelessness, perceived certainty and celerity of punishment, and commitment to institutional rules. Incarcerated individuals' commitment to rules with an adult sample has not been explored with consideration to emotionality. Findings suggest that futurelessness and risk perceptions are directly and significantly associated with commitment to institutional rules after controlling for several importation and deprivation factors associated with institutional misconduct. Contrary to the suggestions of prior research, risk perceptions did not mediate the futurelessness-commitment to institutional rules relationship. Direct quotes from study participants are included to contextualize and frame the policy implications of the findings. Theoretical implications and directions for future research are also discussed.

A Jail-Based Competency Restoration Unit as a Component of a Continuum of Restoration Services.

This study reports on restoration outcomes of a sample of pretrial defendants (n = 877, 69% male) who were found incompetent to stand trial and underwent restoration services in a large urban county. Each male defendant was initially assigned to restoration in one of four settings on a continuum of services of varying intensity (ie, outpatient, jail general population, dedicated jail-based restoration unit, or forensic hospital inpatient unit) based on the defendant's assessed clinical need. Of those who received services on the jail-based restoration unit (n = 398), 40 percent were restored to competency, 31 percent were diverted out of the criminal justice system, and 29 percent were referred for more intensive inpatient services, primarily because of refusal of medication (i.e., the jail would not allow involuntary medication, even if court-ordered). Advantages of restoration on the jail unit compared with inpatient hospitalization included more rapid institution of restoration services and higher rates of diversion out of the criminal justice system at one-third of the cost of inpatient restoration services. A continuum of restoration services that allows the type of restoration service to be matched to the needs of the individual incompetent defendant has significant advantages over routine transfer to a forensic hospital for restoration.