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Date: April 29, 2024 Mon
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Results for medical care
43 results foundAuthor: Beck, Jack Title: Heathcare in New York Prisons, 2004-2007: A Report by the Correctional Association of New York Summary: This report describes the conditions of heathcare in New York State prisons from 2004-2007. It is based on information gathered during 19 monitoring visits and notes administrative factors that can negatively affect care, such as vacancies and low salaries of medical personnel. It also makes recommendations for improvement of medical care provided to state inmates. Details: New York: Correctional Association of New York, 2009. 87p., app. Source: Internet Resource Year: 2009 Country: United States URL: Shelf Number: 113844 Keywords: Medical CarePrisoners |
Author: Shaw, Jenny Title: An Evaluation of In-Possession Medication Procedures Within Prisons in England and Wales: A Report to the National Institute of Health Research Summary: Offenders often come from deprived backgrounds with histories of social exclusion and disadvantage, frequently compounded by complex and multiple health problems. Since the clinical development partnership between the NHS and HM Prison Service was instigated in 1999, a wide ranging work programme has been undertaken to improve prison based health services to improve people's health and life chances. Much of this has been driven by the 'equivalence principle', the notion that prisoners should have access to 'the same quality and range of health care services as the general public receives from the NHS' (Health Advisory Committee for the Prison Service, 1997). Every year, approximately $7,000,000 is spent on medicines for prisoners (DH, 2003). Historically, healthcare staff have been responsible for supervising and administering single doses of all but the most benign of medications. However, the drive for equivalence of care has led towards allowing in-possession medication to become the default position, rather than the exception. In-possession medication means that where possible, prisoners are given autonomy and responsibility for the storage and administration of their medication, dependent on individual risk assessment (Bradley, 2007). Notably, several benefits of in-possession medication have been previously reported including medicines being administered at more appropriate times, reductions in time spent by prisoners queuing at medication hatches and reductions in workload for healthcare staff and escorting officers (DH, 2003). Despite such evidence, there apparently remains unease among some staff working within prisons based on notions that in-possession medication may increase the risk of drugs being abused, traded, stolen or used to self-harm via overdose (Bradley, 2007). This study was commissioned by Offender Health at the Department of Health to establish current practice and policies in relation to in-possession medication currently in operation within prisons in England and Wales. Details: Liverpool, UK: Offender Health Research Network, 2009. 93p. Source: Internet Resource: Accessed April 17, 2018 at: http://www.ohrn.nhs.uk/resource/Research/OHRNInpossessionMedication.pdf Year: 2009 Country: United Kingdom URL: http://www.ohrn.nhs.uk/resource/Research/OHRNInpossessionMedication.pdf Shelf Number: 117118 Keywords: Health Care (Inmates)Medical CarePrisoners (U.K.) |
Author: Chiu, Tina Title: It's About Time: Aging Prisoners, Increasing Costs and Geriatric Release Summary: Correctional facilities throughout the United States are home to a growing number of older adults with extensive, costly medical needs. This report examines statutes related to the early release of geriatric inmates in 15 states and the District of Columbia and concludes that these provisions are rarely used, despite the potential of reduced costs at minimal risk to public safety. The report identifies factors that help explain the discrepancy and provides recommendations for addressing it. Details: New York: Vera Institute of Justice, Center on Sentencing and Corrections, 2010. 14p. Source: Year: 2010 Country: United States URL: Shelf Number: 118356 Keywords: Aged PrisonersCorrections (U.S.)InmatesMedical Care |
Author: Australian Institute of Health and Welfare Title: The Health of Australia's Prisoners 2009 Summary: This report is the culmination of several years' development of national indicators in relation to prisoner health inAustralia. The report presents information on the health of prisoners at the time of entry to prisons, their use of health services while in prison as well as some information on the prison environment. Details: Canberra: AIHW, 2010. Source: Internet Resource Year: 2010 Country: Australia URL: Shelf Number: 118577 Keywords: Health Care, PrisonersMedical CareMental Health, InmatesMentally Ill Offenders (Australia)Prisoners (Australia) |
Author: Lennox, Charlotte Title: Offender Health: Scoping Review and Research Priorities within the UK Summary: This report is a scoping review of the literature surrounding health of people in contact with police custody, court, and probation settings. The aim of this report is: 1) to conduct a review of the current literature the health of people in police custody, courts and probations; 2)to discuss and evaluate the implications of the literature; and 3) to provide research priorities based on the knowledge gaps. Details: Liverpool: Offender Health Research Network, 2009. 71p. Source: Internet Resource Year: 2009 Country: United Kingdom URL: Shelf Number: 117360 Keywords: Drug TreatmentHealth Care, OffendersMedical CareMental Health ServicesRehabilitation |
Author: Paulin, Judy Title: Evaluation of the Mental Health/Alcohol and Other Drug Watch-house Nurse Pilot Initiative Summary: The Watch-house Nurse (WHN) initiative began operating at the Christchurch Central and Counties Manukau Police station watch-houses on 1 July 2008 and 1 August 2008 respectively. The initiative is intended to run as a pilot project until 30 June 2010. The initiative places appropriately qualified nurses within these two watch-houses to assist the police to better manage the risks of those in their custody who have mental health, alcohol or other drug (AOD) problems. Where appropriate, the nurses also make referrals for detainees to treatment providers. This final evaluation report presents the findings about the WHN initiative during its first 18 months of operation. In doing so, it addresses the main objectives of the pilot, and intended outcomes of these objectives in turn. Details: Wellington, NZ: New Zealand Police, 2010. 147p. Source: Internet Resource: Accessed August 23, 2010 at: http://www.police.govt.nz/sites/default/files/resources/evaluation/2010-08-03%20WHN_evaluation_FINAL_ELECTRONIC.pdf Year: 2010 Country: New Zealand URL: http://www.police.govt.nz/sites/default/files/resources/evaluation/2010-08-03%20WHN_evaluation_FINAL_ELECTRONIC.pdf Shelf Number: 119665 Keywords: Alcohol AbuseDrug OffendersMedical CareMental Health ServicesMentally Ill OffendersNursesPolicing |
Author: Khan, Lorraine Title: You Just Get On and Do It: Healthcare Provision in Youth Offending Teams Summary: Children and young people in the youth justice system are at high risk of multiple health inequalities and poor life chances. Research indicates that these young people have their needs under identified and supported after entry into the Youth Justice System. This paper shows the results of our study of healthcare provision in YOTs in England. We also reviewed mental health diversion work along the youth justice pathway to look at how these services might be better developed to improve outcomes for young people and their families. Details: London: Centre for Mental Health, 2010. 95p. Source: Internet Resource: Accessed October 11, 2010 at: http://www.centreformentalhealth.org.uk/pdfs/Centre_for_MH_Healthcare_provision_YOTs.pdf Year: 2010 Country: United Kingdom URL: http://www.centreformentalhealth.org.uk/pdfs/Centre_for_MH_Healthcare_provision_YOTs.pdf Shelf Number: 119917 Keywords: Juvenile InmatesJuvenile OffendersMedical CareMental Health Services |
Author: Hanlon, Carrie Title: A Multi-Agency Approach to Using Medicaid to Meet the Health Needs of Juvenile Justice-Involved Youth Summary: Juvenile justice, mental health, and Medicaid agencies have a common interest in meeting the health needs of youth in the juvenile justice system. There is evidence that youth involved in the juvenile justice system have both unmet, and more extensive than average, needs. Better meeting those needs could result in more efficient and effective use of the resources available to the three agencies – and in decreased recidivism, as well as improvements in children’s well-being and their ability to remain in the community. However, these three agencies have different, yet overlapping, program objectives, funding sources, target populations, and partners at the federal, state, and county levels. This situation creates both barriers and opportunities in using these agencies’ resources to meet the health and behavioral health needs of children involved with the juvenile justice system. In mid-2008, the National Academy for State Health Policy (NASHP) began work to: (1) identify the barriers to the effective use of the resources available to juvenile justice, mental health, and Medicaid agencies to meet the health and mental health needs of children involved with the juvenile justice system, and (2) surface potential policies and strategies that states could implement to address those barriers. Specifically, with the support of the John D. and Catherine T. MacArthur Foundation, NASHP staff conducted a literature review and interviewed agency and community stakeholders in five states. Analysis of the interviews found that the barriers cited by informants fell into two categories: Knowledge: Staff from one a local agencies did not know relevant state policies (and vice versa), and there was little data about the health needs of the children served by more than one agency. Interviewees report that some state policies presented barriers for those seeking to access the coverage or services for which children qualified. Finally, this study identified opportunities for improvement and ‘promising practices’ within four strategic areas: • Improving knowledge of how the relevant systems do (or should) work among state agencies and local/state levels, • Improving eligibility policies and processes to ensure that Medicaid eligible children participate in the program, • Improving service coverage policies to ensure that Medicaid beneficiaries in the juvenile justice system receive the Medicaid covered services they need, and • Collaborating among agencies to use their combined resources to meet the needs of these children. Details: Portland, ME: National Academy for State Health Policy, 2008. 21p. Source: Internet Resource: Accessed October 29, 2010 at: http://www.nashp.org/sites/default/files/Multi_Agency_NASHP.pdf Year: 2008 Country: United States URL: http://www.nashp.org/sites/default/files/Multi_Agency_NASHP.pdf Shelf Number: 120135 Keywords: Juvenile OffendersMedicaidMedical CareMental Health Services |
Author: Clark, Karen Title: Meeting the Health Needs of Youth Involved in the Juvenile Justice System Summary: Nearly 100,000 young people are in juvenile justice facilities of some sort on any given day, with more than 2 million arrested in a year. Of those in residential settings, 62 percent are minorities, 85 percent are boys, and many, if not most, lack adequate health insurance coverage. Youth in juvenile justice facilities - including detention centers, shelters, diagnostic centers, group homes, wilderness programs, residential treatment facilities and training schools (where most juveniles are committed) - suffer disproportionately from a host of mental and physical health problems. The presence and severity of health problems may help explain the behaviors that led to their involvement in the criminal justice system and make it critical they receive the appropriate medical services both in the system and upon their release. Most of those arrested do not end up at trial. Of those who are tried, about two-thirds are sentenced to probation after a trial, allowing a true opportunity for therapeutic intervention in the community. Given the preponderance of low-income youth involved with the juvenile justice system, it is likely that many who enter are enrolled in or eligible for Medicaid. States and local governments face stiff challenges in organizing and funding services for troubled youth. One challenge is to make Medicaid work better for this population during those times an individual is not in a public institution. Another challenge is to ensure that quality and effective services are provided to individuals both during and after their involvement in the juvenile justice system. Medicaid presents unique limits and opportunities compared to state and local funding. Services provided to those involved in the juvenile justice system are impacted by these funding matters. This paper describes these limits and opportunities, and highlights a number of promising practices and service models in states. Details: Portland, ME: National Academy for State Health Policy, 2006. 27p. Source: Internet Resource: Accessed November 1, 2010 at: Year: 2006 Country: United States URL: Shelf Number: 120146 Keywords: Health CareJuvenile OffendersMedical CareMental Health Services |
Author: de Viggiani, Nick Title: Police Custody Healthcare: An Evaluation of an NHS Commissioned Pilot to Deliver a Police Custody Health Service in a Partnership Between Dorset Primary Care Trust and Dorset Police Summary: This evaluation was sponsored by Dorset Primary Care Trust and the South West Strategic Health Authority to examine the local commissioning relationship established to provide police custody healthcare across Dorset's three 24/7 custody suites, located in Poole, Weymouth and Bournemouth. This initiative has the status of a national pilot, and the evaluation is expected to carry lessons for a wide range of audiences in and beyond Dorset. A police custody medical service has operated within Dorset for many years using General Practitioners contracted on a part-time basis as Forensic Physicians (previously referred to as Forensic Medical Examiners or Police Surgeons). Historically, this has been customary practice in the UK, where GPs have been contracted to the police on a part-time basis, although increasing numbers are specialising in forensic work and work as full-time Forensic Physicians, particularly since the establishment of the Faculty of Forensic and Legal Medicine in 2005. The switch to provision commissioned by the NHS was introduced to Dorset in 2008, as a Department of Health/Home Office national pilot. Its purpose was essentially to examine the efficacy of the NHS taking a strategic lead in commissioning police custody healthcare, and, more specifically, to pilot the transfer of commissioning and budgetary responsibility from Dorset Police to Dorset Primary Care Trust. Throughout this trial period, the service has continued to be contracted to an independent provider but is now governed by a partnership agreement between the NHS commissioner and Dorset Police, as the two lead organizations, and through a local partnership board. This shift to mainstream health provision likely reflects the following key areas of thinking: a) concern that a disproportionate number of people entering the criminal justice system present in police custody with significant complex health and social care problems, particularly involving mental illness and/or drug or alcohol dependency, and often require urgent treatment and care; b) perception that the former medical approach to police custody healthcare was inadequate in terms of addressing the complex needs of people entering the criminal justice system, particularly in preventing deaths in custody, a source of intensifying political and professional concern; c) successful reform of prison healthcare, with the shift of commissioning and provision to the NHS in 2006; and d) an emerging "offender pathway‟ health policy focus, led by the Department of Health, that is advocated by the Bradley Report, into which this Dorset pilot fed its experience, and which implies a continuous and integrated approach to the management of health and social needs of people who move through the criminal justice system, between community and custody settings. At the heart of this innovation is the principle of health and social care as a fundamental citizen right. Furthermore, the Audit Commission's 1998 review of the provision of forensic medical services to the police concluded that the service needed to be reformed for the following reasons: [1] difficulties recruiting Forensic Physicians; [2] variable standards of service around the country; [3] inadequate clinical facilities within some custody suites; [4] poor communication and feedback; [5] lack of formal contractual arrangements in some areas; and [5] lack of clear management structure and scrutiny. The service delivered through this pilot represents a shift from the more traditional forensic medical service to one led predominantly by custody nurses. In place of physicians on call, the pilot, as agreed between the NHS Commissioner and Dorset Police required a 24 hour, 7 day nurse presence in each custody suite. An innovative feature of the pilot was the aspiration to link constant nursing presence to a broad triage service, linking police custody detainees to a range of integrated community-based services to address alcohol and drug dependency and other mental and physical healthcare needs. The focus of the evaluation was to understand the commissioning relationship and its impact, given that the key innovative aspect of the Dorset scheme was the introduction of NHS commissioning via an NHS organization (a Primary Care Trust). This particular case of commissioning involves the NHS contracting services on the premises and in the area of action of another public sector service. All Primary Care Trusts are now required to operate as "commissioners‟ in procuring and developing health services, and they are held accountable for their effectiveness as commissioners. Details: Bristol, UK: School of Health and Social Care, University of the West of England, 2010. 55p. Source: Internet Resource: Accessed November 30, 2010 at: http://eprints.uwe.ac.uk/8253/1/PC_Evaluation_final.pdf Year: 2010 Country: United Kingdom URL: http://eprints.uwe.ac.uk/8253/1/PC_Evaluation_final.pdf Shelf Number: 120318 Keywords: Health CareMedical CareMental Health ServicesPolice Custody (UK) |
Author: Stover, Heino Title: Towards a Continuum of Care in the EU Criminal Justice System: A Survey of Prisoners Needs in Four Countries (Estonia, Hungary, Lithuania, Poland) Summary: Most of the ‘new’ Member States of the EU have, to varying degrees, implemented effective treatment programs and harm reduction projects outside of the prison system. However, effective drug treatment and BBV prevention programs within the prison walls and follow up services for released inmates with problematic drug use still have, in most new Member States, to be developed. Overall, prison policies and practices, in particular in dealing with drug users and related (infectious) diseases, remain an important EU concern. In few of the new Member States the public health imperative of a healthy prison system receives the political attention it deserves. The objectives of the study are operationalised into concrete questions on (i) prevalence, (ii) nature and severity, (iii) characteristics and correlates of problematic drug use, including risk behaviours for HIV and other infectious diseases, (iv) need for care and treatment services and available support systems. The study also assesses differences in prevalence, nature, characteristics and need for services associated with gender and ethnicity. Details: Oldenberg: BIS-Verlag, der Carl von Ossietzky Universitat Oldenburg, 2011. 285p. Source: Internet Resource: Accessed December 22, 2010 at: http://www.connectionsproject.eu/the-project Year: 2011 Country: Europe URL: http://www.connectionsproject.eu/the-project Shelf Number: 120587 Keywords: Drug Abuse TreatmentHealth CareMedical CarePrisons (Europe) |
Author: Takacs, Istvan Gabor Title: Prisons and Risks: Results of the Research Study Entitled "Risk Behaviours Related to Blood Borne and Sexually Transmitted Infections, Drug Use and Services in the Hungarian Prison System" Summary: The aim of this research was to assess risk factors of drug use and transmission of blood borne and sexually transmitted infections within the Hungarian prison system, and also to assess the need, the barriers and the possibilities for harm reduction information providing and service implementation. The research further aimed at developing tools for harm reduction information providing and counseling within the prison system. Details: Budapest: Hungarian Civil Liberties Union, 2010. 50p. Source: Internet Resource: Accessed December 22, 2010 at: http://www.connectionsproject.eu/the-project Year: 2010 Country: Hungary URL: http://www.connectionsproject.eu/the-project Shelf Number: 120588 Keywords: Drug Abuse TreatmentDrug OffendersHealth CareMedical CarePrisons (Hungary) |
Author: Maryland. Governor's Family Violence Council Title: Hospital-Based Domestic Violence Programs Summary: This report provides an overview of Maryland's hospital-based domestic violence programs; reviews the subject literature regarding these programs nationally; identifes and compares similar programs across the country; assesses program measures, including impact on violence and healthcare costs; and summarizes the various streams of funding available to support these programs. Details: Baltimore, MD: Governor's Family Violence Council, 2010. 72p. Source: Internet Resource: Accessed April 13, 2011 at: http://www.goccp.maryland.gov/documents/Hospital-based-DV-Programs.pdf Year: 2010 Country: United States URL: http://www.goccp.maryland.gov/documents/Hospital-based-DV-Programs.pdf Shelf Number: 121327 Keywords: Domestic Violence (Maryland)Family ViolenceMedical CareVictims of Family Violence, Services for |
Author: Australian Institute of Health and Welfare Title: The Health of Ausstralia's Prisoners 2010 Summary: The health of Australia’s prisoners 2010 is the second report relating to the National Prisoner Health Indicators, which were developed to help monitor the health of prisoners, and to inform and evaluate the planning, delivery and quality of prisoner health services. The indicators presented in this report are aligned to the National Health Performance Framework. The results in this second report build on the baseline information from the first National Prisoner Health Census, and this time include some state and territory comparisons. Prisoners in Australia have high rates of mental health related issues. In 2010, 31% of prison entrants reported having ever been told that they had a mental health illness and 16% of prison entrants reported that they were currently taking mental health related medication. On entry to prison, almost one-fifth of prison entrants were referred to the prison mental health services for observation and further assessment following the reception assessment. Almost 1 in 10 prisoners in custody visited the clinic for a psychological or mental health issue, and 1 in 5 prisoners in custody was taking mental health related medication. When looking at the type of medication, 18% of all repeat medication was for depression/mood stabilisers, 9% for antipsychotics, 2% for anti-anxiety medication and 1% for sleep disturbance. Prison entrants in Australia reported previously engaging in various risky health behaviours, such as smoking tobacco, drinking alcohol at extreme levels and using illicit drugs. Four in five prison entrants reported being a current smoker, and three in four reported being a daily smoker. More than half of prison entrants reported drinking alcohol at levels that placed them at risk of alcohol-related harm, while less than twenty per cent reported that they did not drink. Further, two-thirds of prison entrants reported illicit drug use in the previous 12 months. These rates are all substantially higher than in the general community. Aboriginal and Torres Strait Islander prison entrants were significantly over-represented in the entrant’s sample, with 43% being Indigenous, compared with 2.5% of the general population. Indigenous prison entrants reported poorer health behaviours than non-Indigenous prison entrants, and were more likely to be current smokers (89% compared with 79%) and to have consumed alcohol at levels considered to place them at risk of alcohol-related harm (73% compared with 48%) in the previous 12 months. However, Indigenous prison entrants reported lower level of mental health related issues (23% compared with 38%), use of mental health medication upon entry to prison (12% compared with 19%), and chronic conditions. Details: Canberra: AIHW, 2011. 206p. Source: Internet Resource: Accessed October 7, 2011 at: http://www.aihw.gov.au/publication-detail/?id=10737420111&tab=2 Year: 2011 Country: Australia URL: http://www.aihw.gov.au/publication-detail/?id=10737420111&tab=2 Shelf Number: 123007 Keywords: Medical CareMental Health ServicesMentally Ill OffendersPrison Health CarePrisoners (Australia) |
Author: Davis, Lois M. Title: Understanding the Public Health Implications of Prisoner Reentry in California: State-of-the-State Report Summary: When prisoners are released and return to communities, an often overlooked concern is the health care needs that former prisoners have and the role that health care plays in how successfully they reintegrate. To a large extent, the reentry population will eventually become part of the uninsured and medically indigent populations in communities. This volume examines the health care needs of newly released prisoners in California, including the need for mental health and substance abuse treatment; which communities are most affected by prisoner reentry; the health care system capacity of those communities; and the experiences of released prisoners, service providers, and families of incarcerated individuals. The authors conducted a geographic analysis to identify where parolees are concentrated in California and the capacity of the safety net in four of these communities — Alameda, Los Angeles, San Diego, and Kern counties — to meet the health care needs of the reentry population. They then conducted focus groups in Alameda, Los Angeles, and San Diego counties with former prisoners and their family members and interviews with relevant service providers and community groups to better understand how health affects reentry; the critical roles that health care providers, other social services, and family members play in successful reentry; and how the children and families of ex-prisoners are affected by reentry. The authors discuss all this in the context of budget cuts that have substantially shrunk California's safety net and the May 2011 U.S. Supreme Court decision ordering California to reduce its prison population by 33,000. The volume concludes with recommendations for improving access to care for this population in the current fiscal environment. Details: Santa Monica, CA: RAND, 2011. 252p. Source: Internet Resource: Accessed November 22, 2011 at: http://www.rand.org/content/dam/rand/pubs/monographs/2011/RAND_MG1165.pdf Year: 2011 Country: United States URL: http://www.rand.org/content/dam/rand/pubs/monographs/2011/RAND_MG1165.pdf Shelf Number: 123423 Keywords: Health CareMedical CareParoleesPrisoner Reentry (California) |
Author: Drug Abuse Warning Network Title: Emergency Department Visits Involving Illicit Drug Use among Males Summary: The use of illicit drugs (e.g., marijuana, heroin, and cocaine) may lead to serious health issues such as unintentional injuries, car accidents, and overdoses that may require acute emergency care. National Survey on Drug Use and Health (NSDUH) data show that 1 in 10 males aged 12 or older reported past month illicit drug use in 2009, compared with 1 in 15 females. The same data show that males were also more likely than females to be past month users of marijuana (8.6 vs. 4.8 percent), the use of which has been found to contribute to traffic accidents and other injuries. The higher illicit drug rates for males suggests that negative consequences associated with illicit drug use, such as emergency department (ED) visits, may be disproportionately found among males. The Drug Abuse Warning Network (DAWN) is a public health surveillance system that monitors drug-related ED visits in the United States. To be a DAWN case, an ED visit must have involved a drug, either as the direct cause of the visit or as a contributing factor. Data are collected on numerous illicit drugs, including cocaine, marijuana, heroin, and stimulants (i.e., amphetamines and methamphetamines). This issue of The DAWN Report focuses on ED visits involving illicit drug use among males. Data for 2004 to 2009 are presented, both as trends over time and also as annual averages for the 6-year period. Illicit drug use among females is covered in a separate report. Details: Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, U.S. Department of Health and Human Services, 2011. 6p. Source: The DAWN Report, DAWN_017: Internet Resource: Accessed March 4, 2012 at Year: 2011 Country: United States URL: Shelf Number: 124381 Keywords: Drug AbuseIllicit DrugsMales 00 InjuryMedical Care |
Author: John Howard Association of Illinois Title: Unasked Questions, Unintended Consequences: Fifteen Findings and Recommendations on Illinois’ Prison Healthcare System Summary: This special report is based on JHA’s analysis of healthcare in 12 diverse correctional facilities, which together embody the state of healthcare in the Illinois prison system. Our findings include the following: •There is insufficient external oversight of prison healthcare services, especially services provided by the private vendor, Wexford Health Sources, who in 2011 negotiated a 10-year contract to provide healthcare services to all 27 IDOC facilities at the cost of $1.36 billion to the state. •JHA found deficient staffing levels that can lead to staff burn out and prevent inmates from timely accessing medical care. •JHA found that while elderly inmates represent the fasting growing segment of prisoners, it is unclear how Illinois will pay for the housing, treatment, and medical care of this population. •The Illinois Department of Corrections (IDOC) is in the process of implementing opt-out HIV testing at reception and classification centers and is piloting an electronic medical records program that promises to enhance data-sharing between facilities and improve quality of care. Details: Chicago: John Howard Association of Illinois, 2012. 28p. Source: Internet Resource: Accessed November 2, 2012 at: http://thejha.org/sites/default/files/Unasked%20Questions-Unintended%20Consequences.pdf Year: 2012 Country: United States URL: http://thejha.org/sites/default/files/Unasked%20Questions-Unintended%20Consequences.pdf Shelf Number: 126816 Keywords: Health CareMedical CarePrisons (Illinois)Privatization |
Author: Legal Action Center Title: Legality of Denying Access to Medication Assisted Treatment In the Criminal Justice System Summary: This report examines the prevalence of opiate addiction in the criminal justice system, its devastating consequences, and the widespread denial of access to one of its most effective forms of treatment: medication assisted treatment (“MAT”). The report then analyzes the circumstances in which the denial of MAT violates Federal anti-discrimination laws and the United States Constitution. Details: New York: Legal Action Center, 2011. 25p. Source: Internet Resource: Accessed July 9, 2013 at: http://www.lac.org/doc_library/lac/publications/MAT_Report_FINAL_12-1-2011.pdf Year: 2011 Country: United States URL: http://www.lac.org/doc_library/lac/publications/MAT_Report_FINAL_12-1-2011.pdf Shelf Number: 129337 Keywords: Drug Abuse and AddictionDrug Abuse TreatmentMedical CareSubstance Abuse Treatment |
Author: London Assembly. Police and Crime Committee Title: Falling Short: The Met's Healthcare of Detainees in Custody Summary: Our investigation into healthcare in custody found that the Metropolitan Police are struggling to provide adequate medical staffing to assess and treat detainees in their custody suites. The Police and Crime Committee report Falling short: The Met's healthcare of detainees in custody , calls for swift action to tackle the more than 60 per cent shortfall in nurses providing medical assessments and care for people held in police custody. As of November 2013 the Met had 78 nurses working in custody suites against a planned total of 198. In the current financial year (2013-14) more nurses have left the service than have been recruited. As of November 2013, 23 nurses left the service while 15 were recruited. While the report welcomes plans to transfer commissioning of custody healthcare to the NHS by 2015, it makes a series of recommendations to address shortcomings in custody care in the short term including: - A new strategy for increasing the number of custody nurses and an independent review of the nature, content and appropriateness of their training - Establish a clear timetable for the transition of commissioning for custody healthcare to the NHS by 2015 - The Met and MOPAC should provide a plan showing how the new Detention Command will be developed, consulted on, implemented and overseen. - MOPAC should demonstrate a clear process for making best use of information provided by Independent Custody Volunteers, including publishing a quarterly report of problems identified during visits and action taken as a result. - The Met should establish a formal consultative group to respond to the immediate concerns raised by Forensic Medical Examiners, and consult with them about current nurse training practices and any future changes to custody arrangements. Details: London: London Assembly Police and Crime Committee, 2014. 24p. Source: Internet Resource: Accessed April 24, 2014 at: http://www.london.gov.uk/sites/default/files/14-01-27-Falling%20short%20the%20Met%27s%20healthcare%20of%20detainees%20in%20custody_Jan%202014.pdf Year: 2014 Country: United Kingdom URL: http://www.london.gov.uk/sites/default/files/14-01-27-Falling%20short%20the%20Met%27s%20healthcare%20of%20detainees%20in%20custody_Jan%202014.pdf Shelf Number: 132157 Keywords: DetaineesHealth CareMedical Care |
Author: Enggist, Stefan Title: Prisons and Health Summary: This book outlines important suggestions by international experts to improve the health of people in prison and to reduce the risks posed by imprisonment to both health and society. In particular, it aims to facilitate better prison health practices in the fields of: -human rights and medical ethics; -communicable diseases; -noncommunicable diseases; -oral health; -risk factors; -vulnerable groups; and -prison health management. It is aimed at professional staff at all levels of responsibility for the health and well-being of detainees and at people with political responsibility. The term "prison" covers all institutions in which a state holds people deprived of their liberty. Details: Copenhagen: World Health Organization, Regional Office for Europe, 2014. 189p. Source: Internet Resource: Accessed June 16, 2014 at: http://www.euro.who.int/__data/assets/pdf_file/0005/249188/Prisons-and-Health.pdf?ua=1 Year: 2014 Country: International URL: http://www.euro.who.int/__data/assets/pdf_file/0005/249188/Prisons-and-Health.pdf?ua=1 Shelf Number: 132461 Keywords: Health CareHuman RightsMedical CarePrison ViolencePrisoner Health |
Author: Ogloff, James R.P. Title: Koori Prisoner Mental Health and Cognitive Function Study Summary: The Centre for Forensic Behavioural Science at Monash University (CFBS) and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) were engaged by the Department of Justice to examine the mental health, cognitive functioning, and social and emotional wellbeing of Koori prisoners in Victoria. The study arose from the policies and priorities articulated by the original Aboriginal Justice Agreement (AJA) released in 2000 to address Koori overrepresentation in the criminal justice system and the expanded AJA2 of 2006. The study was jointly overseen by Justice Health and the Koori Justice Unit. The project firstly sought to conduct a thorough assessment of needs from the perspective of Aboriginal and Torres Strait Islander prisoners in Victoria, and secondly, to gain an understanding of the service gaps and needs from the perspective of key stakeholders in Victoria. To this end, the aims of the project were to: - Identify the Social and Emotional Well-Being (SEWB) strengths and needs of Aboriginal and Torres Strait Islander prisoners, including levels of psychological distress - Identify the nature and extent of mental illness for Aboriginal and Torres Strait Islander prisoners and their associated needs- Assess the cognitive functioning of Aboriginal and Torres Strait Islander prisoners and their associated needs- Identify barriers to accessing services and other potential gaps in meeting identified needs- Develop recommendations for improving current service systems and clinical practice Details: Clifton Hill, VIC: Centre for Forensic Behavioural Science, Monash University, 2013. 155p. Source: Internet Resource: Accessed July 31, 2014 at: https://assets.justice.vic.gov.au/corrections/resources/07c438bf-63a6-49bb-8426-d7fd073808a6/koori_prisoner_mental_health.pdf Year: 2013 Country: Australia URL: https://assets.justice.vic.gov.au/corrections/resources/07c438bf-63a6-49bb-8426-d7fd073808a6/koori_prisoner_mental_health.pdf Shelf Number: 120181 Keywords: AboriginalsMedical CareMental Health ServicesMentally Ill OffendersPrisoners (Australia) |
Author: Isaacs, Caroline Title: Death Yards: Continuing Problems with Arizona's Correctional Health Care Summary: On March 6, 2012, the American Civil Liberties Union (ACLU) filed suit against the Arizona Department of Corrections (ADC) charging that prisoners in the custody of the Arizona Department of Corrections receive such grossly inadequate medical, mental health and dental care that they are in grave danger of suffering serious and preventable injury, amputation, disfigurement and premature death. This class action lawsuit has the potential to force the state of Arizona to improve its prison medical care. But legal battles are long and costly. The state is fighting tooth and nail, including an upcoming challenge to the suit's class action status. The final resolution will likely take years. But what has changed in the day-to-day provision of medical care to prisoners in Arizona? Have conditions improved in light of the charges brought by the suit? Has the transition in management of the medical care from one for-profit corporate contractor (Wexford) to another (Corizon) addressed any of the previous health care lapses? Sadly, the answer appears to be no. Correspondence from prisoners; analysis of medical records, autopsy reports, and investigations; and interviews with anonymous prison staff and outside experts indicate that, if anything, things have gotten worse. Details: Tucson: American Friends Service Committee -- Tucson, 2013. 34p. Source: Internet Resource: Accessed November 20, 2014 at: http://afscarizona.files.wordpress.com/2014/03/death-yards-continuing-problems-with-arizonas-correctional-health-care-2013.pdf Year: 2013 Country: United States URL: http://afscarizona.files.wordpress.com/2014/03/death-yards-continuing-problems-with-arizonas-correctional-health-care-2013.pdf Shelf Number: 134161 Keywords: Correctional AdministrationCorrectionsHealth CareMedical CarePrisonersPrisons (Arizona)Privatization |
Author: Cloud, David Title: On Life Support: Public Health in the Age of Mass Incarceration Summary: Each year, millions of incarcerated people-who experience chronic health conditions, infectious diseases, substance use, and mental illness at much higher rates than the general population-return home from correctional institutions to communities that are already rife with health disparities, violence, and poverty, among other structural inequities. For several generations, high rates of incarceration among residents in these communities has further contributed to diminished educational opportunities, fractured family structures, stagnated economic mobility, limited housing options, and restricted access to essential social entitlements. Several factors in today's policy climate indicate that the political discourse on crime and punishment is swinging away from the punitive, tough-on-crime values that dominated for decades, and that the time is ripe to fundamentally rethink the function of the criminal justice system in ways that can start to address the human toll that mass incarceration has had on communities. At the same time, the nation's healthcare system is undergoing a historic overhaul due to the passage of the Affordable Care Act (ACA). Many provisions of the ACA provide tools needed to address long-standing health disparities. Among these are: Bolstering community capacity by expanding Medicaid eligiblity, expanding coverage and parity for behavioral health treatment, and reducing health disparities. Strengthening front-end alternatives to arrest, prosecution, and incarceration. Bridging health and justice systems by coordinating outreach and care, enrolling people in Medicaid and subsidized health plans across the criminal justice continuum, using Medicaid waivers and innovation funding to extend coverage to new groups, and advancing health information technology. There is growing interest among health and justice system leaders to work together in the pursuit of health equity, public safety, and social justice. In many states and localities, efforts are already underway. While challenges remain, including regional differences in using the ACA, the combination of political will, public support, and increased access to healthcare funding presents a momentous opportunity to address the impacts of mass incarceration on community health, develop policy and programmatic reforms to undo the damage, and rethink the core values and goals of the American justice system moving forward. Details: New York: Vera Institute of Justice, 2014. 34p. Source: Internet Resource: Accessed November 20, 2014 at: http://www.vera.org/pubs/public-health-mass-incarceration Year: 2014 Country: United States URL: http://www.vera.org/pubs/public-health-mass-incarceration Shelf Number: 134162 Keywords: Health Care (U.S.)Mass IncarcerationMedicaidMedical CareMental HealthPrisoners |
Author: Maruschak, Laura M. Title: Medical Problems of State and Federal Prisoners and Jail Inmates, 2011-2012 Summary: The report presents the prevalence of medical problems among state and federal prisoners and jail inmates, highlighting differences in rates of chronic conditions and infectious diseases by demographic characteristic. The report describes health care services and treatment received by prisoners and jail inmates with health problems, including doctor's visits, use of prescription medication, and other types of treatment. It also explains reasons why inmates with health problems were not receiving care and describes inmate satisfaction with health services received while incarcerated. Data were from the 2011-12 National Inmate Survey. Highlights: In 2011-12, an estimated 40% of state and federal prisoners and jail inmates reported having a current chronic medical condition while about half reported ever having a chronic medical condition. Twenty-one percent of prisoners and 14% of jail inmates reported ever having tuberculosis, hepatitis B or C, or other STDs (excluding HIV or AIDS). Both prisoners and jail inmates were more likely than the general population to report ever having a chronic condition or infectious disease. The same finding held true for each specific condition or infectious disease. Among prisoners and jail inmates, females were more likely than males to report ever having a chronic condition. High blood pressure was the most common chronic condition reported by prisoners (30%) and jail inmates (26%). About 66% of prisoners and 40% of jail inmates with a chronic condition at the time of interview reported taking prescription medication. More than half of prisoners (56%) and jail inmates (51%) said that they were either very satisfied or somewhat satisfied with the health care services received since admission. Details: Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, 2015. 23p. Source: Internet Resource: Accessed February 9, 2015 at: http://www.bjs.gov/content/pub/pdf/mpsfpji1112.pdf Year: 2015 Country: United States URL: http://www.bjs.gov/content/pub/pdf/mpsfpji1112.pdf Shelf Number: 134585 Keywords: Health CareHealth ServicesMedical CareMentally Ill OffendersPrisoners (U.S.) |
Author: Kraft-Stolar, Tamar Title: Reproductive Injustice:The State of Reproductive Health Care for Women in New York State Prisons Summary: each and every visit the Correctional Association of New York (CA) conducts to women's prisons in New York, we meet women who tell us about the serious problems they face in accessing appropriate health care and the particular challenges of securing women-specific care during their incarceration. The consistency and intensity of these concerns over the years led us to undertake this study, the most extensive study of reproductive health care in a state prison system to date. Shining a light on this topic is critical because access to quality reproductive health care is a basic human right, as is a woman's ability to control her own reproductive decisions. Prison infringes on those rights, exposing women to substandard reproductive health care and denying women the right to choose when to have children and the right to be full-time parents to the children they already have. Prisons fuel social and racial injustice, undermining the conditions necessary for women to have reproductive autonomy, and to live safe and fulfilling lives. Reproductive health also serves as an important lens onto the unique experiences of incarcerated women and the dehumanization that defines life in prison. It illuminates the specific degradation that accompanies being a woman in prison, from shackling during pregnancy to the separation of mothers from their newborns to the denial of sufficient sanitary supplies. Finally, reproductive health care in prison is fundamental to the well-being of families and communities as almost everyone in prison eventually goes home. Despite this, state prison officials do not pay adequate attention to reproductive health care and neither do public health authorities when this care happens behind prison walls. The lack of oversight is alarming considering that the New York State Department of Corrections and Community Supervision (DOCCS) is responsible for providing reproductive health care to more than 2,300 women on any given day, and to nearly 4,000 women over the course of one year, about 40 of whom are pregnant. Women in prisons across the country face similar problems in accessing adequate reproductive health care and humane treatment, and the explosion in the number of incarcerated women over the past few decades has only exacerbated these problems. The U.S. women's prison population rose from about 11,200 in 1977 to about 111,300 in 2013, an increase of nearly 900% over a 36-year time span. As a result, the U.S. currently incarcerates more women per capita than any other country in the world: we have less than 5% of the world's women yet nearly 33% of the world's incarcerated women. This massive overuse of incarceration does not affect all women equally. Women in prison are overwhelmingly from low-income communities, and a vastly disproportionate number are women of color. Many have had little formal education, and many struggle with serious health conditions, including substance abuse and mental illness. Almost all have brutal histories of abuse. A majority are mothers, often of small children, and many were caring for their children on their own before prison. Most women are in prison for crimes related to addiction, poverty, mental illness, domestic violence and trauma. These realities reflect the criminal justice system's racism and targeting of marginalized communities, and our society's destructive over-reliance on incarceration as a response to problems that are, at their root, social and economic. Details: New York: Women in Prison Project, Correctional Association of New York, 2015. 233p. Source: Internet Resource: Accessed February 19, 2015 at: http://www.correctionalassociation.org/wp-content/uploads/2015/02/Reproductive-Injustice-FULL-REPORT-FINAL-2-11-15.pdf Year: 2015 Country: United States URL: http://www.correctionalassociation.org/wp-content/uploads/2015/02/Reproductive-Injustice-FULL-REPORT-FINAL-2-11-15.pdf Shelf Number: 134657 Keywords: Female InmatesFemale PrisonersHealth CareMedical CarePregnant Inmates (New York) |
Author: Equality and Human Rights Commission Title: Preventing Deaths in Detention of Adults with Mental Health Conditions: An Inquiry Summary: Our Inquiry was launched in June 2014 to examine how compliance with human rights obligations can reduce 'non-natural' deaths of adults with mental health conditions in state detention. We looked at deaths in three state detention settings - prisons, police cells and hospitals - consulting with inspectorates, regulators and others with responsibilities in this area. The Equality and Human Rights Commission's (the Commission's) Inquiry examined the available evidence in relation to the deaths of 367 adults with mental health conditions who died of 'non-natural' causes while in police cells or as detained patients over the period 2010-13, plus a further 295 who died in prison custody, many of whom also had mental health conditions. This is a large number in itself, yet for each individual who died there are family members and other loved ones who suffer as a result of these deaths. Previous inquiries, investigations, inquests and court cases have established that, too often, the circumstances surrounding deaths in detention involve breaches of people's most basic human rights - including the right to life. We wanted to establish whether a focus on increased compliance with Article 2 of the European Convention on Human Rights, including the State's positive obligation to protect people's life, would reduce avoidable deaths. One in four British adults experience at least one mental health condition, and one in six are experiencing a mental health condition at any given time. Some people will experience more than one mental health condition. While many people continue to lead productive and fulfilling lives with very little involvement from the State, the Government recognises its role to provide specific care for people experiencing mental health conditions at a time of vulnerability. Details: Manchester, UK: Equality and Human Rights Commission, 2015. 84p. Source: Internet Resource: Accessed February 26, 2015 at: http://www.equalityhumanrights.com/sites/default/files/publication_pdf/Adult%20Deaths%20in%20Detention%20Inquiry%20Report.pdf Year: 2015 Country: United Kingdom URL: http://www.equalityhumanrights.com/sites/default/files/publication_pdf/Adult%20Deaths%20in%20Detention%20Inquiry%20Report.pdf Shelf Number: 134723 Keywords: Deaths in Custody (U.K.)Medical CareMental Health ServicesMentally Ill InmatesMentally Ill Offenders |
Author: Davis, Chelsea Title: Bridging the Gap: Improving the Health of Justice-Involved People through Information Technology Summary: On September 17, 2014, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) convened a two-day conference in Rockville, Maryland called Bridging the Gap: Improving the Health of Justice-Involved People through Information Technology. The meeting aimed to address the problems of disconnected justice and health systems and to develop solutions by describing barriers, benefits, and best practices for connecting community providers and correctional facilities using health information technology (HIT). The gathering, organized by the SAMSHA Health Information Technology and Criminal Justice Team and the Federal Interagency Reentry Council HIT Workgroup, included representatives from federal agencies; national advocacy organizations; and nonprofit, state, and local agencies providing health services to justice-involved populations. The following proceedings give an overview of each session and a synthesis of the obstacles to instituting HIT solutions for information sharing detailed during the meeting. The proceedings address the importance of using emerging HIT to respond to the growing problem of people with mental health and substance use disorders involved in the criminal justice system and to articulate a vision of how HIT can facilitate ongoing connections between health and justice systems. Several jurisdictions that are implementing new HIT programs - both those that connect community providers to correctional facilities during initial intake into the justice system and those that connect correctional facilities to community providers during reentry - are highlighted here. Common challenges emerged among jurisdictions despite their unique environments and systems. Conference participants discussed these challenges along with opportunities for overcoming them. An in-depth case study of new HIT initiatives in Louisville, Kentucky, is included, illustrating how to build and sustain collaborative cross-sector teams. The conference coalesced around six key themes: - An underdeveloped HIT landscape makes it difficult for health and justice systems to communicate and share data vital to the health of justice-system-involved populations. - Innovative programs from jurisdictions around the country can help others figure out how to successfully launch HIT programs intended to share data between community providers and correctional facilities. - Representatives from Medicaid agencies, corrections departments, and community providers need to be at the table together to develop solutions that advance common goals that promote public health and public safety. - Every locale must build a program based on its specific needs, infrastructure, and partners, but resources such as Justice and Health Connect, NIEM, and Global can guide jurisdictions looking to bridge the justice and health gap. - Privacy, security, consent, and technology adaptation are difficult but surmountable obstacles to providing healthcare to the justice-system-involved population. - Data-driven programs such as justice reinvestment seek to cut spending and reinvest the savings in practices that have been empirically shown to improve safety and hold offenders accountable. The trend toward evidence-based evaluation of justice programs, coupled with mounting evidence that current incarceration and recidivism rates are economically unsustainable, have galvanized diverse stakeholders to collaborate on developing better responses to justice-involved people who have substance use and mental health issues. Details: New York: Vera Institute of Justice, 2015. 36p. Source: Internet Resource: Accessed May 18, 2015 at: http://www.vera.org/sites/default/files/resources/downloads/samhsa-justice-health-information-technology.pdf Year: 2015 Country: United States URL: http://www.vera.org/sites/default/files/resources/downloads/samhsa-justice-health-information-technology.pdf Shelf Number: 135699 Keywords: Inmate Health CareMedicaidMedical CareMental HealthMentally Ill OffendersSubstance Abuse Treatment |
Author: Hallam, Christopher Title: The International Drug Control Regime and Access to Controlled Medicines Summary: The World Health Organisation estimates that some 5.5 billion people around the globe inhabit countries with low to non-existent access to controlled medicines and have inadequate access to treatment for moderate to severe pain. This figure translates to over 80 per cent of the world's population. Only in a small number of wealthy countries do citizens stand a reasonable chance of gaining adequate access to pain care, though even here room for improvement remains. According to the International Narcotics Control Board, recent data indicate that more than 90 per cent of the consumption of strong opioids takes place in Australia, New Zealand, Canada, the United States and Western Europe. In poor and developing nations, meanwhile, and even in several industrialised states, pain remains largely uncontrolled. Africa is the least well served continent for access to analgesia. The situation affects numerous conditions: pain may go untreated for those with cancer and with HIV/AIDS, for women in childbirth, for numerous chronic conditions, for those in post-surgical settings, those who are wounded in armed conflicts, those who have suffered accidents, and so on. Conclusions and recommendations - The unacceptable situation with respect to access to controlled medicines is another indicator that the time is right to consider the revision of the international drug control treaties in order to achieve a better balance between the twin objectives of restricting nonmedical drug use and ensuring access for medical and scientific requirements. - While the treaties remain unreformed, the INCB should achieve a better understanding of the manner in which its concerns with restricting diversion and nonmedical use impacts upon the system's public health imperatives, in particular the provision of access to essential medicines. - With this in mind, the INCB should refrain from interfering in those areas of the system that are mandated to WHO, such as the scheduling of substances under the 1961 and 1971 conventions. - The WHO has demonstrated courage and leadership in its defence of public health priorities in its scheduling recommendations. It should continue to adopt this position, and should receive the commendation and support of Parties and NGOs in so doing. - Again, until the treaties are reformed to represent a better balance between their twin objectives, the INCB should consider utilising Article 14 of the Single Convention in relation to those states who fail to progressively establish access to essential medicines. In most cases, the Article should be invoked together with Article 14 bis, which would allow supportive technical and financial steps to be taken to assist non-compliant countries. - Funds to assist governments to comply with their obligation along the lines of Article 14 bis could come from individual states with an interest, or from a special group fund dedicated to the purpose. - NGOs in the field of palliative care and those working to reform the drug control system should cooperate to bring about change. Details: Amsterdam: Transnational Institute; London: International Drug Policy Consortium, 2014. 16p. Source: Internet Resource: Series on Legislative Reform of Drug Policies No. 26: Accessed May 21, 2015 at: http://www.tni.org/sites/www.tni.org/files/download/dlr26-e.pdf Year: 2014 Country: International URL: http://www.tni.org/sites/www.tni.org/files/download/dlr26-e.pdf Shelf Number: 135739 Keywords: Drug ControlDrug Control PolicyMedical Care |
Author: de Viggiani, Nick Title: A Healthy Prison Strategy for HMP Bristol Summary: This report summarises progress in establishing a Healthy Prison strategy for HMP Bristol. It follows a period of consultancy with the prison commissioned by NHS Bristol, and carried out as follow-up to a 2007-8 Health Needs Assessment (HNA) conducted at the prison. The aims of this work were to: [1] assess and build commitment within the prison for a 'healthy prison' strategy; [2] produce a realistic and feasible plan for developing the strategy; [3] create a strategy group to lead and drive the project; and [4] form and publish key performance standards for the prison. A period of consultation preceded publication of this report, which involved interviews and meetings with a range of Prison Service and NHS stakeholders and close scrutiny of relevant reports and publications. It should be noted that work on this strategy is ongoing and now forms part of the core business of HMP Bristol. Details: Bristol, UK: University of the West of England, 2009. 49p. Source: Internet Resource: Accessed June 4, 2015 at: http://eprints.uwe.ac.uk/8252/1/HMP_Bristol_strategy.pdf Year: 2009 Country: United Kingdom URL: http://eprints.uwe.ac.uk/8252/1/HMP_Bristol_strategy.pdf Shelf Number: 135903 Keywords: Health CareMedical CarePrisons |
Author: United Nations Office on Drugs and Crime, Country Office Pakistan Title: Females Behind Bars: Situation and Needs Assessment in Female Prisons and Barracks Summary: The Joint United Nations Programme on AIDS (UNAIDS) has listed prisoners among the four most 'at risk and neglected populations' in the HIV/AIDS pandemic. The 2006 report states that "Prisons are sites for illicit drug use, unsafe injecting practices, tattooing with contaminated equipment, violence, rape and unprotected sex. Prisons are often overcrowded, have limited access to healthcare, offer poor nutrition and have high rates of airborne and blood borne diseases. Particularly women make up a very small proportion of the prison population in Pakistan and they are faced with much greater challenges than men in accessing healthcare. UNODC Pakistan, through one of its projects initiated HIV prevention services for female prisoners. The project contains significant importance as is only the project targeting female prisoners in the country. Data was collected in 09 female prisons and barracks across the country, where the project was being implemented. All females who were admitted to a female prison within the study period formed the study population. To be eligible for participation, a woman should be an inmate in one of the targeted prisons, be of 18 years of age or older, irrespective of her drug using status and risk behaviors and was willing to provide an informed consent for participation in the study. A total number of 375 subjects was calculated to be the final sample size for this study. The preliminary data available from the project suggested that a more or less 400 female prisoners existed in the prisons. Owing to the small number of female prisoners reported from these target prisons, no strict inclusion or exclusion criteria were used and all available prisoners who showed a willingness and provided consent to participate, were included in the study. Data collection was preceded by a pre-survey phase, which lasted for a couple of weeks. The supervisory staff in prisons was contacted by the field teams and were explained the objectives of the study to ensure their involvement in the study. This phase focused on answering any concerns of the prison staff and address any of their apprehensions about the study and confidentiality of data. Data collection lasted for a period of 6 weeks. The team members were lead by the project psychologist, who played a key role in data collection. Data were collected on a predesigned format which was developed through a consultative process between the project staff, the UNODC technical team and the research consultant. Data was collected in a secure room (project's counseling room) separate from the prison's main building and provided enough privacy for the interviews to be conducted smoothly without any interference. The questionnaire was of a structured format, developed to gather information on various socio-demographic, prison related information and personal characteristics of the individual herself. After the questionnaire information was collected, the interviewer answered any questions that participants had raised and registered with the project for future follow-up. After editing, all questionnaires were rechecked using a software designed in MS Access for data entry. Analysis was done using the statistical software package, SPSS version 12.0 (statistical package for social sciences). Since prisons have peculiar characteristics regarding exertion of rights, the numerous ethical issues such as voluntary participation, taking informed consent, and measures to ensure and maintain participants' confidentiality were taken into consideration during the entire length of this study. A total number of 359 interviews were conducted for this study, within the time allocated for data collection. The average age of prisoners across all prisons was reported to be 35.2 years - 12.6 (median = 32), with little variability between different prisons. The maximum proportion of prisoners interviewed were illiterate (68%) and more than half of the prisoners interviewed were married with children. Half of the women interviewed shared in the family expenses by providing some sort of financial support. 4% of the women interviewed were non Pakistanis; the maximum numbers of non-Pakistani women interviewed were from Zambia. Of the 359 women prisoners interviewed, an astounding 59% of the women were reported to be under trial. A remaining 31 (8.6%) were detained while the remaining 32.6% (117) were convicted. The maximum proportion of women was imprisoned due to crime such as murders (40%), and drug related offenses. These included using as well as possession of illegal drugs. Another issue of concern is the high number of women who were imprisoned on account of commercial sex work. Upon further inquiry 23.7% of the women stated that they had ever been imprisoned for drug related offenses, while another 15.6% informed that they had been imprisoned for commercial sex work. A fairly large proportion of women had been tobacco smokers before imprisonment and nearly half of them continued smoking even within prisons. In addition a substantial proportion of the overall female prisoner population indicated use of psychotic drugs before being imprisoned, but did not continue their drug using habit, as drugs were not available in prisons. Of the 359 women interviewed, only 22 (6.1%) reported that they had ever injected any form of drug. Further inquiry into drug injecting practices revealed that all these injections took place among the women were imprisoned. Forty five (12.5%) of the total women interviewed stated that they had faced some form of sexual harassment while in prison (not rape). Multiple sex partners were notified, with sex between various prisoners being the most common form of consensual sex seen in prisons. 52% of the women interviewed informed that they had heard of HIV and AIDS. Knowledge of sexual intercourse as a mode of transmission of the disease was prevalent among 27.3% of the women interviewed and 42% knew that HIV can be transmitted by sharp instrument/needles and syringes. 49% knew that HIV can spread through blood transfusion, while knowledge of mother to child transmission was found to be 26%. One fifth reported to have experienced an STI in the past 06 months, while 18% received proper treatment for these infections. An evaluation of the prison environment showed that unlike male prisons, overcrowding is not reported to be an issue in female prisons. The hygiene conditions in all prisons visited were far from ideal. The sanitation facilities available for prisoners varied according to various prisons or barracks. The number of wash rooms ranged from 3 to 4 prisoners per wash room to 60 prisoners per wash room in one of the larger prisons. Only one of the prisons visited had safe drinking water available for the prisoners. All prisons other than two had tap water available for 24 hours, however the water was not purified leading to various water borne diseases. While women prisoners were reported to keep their children with them in prisons, it is also worth mentioning that there were no child care facilities in any of the prison evaluated. Inadequate medical facilities were reported by female prisoners from nearly all prisons. Although doctors are available in all prisons, but the diagnostic and treatment facilities were found to be far from satisfactory. No measures to deal with the mental health issues were reported to be provided by the prison authorities. In all prisons, psychologists were made available through UNODC supported project. The psychological problems reported are depression, stress, mental illness, attention seeking behavior, sleep disorder and generalized anxiety. No recreational facilities are available except television, which was available in only 2 prisons. No indoor games or activities to keep the prisoners involved were seen in any of the prisons visited. Based upon the results of this study, a series of key principles and actions are recommended, to promote principles of public health, improve the mental state of health of the confined, and prevent the spread of HIV and other communicable diseases in prisons. These services should include the provision of basic determinants of health such as adequate nutrition, clean drinking water, sanitation facilities, provision of an adequate gender-sensitive and interdisciplinary mental healthcare and provision of drug dependence treatment options for prisoners with problematic drug use. Comprehensive education and awareness of HIV/AIDS and ways to prevent HIV transmission, with a special reference to the likely risks of transmission within prison environments should be provided to both Prisoners and prison staff. Prison systems should provide easy access to voluntary HIV testing and counseling, which should be easily accessible to all prisoners. While HIV, HCV and HBV testing is continuously done in most prisons under the project supported by UNODC, it is strongly recommended that TB testing should also be initiated in prisons. Some basic child health services including nutrition, immunization, basic health care needs can be provided by the project as part of the holistic support program. Women should be provided access to legal counseling and provision of legal aid if desired, to access lawyers and follow up their cases in courts. Every effort should be made to develop positive partnerships with the higher prison authorities and the prison staff for every initiative undertaken. Details: Islamabad : United Nations Office on Drugs and Crime, Country Office Pakistan, 2011. 50p. Source: Internet Resource: Accessed November 25, 2015 at: https://www.unodc.org/documents/pakistan//female_behind_bars_complete_final.pdf Year: 2011 Country: Pakistan URL: https://www.unodc.org/documents/pakistan//female_behind_bars_complete_final.pdf Shelf Number: 137338 Keywords: Female InmatesFemale OffendersFemale PrisonersHealth ServicesMedical CarePrisons |
Author: Carceres-Monroy, Alejandro Title: Breaking the Silence: Civil and Human Rights Violations Resulting from Medical Neglect and Abuse of Women of Color in Los Angeles County Jails Summary: Women of color with mental health conditions in LA county jails and California prisons are exceptionally vulnerable to medical neglect and abuse that violate domestic civil rights law and regional and international human rights law. This Report by Dignity and Power Now ("DPN") documents how jail and prison officials violated the rights of seven women of color, and highlights the mental health consequences of the medical neglect and abuse these women suffered. It relies on the testimonies of these women, interviews with two former CRDF psychiatric social workers, and a growing literature on the unlawful treatment of incarcerated populations with mental health conditions across the United States of America. Although this Report's focus is the Century Regional Detention Facility ("CRDF"), an all-female facility operated by the Los Angeles County Sheriff's Department ("LASD"), it includes violations against women at the LASD's Twin Towers facility and at the California Institution for Women ("CIW"), an all-female state prison. This Report documents how LASD Deputies and other personnel-including Los Angeles County Department of Mental Health personnel working in detention facilities-systematically denied the women interviewed vital mental and physical health care services. These officials forced women suffering from mental health conditions such as bipolar disorder, schizophrenia and depression to suffer - sometimes for months - without access to necessary medication. These Deputies verbally abused these women and rarely permitted them to leave their cells. These officials forced these women to lie in their own filth for days, and denied them access to adequate reproductive hygiene products such as tampons or pads, leaving these women to bleed on themselves. Women interviewed for this Report recounted how Deputies shackled pregnant women, and punished women with mental health conditions by placing them in solitary confinement. The experiences of these interviewees also reveal how, by medically neglecting and abusing women of color, Deputies and other personnel increased these women's risk of suicide. These abuses are unacceptable by any measure. That they occur at the hands of public employees entrusted with the humane care of these women - some of whom are our communities' most mentally and physically vulnerable - is heinous. In addition to detailing these women's stories, this Report demonstrates that the medical neglect and abuse of incarcerated women of color by LASD and other public officials violates domestic civil rights law, regional human rights law, and international human rights law. The violations this Report documents make clear the human cost of the growing trend of incarceration of women, a trend that is by no means mitigated by so-called gender responsive incarceration. In 2007 some California legislators proposed the construction of more incarceration facilities for women, and used a need for gender responsiveness as a justification for this expansion. A report by Californians United for a Responsible Budget, also released that year, explained that so-called gender responsive incarceration proposals used "the grave needs of people in women's prisons to manipulate public sentiment in favor of rehabilitation and services to expand a failing system." Even today, building more facilities will not prevent the gross human rights violations incarcerated women endure in Los Angeles County, or anywhere else in the United States. Details: Los Angeles, CA: Dignity and Power Now, 2015. 28p. Source: Internet Resource: Accessed January 11, 2016 at: http://dignityandpowernow.org/wp-content/uploads/2015/07/breaking_silence_report_2015.pdf Year: 2015 Country: United States URL: http://dignityandpowernow.org/wp-content/uploads/2015/07/breaking_silence_report_2015.pdf Shelf Number: 137456 Keywords: African AmericansFemale InmatesFemale OffendersFemale PrisonersJailsMedical CareMental Health ServicesMentally Ill Offenders |
Author: Minnesota Department of Corrections Title: TBI In Minnesota Correctional Facilities: Systems Change for Successful Return to the Community Summary: Each year, in the United States, some 1.7 million Americans seek medical care for Traumatic Brain Injury (TBI) (Faul, Wald, & Coronado, 2011). Nationally, TBI is a contributing factor in approximately a third of all injury-related deaths and a substantial number of cases of permanent disability (Centers for Disease Control and Prevention, 2014). While promising advances in medical technology and regional trauma services have led to an increase in the number of survivors of TBI, the stark reality is that these advancements have also led to social and medical challenges associated with a growing pool of people with TBI-related disabilities. The outcomes of TBI can result in a variety of cognitive, emotional, and/or behavioral consequences that not only affect the individual but can also have lasting effects on families and communities. In 2012, there were approximately 1.35 million individuals incarcerated in state prisons, 217,800 in federal prisons and 744,500 in local jails (Bureau of Justice Statistics, 2013). Although still limited in scope, emerging literature is supporting the commonly observed phenomenon amongst correctional professionals that there is an elevated prevalence of TBI in correctional populations in comparison to the general public. A meta-analytic review found the prevalence of TBI in the overall offender population to be 60.25% (Shiroma, Ferguson, & Pickelsimer, 2010), while even higher prevalence has been reported in other correctional systems (e.g., 80.2% of adult male offenders MN-DOC, 2008). In addition to understanding prevalence rates of TBI within correctional systems, research is beginning to recognize the influence of an offender's lifetime history of TBI on the delivery of correctional health services and offender management. Recent findings have suggested an association between TBI and increased use of state correctional psychological/medical services, higher rates of prison rule violations and recidivism, and lower chemical dependency treatment completion rates (Piccolino & Solberg, 2014). Prompted by local and national calls for increased health screenings, evaluations, and targeted treatment of offenders (Gibbons & Katzenbach, 2006), the MN-DOC in collaboration with the MN-DHS began developing an infrastructure in which identification, assessment, and services for offenders with TBI are provided. The following looks at this evolving process and discusses the successes and challenges that a state correctional system has experienced to date with support from two federally funded HRSA grants. Details: St. Paul, MN: Minnesota Department of Corrections, 2015. 32p. Source: Internet Resource: Accessed March 22, 2016 at: http://www.doc.state.mn.us/PAGES/files/6714/3456/0599/TBI_White_Paper_MN_DOC-DHS.pdf Year: 2015 Country: United States URL: http://www.doc.state.mn.us/PAGES/files/6714/3456/0599/TBI_White_Paper_MN_DOC-DHS.pdf Shelf Number: 138366 Keywords: Health ServicesMedical CareTraumatic Brain Injury |
Author: Human Rights Watch Title: Paying the Price: Failure to Deliver HIV Services in Louisiana Parish Jails Summary: In 2011, the United States, in concert with countries around the world, announced the "beginning of the end of AIDS." Defeating AIDS would be a stunning public health achievement. But doing so requires addressing HIV in correctional systems-and nowhere more so than in Louisiana, which leads the nation in new HIV infections and incarceration rates. The same socio-economic factors that place people at risk for HIV-poverty, homelessness, drug dependence, mental illness- are also associated with higher rates of incarceration. For heavily policed groups, the overlap of HIV and imprisonment is not a coincidence. Going to jail tends to make people poorer, less stably housed, and more likely to be jailed again-factors known to play a part in HIV prevention and outcomes. Repeated incarceration, often for minor crimes, can have serious health consequences for people living with HIV. Paying the Price presents the voices of people living with HIV who have been detained in parish jails across Louisiana, where HIV services are limited, sporadic, and often non-existent. HIV testing is limited to a handful of facilities; treatment for HIV in parish jails is delayed, interrupted, and sometimes denied altogether. Despite the importance of continuity of care to people with HIV, those who leave most parish jails in Louisiana endure a haphazard process, including leftover medications, a list of HIV providers, and in some cases nothing at all. Federal, state, and local governments should immediately increase inmates' access to HIV testing, treatment, and linkage to care upon release from Louisiana parish jails. Louisiana should continue to press forward criminal justice reforms that promote alternatives to incarceration. Details: New York: HRW, 2016. 78p. Source: Internet Resource: Accessed April 7, 2016 at: https://www.hrw.org/sites/default/files/report_pdf/usaids0316web.pdf Year: 2016 Country: United States URL: https://www.hrw.org/sites/default/files/report_pdf/usaids0316web.pdf Shelf Number: 138592 Keywords: Health CareHIV(Viruses)Jail InmatesMedical Care |
Author: Californians for Safety and Justice Title: Enrollment Efforts for California's Justice-Involved Populations Summary: Potential to Expand Health Coverage to Justice-Involved Populations California's implementation of the Affordable Care Act (ACA), including its expansion of Medi-Cal (the state's Medicaid program) for low-income childless adults, created an unprecedented opportunity for previously uninsured individuals to receive health coverage and access to health services. Among the newly eligible are many individuals with histories of criminal justice system involvement, including people in county jails or under the supervision of county probation departments. Criminal justice populations have high levels of physical and behavioral health care needs, and providing them with health coverage and services could improve individual health, public health, and public safety outcomes, as well as reduce health and criminal justice system costs. California Counties Seize This Opportunity In 2014, Californians for Safety and Justice conducted a statewide survey of California counties to learn about local efforts to provide jail and probation populations with health coverage application assistance. At the time of this initial survey, it was clear that providing health coverage to criminal justice populations was a priority for the majority of counties, most of which were in the early stages of planning or implementing their enrollment initiatives. Out of the 44 counties that responded to the 2014 survey, all 44 reported that they were actively providing or planning to provide application assistance to jail inmates, and 43 reported that they were actively providing or planning to provide application assistance to adult probationers. The results of this initial survey are discussed in more detail in "Health Coverage Enrollment of California's Local Criminal Justice Populations," available at .safeandjust.org. Details: Oakland, CA: Californians for Safety and Justice, 2016. 16p. Source: Internet Resource: Accessed June 1, 2016 at: http://libcloud.s3.amazonaws.com/211/01/2/685/1/Cnty_CriminalJustice_EnrollmentBrief-FINAL-online_copy.pdf Year: 2016 Country: United States URL: http://libcloud.s3.amazonaws.com/211/01/2/685/1/Cnty_CriminalJustice_EnrollmentBrief-FINAL-online_copy.pdf Shelf Number: 139259 Keywords: Affordable Care ActHealth CareMedical Care |
Author: Australian Institute of Health and Welfare Title: Medication use by Australia's prisoners 2015: how is it different from the general community? Summary: It is known that prisoners generally have poor health and complex health needs that are reflected in the number and types of medications they take. Less is known about how this medication use compares with people in the general community. This bulletin uses data from the Australian Institute of Health and Welfare's National Prisoner Health Data Collection and the Australian Bureau of Statistic's National Health Survey to compare medications taken by prisoners with people in the general community. Contextual information from a focus group of prison health professionals is used to discuss some of the differences between prescribing in a prison and in the general community. Details: Canberra: AIHW, 2016. 20p. Source: Internet Resource: Bulletin 135: Accessed July 25, 2016 at: http://apo.org.au/files/Resource/19578.pdf Year: 2016 Country: Australia URL: http://apo.org.au/files/Resource/19578.pdf Shelf Number: 139837 Keywords: Medical CarePrisoner Health Prisoner Medications |
Author: Human Rights Watch Title: Systemic Indifference: Dangerous and Substandard Medical Care in US Immigration Detention Summary: On April 6, 2015, Raul Ernesto Morales-Ramos, a 44-year-old citizen of El Salvador, died at Palmdale Regional Medical Center in Palmdale, California, of organ failure, with signs of widespread cancer. He had entered immigration custody four years earlier in March 2011. He was first detained at Theo Lacy Facility, operated by the Orange County Sheriff's Department, and then at Adelanto Detention Facility, operated by the private company Geo Group, both of which had contracts with US Immigration and Customs Enforcement ("ICE") to hold non-citizens for immigration purposes. An ICE investigation into the death of Morales-Ramos found that the medical care he received at both facilities failed to meet applicable standards of care in numerous ways. Two independent medical experts, analyzing ICE's investigation for Human Rights Watch, agreed that he likely suffered from symptoms of cancer starting in 2013, but that the symptoms essentially went unaddressed for two years, until a month before he died. Details: New York: HRW, 2017. 113p. Source: Internet Resource: Accessed May 16, 2017 at: https://www.hrw.org/sites/default/files/report_pdf/usimmigration0517_web_0.pdf Year: 2017 Country: United States URL: https://www.hrw.org/sites/default/files/report_pdf/usimmigration0517_web_0.pdf Shelf Number: 145479 Keywords: Health CareIllegal ImmigrantsImmigrant DetentionMedical Care |
Author: U.S. Government Accountability Office Title: Bureau of Prisons: Better Planning and Evaluation Needed to Understand and Control Rising Inmate Health Care Costs Summary: As of June 2017, BOP was responsible for the custody and care - including health care - of about 154,000 inmates housed in BOP institutions. Health care includes medical, dental, and psychological treatment. BOP provides most care inside its institutions, but transports inmates outside when circumstances warrant. GAO was asked to review health care costs at BOP institutions. This report addresses: (1) BOP's costs to provide health care services and factors that affect costs; (2) the extent to which BOP has data to help control health care costs; and (3) the extent to which BOP has planned and implemented cost control efforts. GAO analyzed BOP health care obligations data for fiscal years 2009 through 2016, gathered information on BOP's health care cost control initiatives through a data collection instrument, and reviewed BOP's health care related strategic plans. GAO also interviewed BOP officials and visited 10 BOP institutions, selected in part, for total and per capita medical services costs. What GAO Recommends GAO is making five recommendations, including that BOP conduct a costeffectiveness analysis to identify the most effective method to collect health care utilization data; conduct a spend analysis of health care spending data; evaluate cost control initiatives; and enhance its planning efforts by incorporating elements of a sound planning approach. BOP concurred with the recommendations. Details: Washington, DC: GAO, 2017. 74p. Source: Internet Resource: GAO-17-379: Accessed August 24, 2017 at: http://www.gao.gov/assets/690/685544.pdf Year: 2017 Country: United States URL: http://www.gao.gov/assets/690/685544.pdf Shelf Number: 146887 Keywords: Costs of Corrections Federal Bureau of Prisons Health Care Medical Care |
Author: Lehtmets, Andres Title: Prison health care and medical ethics. A manual for health-care workers and other prison staff with responsibility for prisoners' well-being Summary: This manual is addressed to prison health‑care workers and other prison staff with responsibility for prisoners' well‑being. It provides practical information about a range of issues related to psychiatric care, prevention of the spread of transmissible diseases (such as acquired immunodeficiency syndrome, hepatitis and tuberculosis), psychoactive drugs and the medical management of drug‑addicted prisoners. The text highlights important ethical standards and suggests responses to ethical dilemmas related to access to a doctor, equivalence of care, patient's consent and confdentiality, preventive health care, humanitarian assistance, professional independence and competence. Details: Strasbourg: Council of Europe, 2015. 84p. Source: Internet Resource: Accessed October 3, 2017 at: https://book.coe.int/eur/en/penal-law-and-criminology/6882-pdf-prison-health-care-and-medical-ethics.html Year: 2015 Country: Europe URL: https://book.coe.int/eur/en/penal-law-and-criminology/6882-pdf-prison-health-care-and-medical-ethics.html Shelf Number: 147539 Keywords: Health Care Medical CarePrison Health Care |
Author: Mallik-Kane, Kamala Title: Measuring Progress in Connecting Criminal Justice to Health: A How-to Guide to Performance Management for Practitioners Summary: This guide provides performance management strategies for practitioner agencies to measure the performance of initiatives to enroll people in Medicaid upon release from incarceration and connect them with health care services in the community. The guide details the steps for performance management and outlines potential performance metrics specific to Medicaid enrollment, prescription continuity, and connection with community-based care. These performance measurement strategies are illustrated in two case studies, one representing a state and Medicaid-led effort, the other representing a local and corrections-led effort Details: Washington, DC: Urban Institute, 2018. 62p. Source: Internet Resource: Accessed March 19, 2018 at: https://www.urban.org/sites/default/files/publication/97031/measuring_progress_in_connecting_criminal_justice_to_health.pdf Year: 2018 Country: United States URL: https://www.urban.org/sites/default/files/publication/97031/measuring_progress_in_connecting_criminal_justice_to_health.pdf Shelf Number: 149522 Keywords: Health Care Health Services Medicaid Medical Care |
Author: Guyer, Jocelyn Title: State Strategies for Establishing Connections to Health Care for Justice-Involved Populations: The Central Role of Medicaid Summary: Issue: With many states expanding Medicaid eligibility, individuals leaving jail or prison are now often able to enroll in health coverage upon release. It is increasingly clear, however, that coverage alone is insufficient to address the often complex health and social needs of people who cycle between costly hospital and jail stays. Goals: To identify emerging trends in the care delivery models that state Medicaid programs use for former inmates. Methods: Literature review and interviews with state officials, plans, and providers. Key Findings: The care delivery models for individuals leaving jail or prison provide comprehensive primary care, typically including: data exchange to ensure providers are notified when someone is leaving jail or prison; "in-reach" to help inmates establish a relationship with a primary care provider prior to release, identify health conditions, and set up community-based care; strategies for addressing housing issues and other social determinants of health; use of a peer-support specialist who has experienced incarceration; and specialized training for primary care providers and specialists who work with the formerly incarcerated. Conclusion: With a foundation of insurance coverage, states have developed a range of promising, replicable approaches to providing care to people leaving jail or prison. Details: New York: Commonwealth Fund, 2019. 12p. Source: Internet Resource: Issue Brief: Accessed March 18, 2019 at: https://www.commonwealthfund.org/sites/default/files/2019-01/Guyer_state_strategies_justice_involved_Medicaid_ib_v2.pdf Year: 2019 Country: United States URL: https://www.commonwealthfund.org/sites/default/files/2019-01/Guyer_state_strategies_justice_involved_Medicaid_ib_v2.pdf Shelf Number: 155011 Keywords: Correctional Health CareHealth CareMedicaidMedical Care |
Author: Transparency International Title: The Ignored Pandemic: How corruption in healthcare service delivery threatens Universal Health Coverage Summary: Universal health coverage, meaning that all individuals and communities can access essential quality health services without suffering financial hardship, has become the top priority of the World Health Organisation. Achieving the ambitious goal of universal health coverage will require more resources, and the better use of existing resources. At the same time, efforts to achieve universal health coverage are being significantly undermined by widespread corruption in frontline healthcare service delivery. Corruption in the health sector kills an estimated 140,000 children a year, fuels the global rise in anti-microbial resistance, and hinders the fight against HIV/AIDS and other diseases. Unless the most harmful forms of corruption are curbed, universal health coverage is unlikely to be achieved. Based on an extensive review of the literature, this report seeks to open a new page by taking a fresh look at the evidence on corruption and anti-corruption. It explores the drivers, prevalence, and impact of corruption at the service delivery level. In many countries, deep structural problems drive frontline healthcare workers to absent themselves from work, solicit gifts and extort bribes from patients, steal medicines, and abuse their positions of power in a variety of other ways, usually without facing any consequences. Details: London: Transparency International, 2019. 54p. Source: Internet Resource: Accessed March 22, 2019 at: http://ti-health.org/wp-content/uploads/2019/03/IgnoredPandemic-WEB-v2.pdf Year: 2019 Country: International URL: http://ti-health.org/wp-content/uploads/2019/03/IgnoredPandemic-WEB-v2.pdf Shelf Number: 155100 Keywords: Corruption Embezzlement Health Care Health Industry Medical CareTheft |
Author: Roehm, Scott Title: Deprivation and Despair: The Crisis of Medical Care at Guantanamo Summary: From the inception more than 17 years ago of the Guantanamo Bay detention center located on the U.S. naval base in Guantanamo Bay, Cuba, senior detention facility personnel have consistently lauded the quality of medical care provided to detainees there. For example, in 2005, Joint Task Force (JTF) Guantanamo's then-commander said the care was "as good as or better than anything we would offer our own soldiers, sailors, airmen or Marines." In 2011, a Navy nurse and then deputy command surgeon for JTF Guantanamo made a similar claim: "The standard of care here is the best possible standard of care (the detainees) could get." In late 2017, Guantanamo's senior medical officer again echoed those sentiments: "Detainees receive timely, compassionate, quality healthcare...(which is)...comparable to that afforded our active duty service members on island." There have been many more such assertions in the intervening years and since. Following an in-depth review of publicly available information related to medical care at Guantanamo - both past and present - as well as consultations with independent civilian medical experts and detainees' lawyers, the Center for Victims of Torture and Physicians for Human Rights have determined that none of those assertions is accurate. To the contrary, notwithstanding Guantanamo's general inaccessibility to independent civilian medical professionals, over the years a handful of them have managed to access detainees, review medical records, and interface with Guantanamo's medical care system to a degree sufficient to document a host of systemic and longstanding deficiencies in care. These include: - Medical needs are subordinated to security functions. For example, prosecutors in a military commission case told the judge explicitly that the commander of Guantanamo's detention operations is free to disregard recommendations of Guantanamo's senior medical officer. - Detainees' medical records are devoid of physical and psychological trauma histories. This is largely a function of medical professionals' inability or unwillingness to ask detainees about torture or other traumatic experiences during their time in the CIA's rendition, detention, and interrogation program, or otherwise with respect to interrogations by U.S. forces - which has led to misdiagnoses and improper treatment. -In large part due to a history of medical complicity in torture, many detainees distrust military medical professionals which has led repeatedly to detainees reasonably refusing care that they need. Guantanamo officials withhold from detainees their own medical records, including through improper classification. -Both expertise and equipment are increasingly insufficient to address detainees' health needs. For example, a military cardiologist concluded that an obese detainee required testing for coronary artery disease, but that Guantanamo did not have the "means to test" him, and so the testing was not performed. With regard to mental health, effective torture rehabilitation services are not, and cannot be made, available at Guantanamo. - Detainees have been subjected to neglect. One detainee urgently required surgery for a condition he disclosed to Guantanamo medical personnel in 2007 - and they diagnosed independently in 2010 - but he did not receive surgery until 2018 and appears permanently damaged as a result. - Military medical professionals rotate rapidly in and out of Guantanamo, which has caused discontinuity of care. For example, one detainee recently had three primary care physicians in the course of three months. - Detainees' access to medical care and, in some cases, their exposure to medical harm, turn substantially on their involvement in litigation. For example, it appears extremely difficult, if not impossible, for detainees who are not in active litigation to access independent civilian medical professionals, and for those who are to address a medical need that is not related to the litigation. For detainees charged before the military commissions, prosecution interests have superseded medical interests, as with a detainee who was forced to attend court proceedings on a gurney writhing in pain while recovering from surgery. These deficiencies are exacerbated by - and in some cases a direct result of - the damage that the men have endured, and continue to endure, from torture and prolonged indefinite detention. It is long past time that the medical care deficiencies this report describes were acknowledged and addressed. Systemic change is necessary; these are not problems that well- intentioned military medical professionals - of which no doubt there are many, working now in an untenable environment - can resolve absent structural, operational, and cultural reform. Nor, in many respects, are they problems that can be fully resolved as long as the detention facility remains open. Guantanamo should be closed. Unless and until that happens, the Center for Victims of Torture and Physicians for Human Rights call upon Congress, the Executive Branch, and the Judiciary to adopt a series of recommendations aimed at meaningfully improving the status quo. These include, but are not limited to: lifting the legal ban on transferring detainees to the United States and mandating such transfers when detainees present with medical conditions that cannot be adequately evaluated and treated at Guantanamo; ensuring detainees have timely access to all of their medical records upon request while otherwise maintaining confidentiality of those records (especially with regard to access by prosecutors); and allowing meaningful and regular access to Guantanamo by civilian medical experts, including permitting such experts to evaluate detainees in an appropriate setting. If the United States declines to take the steps this report recommends, complex medical conditions that cannot be managed at Guantanamo should be expected to accelerate in frequency and escalate in severity. Details: New York: Physicians for Human Rights and The Center for Victims of Torture, 2019. 58p. Source: Internet Resource: Accessed July 19, 2019 at: https://phr.org/wp-content/uploads/2019/06/PHR_CVT-Guantanamo-medical-crisis-report-June-2019-1.pdf Year: 2019 Country: United States URL: https://phr.org/our-work/resources/deprivation-and-despair/ Shelf Number: 156815 Keywords: DetaineeDetentionGuantanamoHuman Rights AbusesMedical CarePrison ConditionPrisonersTorture |
Author: Physicians for Human Rights Title: Not in my Exam Room: How U.S. Immigration Enforcement is Obstructing Medical Care Summary: Across communities that line the United States' southern border with Mexico, U.S. immigration enforcement actions in or near hospitals, clinics, and other health care facilities are putting increasing pressure on medical professionals to compromise patient care. Customs and Border Patrol agents conduct searches in hospital parking lots and hold ambulances at checkpoints while critically ill patients languish inside. Agents arrest patients about to undergo surgery, stand guard and refuse to unshackle patients during medical evaluations, and send undocumented patients into detention directly from hospitals, at times putting safe medical discharge into question. U.S. and international laws protect the right to nondiscriminatory access to health care for all individuals. But, in certain instances, loopholes permit enforcement actions in medical facilities which interfere with this right and with the ethical obligation of medical professionals to provide care. Through consultations with medical professionals in border communities and across the United States, as well as through desk research, Physicians for Human Rights (PHR) has uncovered cases of egregious violations where medical advice was ignored and patients undergoing urgent treatment were arrested and their treatment impeded. While amending laws and adopting new ones would help solve this problem, there are measures that the medical community can take immediately to help protect patients and providers. This brief examines the impact of enforcement actions on access to health care for hospitalized immigrants, whether in the community or in government custody. It also serves as a resource for policymakers, medical associations, and medical professionals to take concrete action and to advocate for policy solutions, including the notion of creating "sanctuary" or "safe space" hospitals. Details: New York: Physicians for Human Rights, 2019. 20p. Source: Internet Resource: Accessed July 19, 2019 at: https://phr.org/wp-content/uploads/2019/06/Not-in-my-Exam-Room_-PHR-Sanctuary-Hospitals-June-2019.pdf Year: 2019 Country: United States URL: https://phr.org/our-work/resources/not-in-my-exam-room/ Shelf Number: 156816 Keywords: Customs and Border Patrol Health Care Illegal Immigration Immigration Enforcement Immigration Policy Medical Care |