by Traci Pedersen | Oct 18, 2019 | Advocacy and Policy, Brain and Behavior, Depression, Ethnicity, General, Health-related, LifeHelper, Mental Health and Wellness, Mortality, Prison, Psychiatry, Psychology, Psychology and Therapy News, reincarceration, Research, restrictive housing, Social Psychology, solitary confinement, Stress, Substance Abuse, suicide
Prisoners who are held in restrictive housing (i.e., solitary confinement) face an increased risk of death after their release, according to a new study led by researchers from the University of North Carolina (UNC) at Chapel Hill.
The findings show that incarcerated individuals who were placed in restrictive housing in North Carolina from 2000 to 2015 were 24% more likely to die in the first year after their release, compared to those who were not held in restrictive housing.
In addition, those held in restrictive housing were 78% more likely to die from suicide, 54% more likely to die from homicide, and 127% more likely to die from an opioid overdose in the first two weeks after their release.
Further, the number of restrictive housing placements and spending more than 14 consecutive days in restrictive housing were associated with an even greater increase in the risk of death and reincarceration.
“For the first time ever, using data shared with us from our partners at the North Carolina Department of Public Safety, we’ve been able to demonstrate a connection between restrictive housing during incarceration and increased risk of death when people return to the community,” said lead author Lauren Brinkley-Rubinstein, PhD, an assistant professor of social medicine in the UNC School of Medicine.
“In addition, our study found that the more time people spent in restrictive housing the higher the risk of mortality after release. This study provides empirical evidence to support ongoing nationwide reforms that limit the use of restrictive housing.”
“North Carolina is a leader in this thinking as the Department of Public Safety has preemptively implemented multiple reforms that have resulted in the limited use of restrictive housing.”
“We appreciate this research collaboration and recognize the importance of these results in shaping policy and practice,” said Gary Junker, PhD, Director of Behavioral Health for the N.C. Department of Public Safety Adult Correction and Juvenile Justice.
“Since 2015, the department has initiated several programs to divert people from restrictive housing, including Therapeutic Diversion Units for those with mental illness. While safety and security must remain our top priority, we recognize that reduced use of restrictive housing will likely improve post-release outcome.”
These findings, published in the journal JAMA Network Open, are from a retrospective cohort study conducted by Brinkley-Rubinstein and co-authors from UNC, Emory University, the N.C. Department of Public Safety and the N.C. Department of Public Health.
Incarceration data for people who were confined in North Carolina between 2000 and 2015 were matched with death records from 2000 to 2016.
“We also found that non-white individuals were disproportionately more likely to be assigned to restrictive housing than their white counterparts,” said co-author Shabbar Ranapurwala, PhD, MPH, an assistant professor of epidemiology in the UNC Gillings School of Global Public Health and a core faculty member of the UNC Injury Prevention Research Center.
“In fact, the mortality and reincarceration outcomes after release were also quite different between these racial groups. The post-release opioid overdose and suicide death outcomes among those receiving restrictive housing were more pronounced among white individuals compared to non-whites, while the all-cause and homicide death and reincarceration outcomes were higher among non-white Americans compared to whites.”
Given the observational nature of the study, establishing cause and effect may be difficult, yet, the strength and consistency of the findings points to the fact that restrictive housing is an important marker of increased mortality risk among formerly incarcerated individuals.
Source: University of North Carolina Health Care
by YouTube | Feb 22, 2019 | Advocacy and Policy, Assessment and Diagnosis, Brain and Behavior, Cognition, Depression, Emotion, General, Incarceration, IPT, Memory and Perception, Mental Health and Wellness, Prison, Psychiatry, Psychology, Psychology and Therapy News, Reentry, Research, Therapy
Around 4 million prisoners are released each year, and 23 percent of these have suffered from major depressive disorder (MDD). Due to a general lack of funding for mental health treatment in prison, these individuals often rejoin society in worse mental condition than before their incarceration.
But a new study led by Michigan State University shows that this scenario can be prevented with a cost-effective treatment approach designed specifically to improve mental health in prison.
The research, published in the Journal of Consulting and Clinical Psychology, tested the effectiveness of interpersonal psychotherapy (IPT) for inmates battling MDD as a strategy to bring affordable treatment into a prison setting. The study is the first large randomized trial of any treatment for MDD, including therapy or medications, in any incarcerated population.
“About 15 million people touch the criminal justice system each year in the United States,” said Jennifer Johnson, lead author and professor of public health in MSU’s College of Human Medicine. “Most of us have friends, family or neighbors who have been through this system. The fact we’ve waited until 2019 to conduct a trial like this means we’ve understudied and underserved a huge population.”
Prison funding for mental health care is determined by state legislatures, which often leaves them understaffed and under-resourced, Johnson says. In addition, voters may be unsympathetic, which creates a deficit for mental health treatment in the prison system — which houses many people with untreated mental illnesses.
For the study, Johnson and colleagues trained a team to treat 181 inmates through interpersonal psychotherapy. The team included master’s level health therapists working in the prisons and bachelor’s level re-entry counselors. This allowed the researchers to keep costs down by extending the reach of counselors and care without having to hire new mental health professionals.
IPT is one of the most-effective forms of therapy because it addresses difficult life events, which consistently burden prison populations, says Johnson. She explains that traumatic and challenging experiences — such as assault, abuse, poverty, death of loved ones and loss of family members, children and friends — are overwhelmingly present with those incarcerated.
“When practicing IPT, you go back to when someone’s depressed mood began and talk about what was going on in their life at that time,” Johnson said.
“IPT deals with relationships, feelings, conflicts with others, life changes and grief. Using this therapy, you’re helping people feel and express emotions, and problem-solve with them in ways to improve communications or improve relationships that address the original problem.”
Counselors worked in a group-setting with inmates twice a week for 10 weeks, which lowered treatment costs. Inmates were individually assessed at the beginning of the trial, after the trial ended and then again three months later to see if the therapy had a lasting impact.
“As compared to the usual treatment prisons offer, IPT reduced depressive symptoms, hopelessness and PTSD symptoms and was better at ending cases of major depression,” Johnson said.
Using IPT proved a low-cost intervention as well. Once counselors are trained and supervision is no longer needed, the cost per patient would be $575 — significantly less than treatment options outside of prison, Johnson says.
Source: Michigan State University
