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Examines the policy of deinstitutionalization of the mentally ill and what can be done about it.
Over the past four decades, the rate of incarceration in the United States has skyrocketed to unprecedented heights, both historically and in comparison to that of other developed nations. At far higher rates than the general population, those in or entering U.S. jails and prisons are prone to many health problems. This is a problem not just for them, but also for the communities from which they come and to which, in nearly all cases, they will return. Health and Incarceration is the summary of a workshop jointly sponsored by the National Academy of Sciences(NAS) Committee on Law and Justice and the Institute of Medicine(IOM) Board on Health and Select Populations in December 2012. Academics, practitioners, state officials, and nongovernmental organization representatives from the fields of healthcare, prisoner advocacy, and corrections reviewed what is known about these health issues and what appear to be the best opportunities to improve healthcare for those who are now or will be incarcerated. The workshop was designed as a roundtable with brief presentations from 16 experts and time for group discussion. Health and Incarceration reviews what is known about the health of incarcerated individuals, the healthcare they receive, and effects of incarceration on public health. This report identifies opportunities to improve healthcare for these populations and provides a platform for visions of how the world of incarceration health can be a better place.
The high rate of incarceration in the United States contributes significantly to the nation's health inequities, extending beyond those who are imprisoned to families, communities, and the entire society. Since the 1970s, there has been a seven-fold increase in incarceration. This increase and the effects of the post-incarceration reentry disproportionately affect low-income families and communities of color. It is critical to examine the criminal justice system through a new lens and explore opportunities for meaningful improvements that will promote health equity in the United States. The National Academies convened a workshop on June 6, 2018 to investigate the connection between incarceration and health inequities to better understand the distributive impact of incarceration on low-income families and communities of color. Topics of discussion focused on the experience of incarceration and reentry, mass incarceration as a public health issue, women's health in jails and prisons, the effects of reentry on the individual and the community, and promising practices and models for reentry. The programs and models that are described in this publication are all Philadelphia-based because Philadelphia has one of the highest rates of incarceration of any major American city. This publication summarizes the presentations and discussions of the workshop.
"Authored by academic, policy, and practice experts in this area, Criminal Justice and Mental Illness offers an overview of the changes in correctional policy and practice during the last decade that reflect an increased focus on community-based alternatives for offenders."--
Public Health Behind Bars From Prisons to Communities examines the burden of illness in the growing prison population, and analyzes the impact on public health as prisoners are released. This book makes a timely case for correctional health care that is humane for those incarcerated and beneficial to the communities they reenter.
After decades of stability from the 1920s to the early 1970s, the rate of imprisonment in the United States has increased fivefold during the last four decades. The U.S. penal population of 2.2 million adults is by far the largest in the world. Just under one-quarter of the world's prisoners are held in American prisons. The U.S. rate of incarceration, with nearly 1 out of every 100 adults in prison or jail, is 5 to 10 times higher than the rates in Western Europe and other democracies. The U.S. prison population is largely drawn from the most disadvantaged part of the nation's population: mostly men under age 40, disproportionately minority, and poorly educated. Prisoners often carry additional deficits of drug and alcohol addictions, mental and physical illnesses, and lack of work preparation or experience. The growth of incarceration in the United States during four decades has prompted numerous critiques and a growing body of scientific knowledge about what prompted the rise and what its consequences have been for the people imprisoned, their families and communities, and for U.S. society. The Growth of Incarceration in the United States examines research and analysis of the dramatic rise of incarceration rates and its affects. This study makes the case that the United States has gone far past the point where the numbers of people in prison can be justified by social benefits and has reached a level where these high rates of incarceration themselves constitute a source of injustice and social harm. The Growth of Incarceration in the United States examines policy changes that created an increasingly punitive political climate and offers specific policy advice in sentencing policy, prison policy, and social policy. The report also identifies important research questions that must be answered to provide a firmer basis for policy. This report is a call for change in the way society views criminals, punishment, and prison. This landmark study assesses the evidence and its implications for public policy to inform an extensive and thoughtful public debate about and reconsideration of policies.
Recent surveys demonstrate a high and possibly increasing prevalence of mental disorders in prisoners. They have an increased risk of suffering from a mental disorder that transcends countries and diagnoses. Ethical dilemmas in prison psychiatry arise from resource allocation and include issues of patient choice and autonomy in an inherently coercive environment. Ethical conflicts may arise from the dual role of forensic psychiatrists giving raise to tensions between patient care/protection of the public.This book describes models and ethical issues of psychiatric healthcare in prison in several countries. Relevant issues are: the professional medical role of a psychiatrist and/or psychotherapist working in prison, the involvement of psychiatrists in disciplinary or coercive measures; consent to treatment, the use of coercion in forcing a prisoner to undergo treatment, hunger strike, confidentiality. The book ends with consensus guidelines concerning good practice in Prison Psychiatry.
Every year, hundreds of thousands of jailed Americans leave prison and return to society. Largely uneducated, unskilled, often without family support, and with the stigma of a prison record hanging over them, many if not most will experience serious social and psychological problems after release. Fewer than one in three prisoners receive substance abuse or mental health treatment while incarcerated, and each year fewer and fewer participate in the dwindling number of vocational or educational pre-release programs, leaving many all but unemployable. Not surprisingly, the great majority is rearrested, most within six months of their release. What happens when all those sent down the river come back up--and out? As long as there have been prisons, society has struggled with how best to help prisoners reintegrate once released. But the current situation is unprecedented. As a result of the quadrupling of the American prison population in the last quarter century, the number of returning offenders dwarfs anything in America's history. What happens when a large percentage of inner-city men, mostly Black and Hispanic, are regularly extracted, imprisoned, and then returned a few years later in worse shape and with dimmer prospects than when they committed the crime resulting in their imprisonment? What toll does this constant "churning" exact on a community? And what do these trends portend for public safety? A crisis looms, and the criminal justice and social welfare system is wholly unprepared to confront it. Drawing on dozens of interviews with inmates, former prisoners, and prison officials, Joan Petersilia convincingly shows us how the current system is failing, and failing badly. Unwilling merely to sound the alarm, Petersilia explores the harsh realities of prisoner reentry and offers specific solutions to prepare inmates for release, reduce recidivism, and restore them to full citizenship, while never losing sight of the demands of public safety. As the number of ex-convicts in America continues to grow, their systemic marginalization threatens the very society their imprisonment was meant to protect. America spent the last decade debating who should go to prison and for how long. Now it's time to decide what to do when prisoners come home.
In the era of mass incarceration, over 600,000 people are released from federal or state prison each year, with many returning to chaotic living environments rife with violence. In these circumstances, how do former prisoners navigate reentering society? In Homeward, sociologist Bruce Western examines the tumultuous first year after release from prison. Drawing from in-depth interviews with over one hundred individuals, he describes the lives of the formerly incarcerated and demonstrates how poverty, racial inequality, and failures of social support trap many in a cycle of vulnerability despite their efforts to rejoin society. Western and his research team conducted comprehensive interviews with men and women released from the Massachusetts state prison system who returned to neighborhoods around Boston. Western finds that for most, leaving prison is associated with acute material hardship. In the first year after prison, most respondents could not afford their own housing and relied on family support and government programs, with half living in deep poverty. Many struggled with chronic pain, mental illnesses, or addiction—the most important predictor of recidivism. Most respondents were also unemployed. Some older white men found union jobs in the construction industry through their social networks, but many others, particularly those who were black or Latino, were unable to obtain full-time work due to few social connections to good jobs, discrimination, and lack of credentials. Violence was common in their lives, and often preceded their incarceration. In contrast to the stereotype of tough criminals preying upon helpless citizens, Western shows that many former prisoners were themselves subject to lifetimes of violence and abuse and encountered more violence after leaving prison, blurring the line between victims and perpetrators. Western concludes that boosting the social integration of former prisoners is key to both ameliorating deep disadvantage and strengthening public safety. He advocates policies that increase assistance to those in their first year after prison, including guaranteed housing and health care, drug treatment, and transitional employment. By foregrounding the stories of people struggling against the odds to exit the criminal justice system, Homeward shows how overhauling the process of prisoner reentry and rethinking the foundations of justice policy could address the harms of mass incarceration.
The distinguished historian of medicine Gerald Grob analyzes the post-World War II policy shift that moved many severely mentally ill patients from large state hospitals to nursing homes, families, and subsidized hotel rooms--and also, most disastrously, to the streets. On the eve of the war, public mental hospitals were the chief element in the American mental health system. Responsible for providing both treatment and care and supported by major portions of state budgets, they employed more than two-thirds of the members of the American Psychiatric Association and cared for nearly 98 percent of all institutionalized patients. This study shows how the consensus for such a program vanished, creating social problems that tragically intensified the sometimes unavoidable devastation of mental illness. Examining changes in mental health care between 1940 and 1970, Grob shows that community psychiatric and psychological services grew rapidly, while new treatments enabled many patients to lead normal lives. Acute services for the severely ill were expanded, and public hospitals, relieved of caring for large numbers of chronic or aged patients, developed into more active treatment centers. But since the main goal of the new policies was to serve a broad population, many of the most seriously ill were set adrift without even the basic necessities of life. By revealing the sources of the euphemistically designated policy of "community care," Grob points to sorely needed alternatives. Originally published in 1991. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.