Understanding African American Male Inmates’ Decisions to Seek Mental Health Treatment While Incarcerated

Incarceration in United States correctional facilities has significantly increased in the past decade (The Pew Charitable Trust, 2009). African American adult males are more likely to be incarcerated compared to all other major ethnic groups (U.S. Department of Justice, 2010). One of the current challenges experienced within correctional facilities is the need to provide appropriate mental health treatment services (U.S. Department of Justice, 2011). Studies have noted the need for such services, however, African American adult males generally are not likely to utilize these services (Morgan et al., 2004). In the general (not incarcerated) population, research has found that cultural mistrust (Ward, Clark, and Heidrich, 2009) and mental health stigma (Deane, Skogstad, and Williams, 1999) are barriers to utilization of mental health services by African Americans. However, there is insufficient research examining reasons why African American adult male inmates underutilize mental health services while incarcerated. The purpose of this study was to explore factors that influence African American male inmates’ decisions to seek mental health treatment while incarcerated. Twelve African American males who reported depressive symptoms at intake but who had not sought mental health services were interviewed. Topics explored in the study included (a) how participants defined and described symptoms of mental health problems, (b) participants’ experience of engaging in mental health treatment, (c) participants’ awareness of mental health treatment options during current incarceration, and (d) participants’ general views of mental health treatment for inmates. Grounded theory methodology (Strauss & Corbin, 1990) was used to analyze all data. Results revealed several major themes, including: descriptions of symptoms commonly associated with mental health problems, positive benefits of mental health treatment, and barriers to seeking mental health treatment while incarcerated (e.g., participants’ preference for alternative copings styles, a lack of trust and fear about mental health treatment staff). Participants’ narratives and the overall themes that emerged helped to provide an understanding of the reasons why African American inmates may or may not choose to utilize services in prison when experiencing symptoms of depression. Limitations of the study, as well as implications and directions for future research will be discussed

Prisoners' attitudes towards cigarette smoking and smoking cessation: a questionnaire study in Poland

BACKGROUND: In the last decade Poland has successfully carried out effective anti-tobacco campaigns and introduced tobacco control legislation. This comprehensive strategy has focused on the general population and has led to a considerable decrease in tobacco consumption. Prisoners constitute a relatively small part of the entire Polish population and smoking habits in this group have been given little attention. The aim of the study was to assess the prevalence of cigarette smoking in Polish male prisoners, factors determining smoking in this group, prisoners' attitudes towards smoking cessation, and to evaluate prisoners' perception of different anti-tobacco measures. METHODS: An anonymous questionnaire including personal, demographic and smoking data was distributed among 944 male inmates. Of these, 907 men aged between 17 and 62 years (mean 32.3 years) met the inclusion criteria of the study. For the comparison of proportions, a chi-square test was used with continuity correction whenever appropriate. RESULTS: In the entire group, 81% of the subjects were smokers, 12% – ex-smokers, and 7% – never smokers. Current smokers had significantly lower education level than non-smokers (p < 0.0001) and ever-smokers more frequently abused other psychoactive substances than never smokers (p < 0.0001). Stress was reported as an important factor in prompting smoking (77%). Forty-nine percent of daily smokers were aware of the adverse health consequences of smoking. The majority of smokers (75%) had attempted to quit smoking in the past. Forty percent of smoking prisoners considered an award for abstaining from cigarettes as the best means to limit the prevalence of smoking in prisons. CONCLUSION: The prevalence of cigarette smoking among Polish prisoners is high. However, a majority of smokers attempt to quit, and they should be encouraged and supported. Efforts to reduce cigarette smoking in prisons need to take into consideration the specific factors influencing smoking habits in prisons

Working Inside for Smoking Elimination (Project W.I.S.E.) study design and rationale to prevent return to smoking after release from a smoke free prison

<p>Abstract</p> <p>Background</p> <p>Incarcerated individuals suffer disproportionately from the health effects of tobacco smoking due to the high smoking prevalence in this population. In addition there is an over-representation of ethnic and racial minorities, impoverished individuals, and those with mental health and drug addictions in prisons. Increasingly, prisons across the U.S. are becoming smoke free. However, relapse to smoking is common upon release from prison, approaching 90% within a few weeks. No evidence based treatments currently exist to assist individuals to remain abstinent after a period of prolonged, forced abstinence.</p> <p>Methods/Design</p> <p>This paper describes the design and rationale of a randomized clinical trial to enhance smoking abstinence rates among individuals following release from a tobacco free prison. The intervention is six weekly sessions of motivational interviewing and cognitive behavioral therapy initiated approximately six weeks prior to release from prison. The control group views six time matched videos weekly starting about six weeks prior to release. Assessments take place in-person 3 weeks after release and then for non-smokers every 3 months up to 12 months. Smoking status is confirmed by urine cotinine.</p> <p>Discussion</p> <p>Effective interventions are greatly needed to assist these individuals to remain smoke free and reduce health disparities among this socially and economically challenged group.</p> <p>Trial Registration</p> <p><a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=01122589">NCT01122589</a></p

The severity of pandemic H1N1 influenza in the United States, from April to July 2009: A Bayesian analysis

Background: Accurate measures of the severity of pandemic (H1N1) 2009 influenza (pH1N1) are needed to assess the likely impact of an anticipated resurgence in the autumn in the Northern Hemisphere. Severity has been difficult to measure because jurisdictions with large numbers of deaths and other severe outcomes have had too many cases to assess the total number with confidence. Also, detection of severe cases may be more likely, resulting in overestimation of the severity of an average case. We sought to estimate the probabilities that symptomatic infection would lead to hospitalization, ICU admission, and death by combining data from multiple sources. Methods and Findings: We used complementary data from two US cities: Milwaukee attempted to identify cases of medically attended infection whether or not they required hospitalization, while New York City focused on the identification of hospitalizations, intensive care admission or mechanical ventilation (hereafter, ICU), and deaths. New York data were used to estimate numerators for ICU and death, and two sources of data - medically attended cases in Milwaukee or self-reported influenza-like illness (ILI) in New York - were used to estimate ratios of symptomatic cases to hospitalizations. Combining these data with estimates of the fraction detected for each level of severity, we estimated the proportion of symptomatic patients who died (symptomatic case-fatality ratio, sCFR), required ICU (sCIR), and required hospitalization (sCHR), overall and by age category. Evidence, prior information, and associated uncertainty were analyzed in a Bayesian evidence synthesis framework. Using medically attended cases and estimates of the proportion of symptomatic cases medically attended, we estimated an sCFR of 0.048% (95% credible interval [CI] 0.026%-0.096%), sCIR of 0.239% (0.134%-0.458%), and sCHR of 1.44% (0.83%-2.64%). Using self-reported ILI, we obtained estimates approximately 7-96lower. sCFR and sCIR appear to be highest in persons aged 18 y and older, and lowest in children aged 5-17 y. sCHR appears to be lowest in persons aged 5-17; our data were too sparse to allow us to determine the group in which it was the highest. Conclusions: These estimates suggest that an autumn-winter pandemic wave of pH1N1 with comparable severity per case could lead to a number of deaths in the range from considerably below that associated with seasonal influenza to slightly higher, but with the greatest impact in children aged 0-4 and adults 18-64. These estimates of impact depend on assumptions about total incidence of infection and would be larger if incidence of symptomatic infection were higher or shifted toward adults, if viral virulence increased, or if suboptimal treatment resulted from stress on the health care system; numbers would decrease if the total proportion of the population symptomatically infected were lower than assumed.published_or_final_versio

Regional Study of No-Till Impacts on Near-Surface Aggregate Properties that Influence Soil Erodibility

The extent to which tillage systems modify the near-surface soil aggregate properties aff ecting soil’s susceptibility to erosion by water and wind is not well understood. We hypothesized that an increase in soil organic carbon (SOC) content with conservation tillage systems, particularly no-till (NT), may improve near-surface soil aggregate properties that infl uence soil erodibility. This regional study assessed changes in aggregate resistance to raindrops, dry aggregate wettability, and dry aggregate stability as well as their relationships with changes in SOC content. Four long-term (\u3e19 yr) tillage systems including moldboard plow (MP), conventional till (CT), reduced till (RT), and NT were chosen across the central Great Plains at Hays and Tribune, KS, Akron, CO, and Sidney, NE. The kinetic energy (KE) of raindrops required to disintegrate 4.75- to 8-mm aggregates from NT soils equilibrated at −0.03 and −155 MPa matric potential was between two and seven times greater than that required for MP and CT soils in the 0- to 2-cm depth in all soils. At the same depth, the water drop penetration time (WDPT) in aggregates from NT soils was four times greater at Akron and Hays and seven times greater at Sidney and Tribune compared with that in plowed soils. Aggregates from NT soils were more stable under rain and less wettable than those from plowed soils particularly in the surface 0 to 5 cm, but RT had lesser beneficial effects than NT management. The SOC content increased with NT over MP and CT and explained 35% of the variability across soils in aggregate wettability and 28% of the variability in resistance to raindrops in the 0- to 2-cm depth. Aggregate wettability explained 47% of the variability across soils in KE of raindrops required for the disintegration of aggregates. No-till management did not affect dry aggregate-size distribution and stability except at Akron where mean weight diameter (MWD) in RT and NT was 50% lower than in MP management in the 0- to 2-cm depth. Aggregates in MP and CT soils were either stronger or equally strong when dry but less stable when wet than in NT soils. Overall, NT farming enhanced near-surface aggregate properties affecting erosion by water but had small or no effects on dry aggregate stability