Perceived anxiety and depression and associated factors among women inmates with a long-term sentence in Thailand.

BACKGROUND: In Thailand, the growing prevalence of mental health problems among the increasing number of adult female prisoners has emerged as a significant public health concern. However, studies on the health of women prisoners are primarily conducted in Western societies, and studies in other countries are rare. Thailand, a non-western country, is no exception to this. OBJECTIVES: The objectives of this study were to assess the current levels of anxiety and depression among women drug offenders in Thailand and to identify possible associated factors. METHODS: Data were collected from a sample consisting of 554 women drug offenders serving sentences of eight years or more. Stratified random sampling with proportionate stratification was employed during the data collection. The female inmates were being held in three categories of prisons: correctional institutions, central prisons, and provincial prisons. A single question was used to measure self-perceived levels of anxiety and depression: none, moderate, or substantial. Ordered logit regression was employed in the data analysis. FINDINGS: One out of five (21.1%) of the inmates in the sample reported no perceived current anxiety and depression, 61.7% reported moderate anxiety and depression, and 17.1% reported having substantial perceived levels of anxiety and depression. It was found that chronic health conditions or disease, concerns about economic status, and feelings of shame were associated with the perceived anxiety and depression reported by the inmates. CONCLUSION: The study's findings suggest that integrated mental health services that emphasize a holistic approach that acknowledges the intersectionality of women's mental health and societal gender roles should be provided in prisons. Regular mental health screening and accessible mental health services are essential for all incarcerated women. Empowerment programs during confinement can boost self-esteem and thus lead to better post-release outcomes. The government should also implement programs to alleviate the financial burden on prisoners' households.

Passport to Freedom: A Trauma-Informed Mindfulness Program for Previously Incarcerated Women.

Poly-victimization is often reported by formerly incarcerated women and leads to physical and mental health problems that interfere with daily functioning, sustained employment, and housing stability. Although reentry programs exist, few focus on the physical and emotional impact of multiple traumas. Passport to Freedom (P2F), a woman-centered, trauma-informed reentry program, was developed to support formerly incarcerated women. The pilot intervention, performed in 2017, focused on the connections between trauma and health, coping with symptoms, and managing one's own health. To examine the effectiveness and feasibility of the intervention, we performed the current mixed methods study with two phases: (1) focus groups, and (2) sessions combining mindfulness and health promotion activities with follow-up evaluations. Participants (N = 24) showed decreased symptoms of depression and concerns of everyday stressors after the intervention. Of participants, 84% (n = 16) reported practicing mindfulness and 63% (n = 8) stated that mindfulness exercises helped with daily stress management. The P2F program offers a promising approach to support formerly incarcerated women with health self-management. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 18-26.].

Integrated Safety and Health Promotion among Correctional Workers and People Incarcerated: A Scoping Review.

Improving safety and health for correctional workers and people who are incarcerated are widespread yet separate initiatives. Correctional workers and people who are incarcerated experience similar challenges involved with poor workplaces and living conditions, including mental health crises, violence, stress, and chronic health issues, and the available resources lack integration with respect to safety and health promotion. This scoping review sought to contribute to an integrated approach for correctional system safety and health resources and identify studies of correctional resources that address health promotion among correctional workers and people who are incarcerated. Guided by PRISMA, a search of gray literature, also termed peer-reviewed literature, published between 2013-2023 (n = 2545) was completed, and 16 articles were identified. Resources primarily targeted individual and interpersonal levels. At every level of intervention, resources improved the environment for both workers and those incarcerated, with trends of less conflict, more positive behaviors, and improved relations, access to care, and feelings of safety. The corrections environment is impacted by changes from both workers and people who are incarcerated and should be examined using a holistic approach. Future health and safety resources should target the larger correctional environment by utilizing practices, policies, and procedures to improve safety and health for incarcerated people and workers.

The relationship between self-forgiveness and psychological wellbeing in prison inmates: The mediating role of mindfulness.

BACKGROUND: Previous research with general population samples has consistently shown that forgiveness and mindfulness facilitate coping with distressing experiences and significantly promote mental health. No study, however, has examined their unique contribution to prisoners' psychological wellbeing nor has considered the different forms of self-forgiveness among prisoners. AIMS: Our aim was to investigate the role of mindfulness in mediating any association between prisoners' self-forgiveness and psychological wellbeing and to test whether any such links are moderated by years spent in prison. In this study self-forgiveness was conceptualised as a multidimensional construct, including presence of genuine self-forgiveness, absence of pseudo self-forgiveness and/or absence of self-punitiveness. METHODS: Participants were recruited from a prison in Northern Italy. Consenting men were asked to complete an anonymous self-report questionnaire with only a researcher present. RESULTS: 104 male prisoners (mean age 46.63 years, SD 11.38) took part. Findings were that self-punitiveness was inversely related to well-being, with mindfulness mediating this relationship, this while controlling for the other dimensions of self-forgiveness and the perceived severity of the crime committed. Contrary to expectation, we found no direct relationship between genuine self-forgiveness and well-being, but the moderated mediation models showed that genuine self-forgiveness was positively associated with mindfulness and, through this, had an indirect association with wellbeing, significant only for prisoners who had already spent several years in prison. CONCLUSIONS: Our findings confirm that self-forgiveness is a complex construct, worthy of further investigation among offenders. They suggest that forgiveness interventions for prisoners should include modules aimed at primarily reducing self-punitive attitudes. Promotion of genuine self-forgiveness should be tried only with awareness that this is likely to take a very long time. In such circumstances, interventions may promote energy to be invested in mindful processes with a consequent improvement in psychological wellbeing.

Creative IDEA: Introducing a Statewide Art Therapy in Prisons Program.

Education is regarded as an avenue for success while the under-educated are disproportionately more likely to be incarcerated and remain within the correctional system. Current prison reforms have focused on increasing access to educational programming. However, these programs are not designed to address the lack of control, poor self-regulation, low emotional intelligence, inadequate social skills, or lack of internal motivation that hinder progress. Art therapy has been found effective in mitigating these impediments. Recognizing this, a partnership arose between a state Department of Corrections and a State University's graduate art therapy program out of which emerged an Art Therapy in Prisons Program, funded through the Individuals with Disabilities Education Act. Two art therapists provided services to youthful male and female offenders in four institutions to assuage these obstacles. This article explores the genesis and development of this program, and the flexible adjustments required to address the impending COVID-19. We conclude how those who participated did indeed demonstrate improvement.

Exposure to Family Member Incarceration and Adult Well-being in the United States.

Importance: More than half of the adult population in the United States has ever had a family member incarcerated, an experience more common among Black individuals. The impacts of family incarceration on well-being are not fully understood. Objective: To assess the associations of incarceration of a family member with perceived well-being and differences in projected life expectancy. Design, Setting, and Participants: This nationally representative cross-sectional study used data from the 2018 Family History of Incarceration Survey to examine how experiences of family member incarceration were associated with a holistic measure of well-being, including physical, mental, social, financial, and spiritual domains. Well-being was used to estimate change in life expectancy and was compared across varying levels of exposure to immediate and extended family member incarceration using logistic regression models to adjust for individual and household characteristics. Data were analyzed from October 2019 to April 2020. Exposures: Respondents' history of family member incarceration, including immediate and extended family members. Main Outcomes and Measures: The main outcome was self-reported life-evaluation, a measure of overall well-being from the 100 Million Healthier Lives Adult Well-being Assessment. Respondents were considered thriving with a current life satisfaction score of 7 or greater and a future life optimism score of 8 or greater, each on a scale of 0 to 10. Other outcomes included physical health, mental health, social support, financial well-being, and spiritual well-being, each measured with separate scales. Additionally, life expectancy projections were estimated using population-level correlations with the Life Evaluation Index. All percentages were weighted to more closely represent the US population. Results: Of 2815 individuals included in analysis, 1472 (51.7%) were women, 1765 (62.8%) were non-Hispanic White, and 868 (31.5%) were aged 35 to 54 years. A total of 1806 respondents (45.0%) reported having an immediate family member who was incarcerated. Compared with respondents with no family incarceration, any family member incarceration was associated with lower well-being overall (thriving: 69.5% [95% CI, 65.0%-75.0%] vs 56.9% [95% CI, 53.9%-59.9%]) and in every individual domain (eg, physical thriving: 51.1% [95% CI, 46.2-56.0] vs 35.5% [95% CI, 32.6%-38.3%]) and with a mean (SE) estimated 2.6 (0.03) years shorter life expectancy. Among those with any family incarceration, Black respondents had a mean (SE) estimated 0.46 (0.04) fewer years of life expectancy compared with White respondents. Conclusions and Relevance: These findings suggest that family member health and well-being may be an important avenue through which incarceration is associated with racial disparities in health and mortality. Decarceration efforts may improve population-level well-being and life expectancy by minimizing detrimental outcomes associated with incarceration among nonincarcerated family members.

Nurse-led mind-body relaxation intervention in prison: A multiperspective mixed-method evaluation.

BACKGROUND: Mind-body relaxation techniques are complementary or alternative to medication to manage high stress and anxiety levels in prisons. PURPOSE: To assess the motivation to attend and perceived benefits of a nurse-led group relaxation intervention in prison, investigate the experience of participants, prison officers, and health professionals, and identify improvements. METHOD: Exploratory study was conducted in a post-trial facility in Switzerland using a multiperspective convergent parallel mixed method drawing from participatory action research principles. FINDINGS: Reasons for attendance included back problems, mental tension, physical fitness, relaxation, and sleep problems. Perceived benefits comprised autonomy in self-practice, decreased physical tensions and anxiety, and improvement of sleep and physical fitness. Qualitative findings converged highlighting the importance of body-centering, relaxation as an alternative to medication, negative representations about relaxation sessions (useless, effeminate), and recommendations for improvement, including audio-visual support for self-practice. DISCUSSION: Long-standing mind-body relaxation interventions led by nurses in groups may offer participants a beneficial and operationally feasible complement to stress management in prisons.

Exploring the Benefit of Yoga Programs in Carceral Settings.

This article presents a perspective on the value of yoga and mindfulness programming in carceral settings. The authors explore this topic through interviews with two formerly incarcerated people who participated in yoga programming while incarcerated and who went on to become yoga instructors themselves. Also examined are the potential effects of yoga programming for people who are incarcerated, for those working within carceral settings, and on carceral environments generally. We share recommendations for implementing yoga programming in carceral institutions and discuss policy implications. The stories of both interviewees reflect the value and potential positive effects of yoga programming within criminal justice settings and suggest the need for sustained programming and ongoing empirical evaluation.

Prisoners Helping Prisoners Change: A Study of Inmate Field Ministers Within Texas Prisons.

Research on incarcerated offenders trained to help prisoners change is rare because programs that equip inmates with practical capacities for helping others rehabilitate in prison hardly exist. An exception is the Field Ministry program in Texas, which enlists inmates who have graduated from a prison-based seminary to work as "Field Ministers" and serve other inmates in various capacities. We hypothesize that inmate exposure to Field Ministers is inversely related to antisocial factors and positively to prosocial ones. We applied manifest-variable structural equation modeling to analyze data from a survey of a random sample of male inmates at three maximum-security prisons where the Field Ministry program operated. We found that inmates exposed more frequently to the Field Ministry and for a longer time period tended to report lower levels of criminological risk factors and aggressiveness and higher levels of virtues and predictors of human agency as well as religiosity and spirituality.

A randomized clinical trial of motivational interviewing plus skills training vs. Relaxation plus education and 12-Steps for substance using incarcerated youth: Effects on alcohol, marijuana and crimes of aggression.

BACKGROUND: Motivational Interviewing plus Cognitive Behavior Therapy (MI/CBT) has been used to reduce adolescent substance use, but has rarely been applied in youth correctional settings. This trial compared MI/CBT against Relaxation Training plus Substance-Education/12-Steps (RT/SET) to reduce substance use and crime among incarcerated youth. METHODS: Participants (N = 199) were incarcerated juveniles (64.8 % non-White, 10.1 % girls, mean age of 17.1 years). Two individual sessions of MI (or RT) were followed by 10 group sessions of CBT (or SET). Youth were randomized to condition with follow-ups at 3- and 6-months after release. Major outcomes included alcohol, marijuana and crimes involving aggression. RESULTS: A marginal treatment by time interaction was found for percent heavy drinking days, with follow-up tests indicating less alcohol use in RT/SET than MI/CBT at 6 months, and increased use within MI/CBT from 3 to 6 months. A significant treatment by time interaction was found for alcohol-related predatory aggression, with follow-up tests indicating fewer youth engaged in this behavior from 3 to 6 months within RT/SET, and weak evidence favoring MI/CBT over RT/SET at 3 months. General predatory aggression decreased from 3 to 6-months for both treatments. CONCLUSIONS: Although weak evidence was found favoring MI/CBT with respect to alcohol-related predatory aggression, results generally support RT/SET in reducing percent heavy drinking days.

Examining the role of depression in the Filipino elderly's food preferences in prison setting: data from conjoint analysis and SEM.

PURPOSE: Previous studies suggest that the care for elderly prisoners is a growing problem. The emerging phenomenon such as the correctional ageing crisis is an urgent concern that needs to be collectively and holistically addressed from a multi-sectoral perspective. In a developing country, like the Philippines, where prison congestion is alarming, the need for more empirical investigations that probe into the prison life and services is warranted to better inform penal policy and practice that would improve health outcomes among incarcerated individuals. The purpose of this study is to examine the extent to which depression among Filipino elderly prisoners shape their food choices. DESIGN/METHODOLOGY/APPROACH: A survey of 160 Filipino elderly prisoners of age 60 and above from October to November 2018 was conducted using a three-part research instrument, which consists of a personal and nutrition-related checklist, 15-point geriatric depression scale and a set of cards that were ranked and sorted through the balanced incomplete block design. FINDINGS: Results of the survey were subjected to conjoint analysis and structural equation modeling using the Statistical Package for the Social Sciences 24. Interestingly, taste was the most considered attribute (30.765%) while portion size (9.759%) is the least considered by the Filipino elderly prisoners. Notably, depression has a significant positive effect on their food preferences in all attributes except portion size. RESEARCH LIMITATIONS/IMPLICATIONS: This study was limited to two prison settings in the Philippines. Considering the results from the conjoint analysis, strategies can be developed in designing an individualized meal plan suitable for the needs of each elderly prisoner. Also, sizeable government appropriations should be in place to ensure the nutritional quality of food served to aging Filipino prisoners. PRACTICAL IMPLICATIONS: Provisions for a pool of nutritionists working hand in hand with other health members would guarantee a prison system that promotes the overall well-being of each prisoner. Further, this study can contribute valuable inputs in the menu cycle practice of prisons in the country. There may be a need to prioritize the nutritional aspect of these vulnerable and deprived groups so as to promote a better quality of life among elderly prisoners. Also, other forms of psychosocial, physical and spiritual health activities extended to elderly prisoners may prevent depressive symptoms. ORIGINALITY/VALUE: Conjoint analysis is remarkably gaining prominence in not only the health-care setting (Phillips et al., 2002; Ryan and Farrar, 2000) but also the field of nutrition. It holds a number of unique and practical promises to prison settings.

Compassion meditation increases optimism towards a transgressor.

Past research reveals important connections between meditative practices and compassion. Most studies, however, focus on the effects of one type of meditation (vs. a no-intervention control) on a single expression of compassion (e.g. offering a seat) towards a relatable target (e.g. a person on crutches), without exploring possible mechanisms. Hence, few studies include different types of meditation, active controls, multiple ways to express compassion, unrelatable targets, and potential mediators. To this end, the present study compared the effects of mindfulness meditation with those of compassion meditation on different expressions of compassion towards a convicted murderer. Seventy-four participants were randomly assigned to a mindfulness meditation, compassion meditation, or active control class, or a no-class control. After an 8-week programme, we assessed compassion by giving participants the option of fulfilling a murderer's request that they write him and then coding those letters for empathy, sympathy, forgiveness, and optimism. Participants in the compassion meditation class wrote more optimistic letters compared to participants in the other three conditions, in part because they valued positivity more. No statistically significant differences emerged for the other expressions of compassion. We discuss the implications of these findings for our understanding of how meditation increases compassion towards unrelatable targets.

Fostering spiritual resilience and vitality in formerly incarcerated persons of African American descent.

The process of reentry for formerly incarcerated persons can be a burdensome, stigma-laden transition, and any difficult transition requires resilience. African Americans-the group most impacted by incarceration trauma-commonly depend on faith leaders in times of crisis to provide meaning, encouragement, and guidance, fostering spiritual resilience. This study conceptualizes spiritual resilience and proposes it as a vital quality for successful reentry; giving credence to the significant role clergy and pastoral clinicians play in mediating restorative reintegration.

Holistic primary health care for Aboriginal and Torres Strait Islander prisoners: exploring the role of Aboriginal Community Controlled Health Organisations.

OBJECTIVE: Aboriginal and Torres Strait Islander Community Controlled Health Organisations (ACCHOs) have been identified as having an important role in improving the health and wellbeing of individuals in prison; however, a lack of information exists on how to strengthen this role. This paper explores the experiences of ACCHO staff in primary health care to individuals inside or leaving prison. METHODS: Nineteen staff from four ACCHOs were interviewed. ACCHO selection was informed by proximity to prisons, town size and/or Local Government Area offending rates. Thematic analysis of the interviews was undertaken. RESULTS: While most ACCHOs had delivered post-release programs, primary health care delivery to prisoners was limited. Three themes emerged: i) a lack of access to prisoners; ii) limited funding to provide services to prisoners; and iii) the need for a team approach to primary health care delivery. CONCLUSION: A holistic model of care underpinned by a reliable funding model (including access to certain Medicare items) and consistent access to prisoners could strengthen ACCHOs' role in primary health care delivery to people inside or leaving prison. Implications for public health: ACCHOs have an important role to play in the delivery of primary health care to prisoners. Existing models of care for prisoners should be examined to explore how this can occur.

Designing 'Healthy' Prisons for Women: Incorporating Trauma-Informed Care and Practice (TICP) into Prison Planning and Design.

There has been growing acknowledgment among scholars, prison staff and policy-makers that gender-informed thinking should feed into penal policy but must be implemented holistically if gains are to be made in reducing trauma, saving lives, ensuring emotional wellbeing and promoting desistance from crime. This means that not only healthcare services and psychology programmes must be sensitive to individuals' trauma histories but that the architecture and design of prisons should also be sympathetic, facilitating and encouraging trauma-informed and trauma-sensitive practices within. This article problematises the Trauma-Informed Care and Practice (TICP) initiatives recently rolled out across the female prison estate, arguing that attempts to introduce trauma-sensitive services in establishments that are replete with hostile architecture, overt security paraphernalia, and dilapidated fixtures and fittings is futile. Using examples from healthcare and custodial settings, the article puts forward suggestions for prison commissioners, planners and architects which we believe will have novel implications for prison planning and penal practice in the UK and beyond.

Producing food in English and Welsh prisons.

Most prison food research focuses on aspects of consumption rather than production yet farming, horticulture and gardening have been integral to the prison system in England and Wales for more than 170 years. This paper explores the interplay between penological, therapeutic and food priorities over the last fifty years through an examination of historical prison policies and contemporary case studies associated with the Greener on the Outside for Prisons (GOOP) programme. Findings are discussed in relation to how joined-up policy and practice can impact positively on whole population health and wellbeing within and beyond the prison setting.

Escaping the Prison of Mind: Meditation as Violence Prevention for the Incarcerated.

People in prison are disproportionately affected by health problems, some of which lead to imprisonment and some of which are caused by imprisonment. Mental illness and substance use disorders fall into both of these categories, but they are not the only ailments affiliated with incarceration. Prior to their incarceration, many people in prison did not have safe housing or stable employment and job security, and institutional policies and/or budgetary concerns prevent many inmates from receiving adequate health care while in prison. Prison inmates in the United States are both victims and perpetrators of violence while incarcerated. In all cases, acts of violence have negative psychological consequences for the victim, including depression and shame. Mindfulness meditation training for prison inmates might be among the most effective of interventions, helping to prevent violence, improve quality of life, and reduce recidivism. Research and evaluation of data suggest that mindfulness-based nonviolence programs are transferable to other inmate populations, and the author recommends that both the private and public prison systems implement such programs nationwide, with the support of state and federal governments.

Is food more than a means of survival? An overview of the Balkan prison systems.

Food is a versatile national, social, and cultural marker. It represents more than just a means of survival (Stajcic, 2013); it is an expression of identity (Jones, 2017). Food has a symbolic power and carries a sense of community, relays customs, habits, and values. According to Godderis (2006), people "do" food. In institutional settings, such as prisons, often stripped of basic human rights and dignity, food can acquire yet another dimensions. It can become a means to pass time, regain normalcy, and cope with daily hardships. Despite its multifaceted importance, there is a paucity of research on prisoners' diet, with most being done on the US, UK, and Scandinavian prison systems (Smoyer, 2019; Smoyer & Kjaer Minke, 2015). This article drew from academic and non-academic sources (e.g., government reports, newspaper articles, prison blogs) to provide an overview of the Balkan prison systems through the lens of food. It will present weekly menus from three different countries and discuss alternative ways of accessing food in prisons (i.e., through prison commissary, prison farms, and food packages). It will further demonstrate prisoners' use of food to regain autonomy in the context of multiple deprivations. Lastly, this paper will reflect on the role of food, coffee, and cigarettes in prisoners' socialization, as well as in reiteration of prisoner subculture.

Animal-assisted therapy in a Canadian psychiatric prison.

PURPOSE: Prison-based animal programs are becoming increasingly common in North America. The majority focus on community and animal well-being, with less explicit therapeutic goals for human participants. The purpose of this paper is to measure the objectives of a canine animal-assisted therapy (AAT) program in a Canadian psychiatric prison and examine whether the program supports inmates' correctional plans. DESIGN/METHODOLOGY/APPROACH: A modified instrumental case study design was applied with three inmates over a 24-AAT-session program. Quantitative and qualitative AAT session data were collected and mid- and end-of-program interviews were held with the inmates, their mental health clinicians and the therapy dog handlers. FINDINGS: Inmates connected with the therapy dogs through the animals' perceived offering of love and support. This development of a human-animal bond supported inmates' correctional plans, which are largely situated within a cognitive-behavioral skill development framework. Specifically, inmates' connections with the therapy dogs increased recognition of their personal feelings and emotions and positively impacted their conduct. RESEARCH LIMITATIONS/IMPLICATIONS: The findings suggest that prison-based AAT programs emphasizing inmate mental well-being, alongside that of animal and community well-being generally, merit further exploration. It would be worthwhile to assess this AAT program with a larger and more diverse sample of inmates and in a different institutional context and also to conduct a post-intervention follow-up. ORIGINALITY/VALUE: This is the first study of a prison-based AAT program in a Canadian psychiatric correctional facility.

Mindfulness-Based Stress Reduction in Prison: Experiences of Inmates, Instructors, and Prison Staff.

Mindfulness intervention aims to reduce stress and to improve physical and mental health. The present study investigated feasibility and effectiveness of mindfulness intervention in a prison context, in both a qualitative and quantitative fashion. Specifically, the mindfulness-based stress reduction (MBSR) intervention was investigated, in a retrospective pre-post design, in five Dutch prisons. Twenty-two inmates (out of 25 approached, mean age: 40.1 years (SD = 11.1), convicted of murder, manslaughter, sexual offenses, drug offenses, robbery with violence, and/or illegal restraint/kidnap, and sentenced to incarceration between 15 and 209 months (M = 5.5 years; SD = 3.8) took part in a semistructured interview after completion of the MBSR intervention. The interviews addressed level of satisfaction and challenges regarding the MBSR intervention as well as potential effects on stress responsivity, coping style, impulse control, aggression, and self-esteem. Ten staff members and four MBSR instructors were interviewed about their own practical issues experienced while providing or facilitating the MBSR intervention, and about the effects or changes they observed in the inmates who underwent the intervention. Both participants and instructors/prison staff reported improvements in all of the addressed domains and expressed satisfaction with the intervention. Challenges were mainly identified in practical issues regarding the organization of the intervention sessions. Future studies should investigate mindfulness in longitudinal randomly controlled designs, should strive for a multi-method approach, and distinguish inmates according to personality characteristics.