J. Matthew Webster

Substance Use, Health, and Mental Health: Problems and Service Utilization Among Incarcerated Women

This article profiles self-reported substance use, health, and mental health problems among a sample of incarcerated women in Kentucky as well as lifetime service utilization. Findings indicate that a high percentage of women reported use of alcohol, cocaine, and multiple substances during the month before incarceration. In addition, participants reported common health problems such as dental, female reproductive, physical injuries, and mental health problems including depression and anxiety. Participants reported moderate use of emergency room and mental health treatment but limited substance abuse treatment utilization. Implications for criminal justice programs and linkages with community-based aftercare services for women are recommended based on findings that health and mental health problems are associated with service utilization before incarceration.

The Effect of a Favor on Public and Private Compliance: How Internalized is the Norm of Reciprocity?

The norm of reciprocity requires that we repay in kind what another has done for us. This study examined the degree that social (public) and internal (private) consequences of reciprocation helped to explain both the power and the prevalence of the norm. Participants were randomly assigned to conditions in which they were or were not given a small favor, and then were asked to comply with a request. Participants expected that the favor-doer would either know or not know whether they complied with the request. We found support for both public and private reasons for reciprocation, as the presence of a favor appeared to increase compliance in both public and private conditions. In addition, public compliance was greater than private compliance.

Treatment Retention Predictors of Drug Court Participants in a Rural State

Factors distinguishing clients who complete drug court treatment from those who do not complete drug court have been documented, but differences between urban and rural drug court participants have not been examined. The present study focuses on examining mental health, drug use, criminal activity, and education/employment as factors that are associated with treatment retention, which is measured by graduation from a rural and urban drug court. Study findings indicate that for the urban drug court, marital status, employment, drug use, and criminal activity predicted graduation. For the rural drug court, however, graduation was only predicted by age and juvenile incarceration. Findings from this study suggest there are different factors associated with drug court retention/graduation between urban and rural drug court settings. It is suggested that drug court administrators and other could use this information to better assess potential participants and to target services.

The Roles of Praise and Social Comparison Information in the Experience of Pride

Abstract The authors examined the roles of social comparisons, publicity of success, and praise on the experience of pride in an experiment in which college students successfully completed a timed intelligence task in private and later received 1 of 4 types of feedback from the experimenter: no feedback (private), mere public acknowledgment of completion, general praise containing both a public and an evaluative component, or praise containing explicit comparison information. Half of the participants also received written normative information suggesting they performed at a high level. Participants then completed a number of dependent measures, including a key measure of pride. Overall, results suggest that the public aspect of a performance, together with the superior standing suggested by any praise accompanying this publicity, is important in the experience of pride.

Differences in Prevalence of Prescription Opiate Misuse Among Rural and Urban Probationers

We compared the prevalence of prescription opiate misuse among 2 cohorts of felony probationers (N = 1525). Multiple logistic regression was utilized to determine the independent correlates of prescription opiate misuse among rural (n = 782) and urban (n = 743) probationers participating in an HIV-intervention study. After adjustment for differences in demographic and drug use characteristics, rural participants were almost five times more likely than their urban counterparts to have misused prescription opiates. The prevalence of prescription opiate misuse was significantly higher among the rural probationers; however, given the paucity of illicit opiates and relatively recent emergence of prescription opiates in rural areas, rural substance abuse treatment may be ill-prepared to treat prescription opiate misuse.

Alcohol and Drug Use among Rural and Urban Incarcerated Substance Abusers

A number of prisoners use drugs. Limited information is available about the extent to which urban and urban substance abusers differ in their drug use in criminal justice settings. In addition, many believe that rural areas are protected from drug use. However, findings from this study show only marginally statistical significant differences in drug use between incarcerated rural and urban drug users. It was expected that urban drug users would be more drug career involved with consistently higher levels of drug use and associated problems. Specifically, rural drug users in this study were older at age of first use of marijuana and cocaine; report fewer years of cocaine, hallucinogen, and heroin use; and report more alcohol and sedative use. Findings from this study suggest that rural and urban drug users are similar and that rural areas may be protective from some drug use but risky for other drug use.

An Exploratory Examination of Spiritual Well-Being, Religiosity, and Drug Use Among Incarcerated Men

ABSTRACT This study examines the relationships among spirituality, religiosity, and drug use among incarcerated males. Data were collected from 661 male prison inmates from four Kentucky State Correctional facilities. Spiritual well-being was measured using a modified version of the Spiritual Well-Being Scale (SWBS), and religiosity was measured by worship attendance in the year prior to incarceration. In general, spirituality and religiosity were found to be negatively related to alcohol and drug use, and differed across several individual characteristics that were included in the analysis. Given the relationship between spiritual well-being and religiosity to individual characteristics, such as age and race reported in this study, it is suggested that individual characteristics be considered when examining spirituality and drug use patterns.

Treatment motivation and therapeutic engagement in prison-based substance use treatment.

Abstract Studies of community-based substance use treatment show that motivation for treatment is critical for clients becoming therapeutically engaged. Little research, however, has been conducted on therapeutic engagement in corrections-based substance use treatment. The current study examines the association between internal treatment motivation and therapeutic engagement for a sample of 220 male substance-using offenders enrolled in a corrections-based treatment program. Findings showed that problem recognition and desire for help were associated with cognitive indicators of therapeutic engagement, specifically confidence in and commitment to treatment. Increased focus on internal motivation for treatment may lead to more effective treatment for substance-using offenders. Pretreatment motivational interventions therefore are recommended for substance-using offenders with low internal motivation for treatment.

Prisoners with Substance Abuse and Mental Health Problems: Use of Health and Health Services

Individuals with substance abuse and mental health problems are common in prisons and jails, but relatively little is known about the health or health services utilization of inmates with these types of problems. This study, therefore, focuses onprisoners who self-reported receiving a prior diagnosis from a physician or a psychologist who indicated they had 1) substance abuse problems only, 2) mental health problems only, and 3) substance abuse and mental health problems. A fourth group of prisoners who reported no diagnoses were included as the “no problems” group. Comparisons were made on reports of lifetime health problems, use of preventive health services, and use of medical services. Findings showed the substance abuse and mental health problems group had the most serious health problems profiles. Use of preventive health services was similar across all four groups, but the substance abuse and mental health problems group reported significantly greater use of the emergency room and more hospital stays both for their lifetime and in the year prior to their current incarceration. The policy and practical relevance of the findings are discussed.

A Prospective Examination of High-cost Health Services Utilization among Drug using Prisoners Reentering the Community

The use of health services by prisoners during their incarceration and after their return to the community impacts the U.S. health care system and health care costs associated with this system. These health care costs are expected to increase over the next decade as more prisoners return to their communities. The current study prospectively examines the use of high-cost health care services—emergency room visits and hospitalizations—among 565 male drug-abusing prisoners about 1 year after prison release. A series of structural equation models were used to examine predisposing factors, including health status and drug use, and to estimate the frequency of high-cost health service utilization. As expected, health status was the most robust predictor of high-cost health services. However, the finding that drug abuse had nonsignificant relationships with high-cost health services utilization was not expected. Discussion focuses on health care service issues and health problems as prisoners’ transition from prison to the community.