Michele Staton

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.

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.

HEALTH SERVICE UTILIZATION AND VICTIMIZATION AMONG INCARCERATED FEMALE SUBSTANCE USERS

Women represent the fastest growing population of prison inmates, which has increased dramatically in the past decade. Generally, women use more health services than men but with limited access to health care, incarcerated women tend to experience multiple problems, including problems with drugs, alcohol, and victimization. The purpose of this exploratory qualitative study was to identify specific factors related to health, mental health, drug use, and violence among incarcerated female substance users. Perspectives from 34 females who participated in focus groups in prison are discussed. Key findings indicate that drug use, victimization, and living in a rural area were barriers to accessing health services. In addition, implications for interventions targeting women are presented. [Translations are provided in the International Abstracts Section of this issue.]

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.

Head injury among drug abusers: an indicator of co-occurring problems.

Abstract Alcohol and other drug use has been associated with traumatic brain injury both as a contributing factor to the injury and as a complicating factor for rehabilitation. Brain injury is associated with an increase in mental health and other problems that may be related to drug and alcohol abuse and that may influence recovery. This study examined self-reports of 661 drug-abusing inmates with self-reported head injury, health problems and mental health problems. Three groups were examined for this study: those having no head injury, one head injury, and two or more head injuries. Results indicate that inmates with head injuries had a significantly greater number of health problems, higher levels of alcohol and marijuana use, and significantly more mental health problems including depression, anxiety, suicidal thinking, and difficulties in concentrating and controlling violent behavior. This study suggests that questions regarding head injuries during assessment may identify drug abusers who need a treatment approach that accommodates their co-occurring problems and difficulties with processing and complying with treatment interventions.

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.

Substance Use and Intimate Violence Among Incarcerated Males

The purpose of this study was to examine substance use patterns among a sample of incarcerated males who report engaging in levels of intimate violence, as well as identifying similarities and differences in demographic, economic status, mental health, criminal justice involvement, relationships, and treatment factors for three groups of incarcerated males - those who report perpetrating low intimate violence, those who report perpetrating moderate intimate violence, and those who report perpetrating extreme intimate violence the year preceding their current incarceration. Findings indicated that low intimate violence groups perpetration consisted almost exclusively of emotional abuse. Moderately intimate violent males and extremely intimate violent males, however, report not only high rates of emotional abuse but physical abuse as well. The distinction between moderate and extremely violent groups was substantial. Findings also indicated that perpetrators at different levels of violence in this study did not vary significantly in age, employment history, marital status, or race. However, the three groups showed significant differences in three main areas: (1) cocaine and alcohol use patterns, (2) stranger violence perpetration and victimization experiences, and (3) emotional discomfort. Implications for substance abuse and mental health treatment interventions and for future research are discussed.

Exploring the Type-of-Crime Hypothesis, Religiosity, and Spirituality in an Adult Male Prison Population

This study examined the association between measures of spirituality and religiosity and characteristics of current criminal conviction in a male prison population. Spirituality was operationalized as spiritual well-being and existential well-being. Religiosity was operationalized as frequency of religious service attendance, whether an individual considered himself to be religious, and how strongly an individual believed his religious beliefs influenced his behavior. Inmates whose convictions were property related reported greater spiritual wellbeing, were more likely to consider themselves religious, and to say that religious beliefs influenced their behavior than inmates whose crimes were not property related. Inmates whose convictions were drug related were less likely to consider themselves religious, and inmates whose conviction involved violence were more likely to consider themselves religious but less likely to endorse statements that religious beliefs influenced their behavior. The distinction between religiosity and spirituality is discussed in terms of the type-of-crime hypothesis.

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.