Healthcare in prisons and asylums: Does the government maintain the same quality of it?


United States lawmakers have enacted comprehensive criminal justice policies over the past four decades based on the concept that crime and violence are reduced by sending large numbers of people to prison for a wide range of crimes and, often, for lengthy periods. There have been more than 700% increases in the number of people behind bars in the United States over these four decades; the U.S. penal population of 2.2 million is the world's largest, and it disproportionately affects African Americans and Latinos. By documenting incarceration policies' harmful effects on public health, public health researchers have added to this skepticism. [1]


Police encounter problematic behaviors and situations frequently, despite the adverse health effects of incarceration. Policing, for example, includes dealing with perceived problem behaviors, illicit transnational transactions, minor property crimes, family crises, and initiating the criminal justice process that can result in court appearances and prison. Therefore, the effectiveness of diversion programs is generally measured by outcomes in the criminal justice system, such as reduced re-arrests and incarceration, and public health indicators, such as reduced substance abuse or improved mental health. [1]


Inmates are typically provided health care services by most facilities, though accreditation is voluntary in the United States. Ironically, the court system is responsible mainly for correctional health care oversight, following court decisions requiring system improvements on a local, state, and federal level. Furthermore, interventions are taken at the prison level and after release in several areas widely recognized as necessary, such as chronic disease prevention and dental care, trauma treatments, mild and moderate psychological problems, and reproductive and sexual health. Unfortunately, these areas are poorly researched, and no evidence-based programs or best practices syntheses exist. [1]


Furthermore, even though reentry programs are well documented for their negative impact on health and social outcomes for people leaving prisons or jails, only a few studies are comparing the costs and benefits of reentry programs across health conditions, populations, or criminal justice settings, obstructing policy makers' abilities to set priorities and allocate resources efficiently. Finally, a commitment to clinical ethics in prisons and detention centers and humane detention is impossible without close cooperation between professionals who aim for different goals. Nevertheless, this cooperation's success depends upon clearly defined roles and tasks for each profession and mutual understanding of the challenges, laws, and ethics that each profession faces. [1,2]


References:

1. Freudenberg, N. (2016, March). A review of opportunities to improve the health of people involved in the criminal justice system in the United States. Annual Reviews.