Journal of Correctional Health Care
Article Abstracts

Volume 11, Issue 4

· Improving End-of-life Care of Prisoners
   Susan Franzel Levine, MD, MPH
Health care providers at the University of Connecticut and Connecticut Department of Corrections were surveyed to assess knowledge of, prevalence of, and procedures for completion of advance directives, as well as perceptions and beliefs concerning related issues. Results: Fewer than 1% of inmates have advance directive discussions. Fewer still complete an advance directive, and those that do nearly always have a do-not-resuscitate order. Providers agree that advance directive discussions usually occur at the least optimal time in an inmate’s illness. Opinions differ as to barriers to effective discussions. Whether mental illness and competency affect end-of-life care is not clear to most providers. Opinions also differ with regard to fundamental issues of prisoners’ access to and rights to care. Conclusions: Removing systemic barriers may be a starting point toward establishing more consistency in advance directive discussions and delivery of end-of-life care in this population.

· Juvenile Correctional Workers’ Perceptions of Suicide Risk Factors and Mental Health Issues
   of Incarcerated Juveniles
   Joseph V. Penn, MD, CCHP; Christianne Esposito, PhD; L. A. R. Stein, PhD;
   Molly Lacher-Katz, BA; Anthony Spirito, PhD
Correctional staff knowledge, attitudes, and perceptions of incarcerated juveniles’ mental health needs, including suicide prevention, have not been studied empirically. This study measured juvenile correctional officers’ knowledge and attitudes regarding suicide risk factors and mental health and substance abuse issues through administration of the Mental Health Knowledge and Attitude Test (MHKAT) before and after a staff training on suicide prevention. Seventy-six participants completed the pre- and post-training MHKAT. They demonstrated significant improvement in knowledge of and attitudes toward mental health treatment of incarcerated youth as reflected by higher post-training MHKAT scores. Findings suggest that correctional staff are receptive to increasing knowledge of critical mental health issues. Studies of the retention and implementation of this new knowledge by direct care staff over time and the optimal type and frequency of new staff training and continuing education are indicated.

· Hepatitis C Service Delivery in Prisons: Peer Education From the “Guys in Blue”
   Corrine E. Munoz-Plaza, MPH; Shiela M. Strauss, PhD; Janetta M. Astone, PhD;
   Don C. Des Jarlais, PhD; Holly Hagan, PhD
Inmates in U.S. correctional facilities are approximately 9 times more likely to have hepatitis C virus (HCV) infection than the nonincarcerated population. Some correctional facilities provide HCV services, yet little is known about inmate and staff satisfaction with them. Using qualitative data collected in a prison-based drug treatment program in California, this paper describes inmate and staff perceptions of the benefits and barriers to delivering HCV services. Participants commented primarily on their peer education program and on perceived budgetary constraints as a barrier to ongoing HCV service delivery. Participants’ recommendations for the future included increasing HCV education and staff training, and expanding the peer educators program.

· Position Statements of the National Commission on Correctional Health Care: 2005 Updates
   — Administrative Management of HIV in Correctional Institutions
   — Licensed Health Care Providers in Correctional Institutions
   — Women’s Health Care in Correctional Settings
   Note: All NCCHC Position Statements are available online in the Resources section.

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