Addressing Recidivism: A Challenge for Medical Regulation

Numerous studies have shown that several characteristics of offenders are related to their likelihood of recidivism after release from prison. Nearly all of these studies, however, have focused on offenders from just one state. Few studies have examined recidivism rates controlling for the characteristics of offenders from multiple states, and virtually none have examined recidivism rates controlling for characteristics of offenders from multiple states during different periods of time. Additionally, few studies have explored different types of recidivism across multiple jurisdictions to determine whether the same individual level factors explain variations in rearrest, reconviction, reimprisonment, and parole violations.

2011

x a high percentage of offenders serving long sentences (over 10 years = 46%; life imprisonment = 8.5%) and thus the requirement for any study to be longitudinal in order to track individual's behaviour post-release; and x the fact that roughly one third of the total prison population are unsentenced prisoners who, on average, spent two to three months in custody, and frequently much longer. They are excluded from all rehabilitative services, yet in excess of 250 000 people move through the awaiting trial system annually after being exposed to the negative effects of imprisonment.

Zenodo (CERN European Organization for Nuclear Research), 2021

India's written constitution, which is the world's longest, demonstrates how a democratic society in the Republic of India takes every effort to preserve its citizens' rights. If not the greatest, the provisions have at least given strive to ensure that their nationals' rights are safeguarded and not infringed, so that all inhabitants of the country live with the dignity that they deserve. In this pursuit, a lot of wrongdoers have been incarcerated for the crimes they committed. Often, when the criminals get punished for their actions, the society at large, view these convicts as a negative element and this perception, in a lot of cases, stay forever; thus, affirming a mindset of being perceived as a criminal their entire life. This leaves a very narrow scope for small-time prisoners to get back to the real world and be able to function in a society as a normal citizens after serving their time. As a result, these ex-convicts turn back to crime to conduct their daily livelihood. It is just one of the reasons why recidivism takes place. Which brings us to the question-What is recidivism? A brief into the concept of recidivism: There are several definitions available for recidivism. Although, there isn't one single definition that is universally accepted. Merriam-Webster defines recidivism as-"a tendency to relapse into a previous condition or mode of behavior especially: relapse into criminal behavior". 1 Oxford Learner's Dictionaries has defined recidivism as-"The act or habit of continuing to commit crimes, and seeming unable to stop, even after being punished". 2 National Crime Record's Bureau (NCRB) defines this concept as-"The tendency of relapsing into crimes by the criminals is known as Recidivism. A recidivist is a person who relapses into crime again and again". 3

Federal Sentencing Reporter, 1998

The following is a proposal for a dissertation on Recidivism. The goal is to explore the impact of institutional factors on recidivism. Here 'institutional factors' is conceptualized as correctional facilities policies and procedures, correctional facilities professional and non-professional staff impacts, administrative staff impacts, and correctional programming. The literarture on recidivism clearling indicates that these institutional factors related to recidivism outcomes. However, this writer has not uncovered any research which examines the combined effect of these institutional factors on recidivism. This study proposes to utilize a mixed-methods approach to analyze the relationship of institutional factors on recidivism outcomes.

Health Affairs, 2014

Provisions of the Affordable Care Act offer new opportunities to apply a public health and medical perspective to the complex relationship between involvement in the criminal justice system and the existence of fundamental health disparities. Incarceration can cause harm to individual and community health, but prisons and jails also hold enormous potential to play an active and beneficial role in the health care system and, ultimately, to improving health. Traditionally, incarcerated populations have been incorrectly viewed as isolated and self-contained communities with only peripheral importance to the public health at large. This misconception has resulted in missed opportunities to positively affect the health of both the individuals and the imprisoned community as a whole and potentially to mitigate risk behaviors that may contribute to incarceration. Both community and correctional health care professionals can capitalize on these opportunities by working together to advocate for the health of the criminal justice-involved population and their communities. We present a set of recommendations for the improvement of both correctional health care, such as improving systems of external oversight and quality management, and access to community-based care, including establishing strategies for postrelease care and medical record transfers.

The Milbank quarterly, 2015

Policy Points: The steady increase in incarceration is related to the quality and functioning of the health care system. US states that incarcerate a larger number of people show declines in overall access to and quality of care, rooted in high levels of uninsurance and relatively poor health of former inmates. Providing health care to former inmates would ease the difficulties of inmates and their families. It might also prevent broader adverse spillovers to the health care system. The health care system and the criminal justice system are related in real but underappreciated ways. This study examines the spillover effects of growth in state-level incarceration rates on the functioning and quality of the US health care system. Our multilevel approach first explored cross-sectional individual-level data on health care behavior merged to aggregate state-level data regarding incarceration. We then conducted an entirely aggregate-level analysis to address between-state heterogeneity an...

Federal Sentencing Reporter, 2020

Recidivism is now the guiding principle of punishment and has become the new hallmark of criminal justice reform, as reflected in the U.S. Sentencing Commission’s recidivism project. So far, the Commission has issued three reports in 2020 alone, which outline the parameters within which “safe” criminal justice reform can proceed. Yet the overly broad definition of “recidivism” and the focus on easily measurable and static risk factors, such as prior criminal record, create a feedback loop. The Commission’s work should come with a warning label. Its recidivism studies should not be consumed on their own. Instead, they must be read in conjunction with U.S. Probation and Pretrial Services recidivism research, which includes data on the impact of programming, treatment, and services on reentry success. Yet, concerns about undercounting recidivism events drive the entire U.S. approach. Western European studies reflect different philosophies and values that explain some of the underlying reasons for the dramatically different imprisonment rates on the two sides of the Atlantic. These recidivism studies raise also questions about the Commission’s role. Its ongoing preference for imprisonment indicates that it continues to consider itself the guardian of incarceration-driven guidelines. The studies reenforce the status quo and the Commission’s role in it. They threaten to propel us into data-driven selective incapacitation and continuously long prison terms for those with prior criminal records, all in the name of public safety.

Rethinking Corrections: Rehabilitation, Reentry, and Reintegration

T raditionally, one of the goals of incarceration has been rehabilitation. However, there has been a great debate in the literature about the efficacy of different treatment interventions for offenders and the ability of these treatments to decrease recidivism rates. In the 1950s and 1960s there was some evidence that treating offenders worked (Bailey, 1966; Logan, 1972). However in 1974, Martinson conducted a review of 230 treatment studies and concluded that nothing works in the treatment of offenders (Martinson, 1974). These findings supported the growing movement in the criminal justice system from a rehabilitative approach to a punitive one. While the field moved away from rehabilitation, criminal justice researchers became interested in developing a theory to explain why some treatments worked and others did not (Andrews et al., 1990). This resulted in the development of the risk-need-responsivity (RNR) model for evaluating program effectiveness (Andrews, Bonta, & Hoge, 1990). The RNR model has been empirically supported as a means of effectively evaluating offender treatment programs (Andrews & Bonta, 1998). The basic principles of RNR are that correctional interventions must be structured on three core rehabilitation principles: risk, need, and responsivity. The risk principle addresses the fact that CHAPTER 3

Health & Justice, 2014

Chronic behavioral health conditions, such as psychiatric and substance use disorders, affect at least half of all arrestees, with two-thirds suffering from at least one chronic medical disorder. These conditions contribute to their criminal behaviors and propensities to recycle through the criminal justice system (Binswanger et al. Journal of Urban Health 89:183-190, 2012). Despite their limited resources, jails have nonetheless become de facto settings for the delivery of healthcare services. With the passage of the Affordable Care Act (ACA) of 2010, jail releasees will become eligible for government-subsidized healthcare coverage in 2014. The widespread availability of integrated healthcare services for the released jail population is likely to reduce criminal behavior, which is often associated with psychiatric and substance use disorders and their co-occurrence. This article provides an overview of behavioral healthcare services available to jail releasees. We discuss the evolving landscape of substance use and mental health interventions under healthcare reform, including anticipated changes in funding infrastructures and streams for treatment services. We examine the financial and practical implications of these changes for the criminal justice system, particularly for the nation's jails.

The United States is in the midst of a public health crisis: Every year, well over 24,000 Americans die from opioid overdose. This staggering death toll is equivalent to a weekly jumbo jet crash. After a decade of rapid growth, overdose caused by prescription opioids and heroin now tops the accidental death rankings, beating out automobile accidents, AIDS, and other high-profile killers. Overdose does not discriminate, cutting across all geographic, economic, and racial divides. But some groups are especially vulnerable. This article is dedicated to one such group: individuals re-entering the community from correctional settings. In the immediate two weeks after release, people in this group are almost 130 times more likely to die of an overdose than the general population. It is easy to cast post-incarceration substance use — and consequent overdose — as the re-entering individual’s character weakness or a propensity towards reckless behavior. Nevertheless, modern addiction science reframes such relapse as a foreseeable consequence of the chronic nature of substance use disorders. This scientific evidence also provides clear guidance on how most of the resulting fatalities can be prevented. This article considers the creation of fatal overdose risk among formerly incarcerated individuals as an unacceptable collateral harm emanating from criminal justice involvement. In order to address this largely overlooked public health problem, we explore a range of legal channels that can help persuade the state (broadly construed) to address a risk to which it substantially contributes. We consider a number of doctrinal approaches, guided by the belief that spending time behind bars must not translate to a death sentence for so many Americans. Whether as a part of possible legal actions or an action agenda on its own right, we present a number of programmatic interventions and policy reforms that may alleviate this crisis. Our analysis also highlights the potential role of the Affordable Care Act (ACA) in facilitating overdose prevention before, during and post-incarceration. This agenda is especially timely given the current move by federal and state governments towards releasing large numbers of individuals incarcerated on drug-related charges to ease prison over-crowding or as a result of legal reforms, pardons, or exonerations. In Section I, we provide an overview of the opioid overdose epidemic and the special vulnerability among criminal justice-involved individuals. In Section II, we examine the scientific evidence on prevention measures that should be, but are currently rarely deployed to address this vulnerability. In Section III, we explore various legal theories that could be invoked in efforts to motivate government actors to take a greater responsibility for preventing post-incarceration overdose deaths. In Section IV, we cover additional mechanisms to motivate institutional change. We conclude by outlining a policy and programmatic agenda for reducing the vulnerability of criminal justice-involved individuals to opioid overdose.

Journal of Correctional Health Care, 2018

In many health care settings, hospital readmissions represent poor quality and increased costs. The California Department of Corrections and Rehabilitation includes reduced readmission rates among key performance indicators for the quality of care provided to inmates. More than 25% of the institutions continue to face challenges in minimizing these occurrences. Despite historic deficiencies, the California Substance Abuse Treatment Facility and State Prison at Corcoran reduced 30-day readmissions over a 2-year period. The use of a mnemonic algorithm along with intervention strategies was effective in achieving system goals. In a broader context, the success of this methodology breaks new ground and has promising implications for the improved health status of incarcerated populations. Other correctional environments would be well served in adopting these measures.