How to Talk with Patients about Incarceration and Health

Sue, Kimberly

doi:10.1001/journalofethics.2017.19.9.ecas2-1709

Cited by 22 publications

(6 citation statements)

References 16 publications

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“…Many primary care clinics do not have this particular expertise and thus must consider how to ask about incarceration history in a nonprejudicial way. Recommendations and examples of approaches are available in the literature (Howell et al, 2016; Sue, 2017). As with screening for other potentially sensitive topics, we advocate that providers explain the purpose of asking about incarceration history and communicate knowledge that incarceration is linked with deleterious health effects for many as part of this assessment.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of recently incarcerated primary care patients with and without a positive posttraumatic stress disorder screening upon clinic intake.

Zielinski

Alkov

McCauley³

et al. 2024

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Posttraumatic stress disorder (PTSD) is prevalent among people who have been incarcerated. Here, we examined whether screening positive for PTSD was associated with other indicators of poor health, acute healthcare utilization, and poverty among primary care patients upon release from incarceration. Method: We conducted a cross-sectional survey in a national network of primary care clinics serving people recently released from incarceration. Participants were 416 patients who completed the Primary Care PTSD screen (PC-PTSD) and other questions about mental and physical health, acute healthcare utilization, and economic status within 6 months of release. Results: Screening positive for PTSD was associated with worse status across nearly all variables examined, including being more likely to report: poor/fair health (61.6% vs. 41.7%), current depressive symptoms (89.7% vs. 50.8%), lifetime depression diagnosis (63.3% vs. 35.3%), cannabis use since release (20.7% vs. 9.6%), homelessness (31.9% vs. 18.5%), having no cash on hand (56.3% vs. 39.0%) and severe food insecurity (29.3% vs. 18.2%; all ps < .01). Reporting recent suicidality (14.3% vs. 7.0%), alcohol use since release (30.2% vs. 20.0%), and emergency department utilization (20.4% vs. 12.2%) was also more likely (all ps ≤ .03). These trends were largely upheld when controlling for demographic characteristics and chronic physical health conditions using linear probability regression. Conclusions: Primary care patients recently released from incarceration have a need for wrap-around services that address health challenges and poverty. Patients with significant PTSD symptoms face even greater challenges. Identification and treatment of PTSD both during and after incarceration is warranted.

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Section: Discussionmentioning

confidence: 99%

Characteristics of recently incarcerated primary care patients with and without a positive posttraumatic stress disorder screening upon clinic intake.

Zielinski

Alkov

McCauley³

et al. 2024

Psychological Trauma: Theory, Research, Practice, and Policy

View full text Add to dashboard Cite

show abstract

“…Has this ever happened to you?". 8 By opening up the conversation about this social determinant of health non-judgmentally, patients may disclose relevant information that can lead to more individualized care and identify risk factors that otherwise would not have been known.…”

Section: Discussionmentioning

confidence: 99%

Approaching a Fork in the Road: A Case of Aborting Endoscopy After Discovering a Retained Foreign Object

Perez-Mendez,

Freeman,

Ilyas

et al. 2024

Journal of Brown Hospital Medicine

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We describe a case of a 53-year-old female who presented for elective esophagogastroduodenoscopy (EGD) and eventually needed surgical intervention to remove a plastic fork that she accidentally swallowed twenty years prior while in prison. This article highlights approaches to retrieving a foreign object within the stomach via endoscopy, the importance of recognizing the risks of endoscopy, and serves as a reminder that we must be aware of the social determinants of health that pertain to our patients.

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“…Collaborative care models have been found to be effective in treating depression (Badamgarav et al, 2003;Gilbody, 2006), post-traumatic stress disorder (Fortney et al, 2015), and other severe mental illnesses (Miller et al, 2013;Woltmann et al, 2012). Healthcare providers may also consider including previous incarceration on screenings that covers multiple sources of health inequity may be one method by which providers can engage with all patients to identify potential social and structural barriers to health (Sue, 2017). By integrating mental health and substance use resources into primary care, clinicians can create more opportunities to ensure that their patients' mental health needs are being met.…”

Section: Discussionmentioning

confidence: 99%

Incarceration and subsequent risk of suicide: A statewide cohort study

Morgan

Rivara

et al. 2022

Suicide & Life Threat Behav

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Introduction Increasing suicide rates across the United States are disproportionate among populations most impacted by mass incarceration. We sought to determine if incarceration is associated with risk of suicide and firearm suicide after release from prison. Methods Using a population‐based Washington cohort from Department of Corrections and vital statistics administrative records 1990–2017, individuals were compared to the sex‐, age‐, and race‐matched population of Washington using Poisson regression. Among previously incarcerated individuals, we included incarceration history characteristics to calculate sub‐hazard ratios using Cox proportional‐hazards models. Results Of 140,281 individuals released from prison, 484 died by suicide. Suicide risk was 62% higher among previously incarcerated individuals compared with the general population (RR: 1.62; 95% CI: 1.46–1.79). Suicide risk was higher among individuals convicted of firearm‐involved crimes (RR: 2.27; 95% CI: 1.79–2.89). Individuals released prior to age 18 had substantially higher risk of firearm suicide than those whose first release occurred between ages 18–24 (sHR: 11.91; 95% CI: 4.30–32.96). Conclusion Our findings highlight the need for improved mental health resources and lethal means safety in this population. Mental health and substance use treatment have been proposed as effective alternatives to incarceration—continuing to study their impacts may reveal additional benefits of reducing suicide.

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How to Talk with Patients about Incarceration and Health

Cited by 22 publications

References 16 publications

Characteristics of recently incarcerated primary care patients with and without a positive posttraumatic stress disorder screening upon clinic intake.

Characteristics of recently incarcerated primary care patients with and without a positive posttraumatic stress disorder screening upon clinic intake.

Approaching a Fork in the Road: A Case of Aborting Endoscopy After Discovering a Retained Foreign Object

Incarceration and subsequent risk of suicide: A statewide cohort study

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