Race/ethnic disparities in the utilization of treatment for drug dependent inmates in U.S. State correctional facilities

Abstract

This study examines race/ethnic disparities in treatment for drug dependent inmates in state correctional facilities. The data come from the 2004 Survey of Inmates in State Correctional Facilities. Fixed effects logistic regression is used to analyze treatment outcomes for 5,180 inmates housed within 286 prisons. The analysis accounts for differences in background characteristics (i.e., age, gender, marital status, foreign born status, veteran status), socioeconomic characteristics (i.e., education, employment prior to incarceration), mental health (i.e., diagnosis with a serious mental illness), and incarceration experiences (i.e., current conviction, previous incarceration episodes, time served, additional sentencing requirements, external social support, disciplinary violations). The findings identify a remarkable unmet need among drug dependent inmates in that less than one-half of drug dependent inmates had received any type of treatment in prison at the time of the interview with the most common treatment type being self-help groups. Compared to whites, drug dependent Latino inmates have significantly lower odds of utilizing treatment, yet there are no significant black-white disparities found. Implications for drug treatment within prisons are discussed.

Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review

“…A survey of drug dependent inmates in correctional facilities determined Whites were more likely to have been diagnosed with a co-occurring mental health disorder and were more likely to have mental health counseling and substance use treatment as part of their sentence than non-whites (Nowotny, 2015). There are similar racial and ethnic disparities in treatment referral.…”

“…Further, increased communication and collaboration among medical, mental health, and substance abuse service providers may increase dual disorder identification, inter-professional knowledge with regard to dual disorders, and treatment referrals (Sterling et al, 2010). Racial and ethnic disparities in screening and referral also serve as a barrier to access among minority populations (Nowotny, 2015; Libby et al, 2007; Deck & Vander Ley, 2006). Universal screening across service settings for both mental health and SUDs may decrease inconsistent and biased referrals and increase identification of dual disorders among minority populations.…”

Perceived Discrimination in Health Care and Mental Health/Substance Abuse Treatment Among Blacks, Latinos, and Whites

“…1,2 Blacks and Latinos are less likely than Whites to receive mental health or substance abuse services and are more likely than Whites to delay seeking care. 3–5 Even when Blacks and Latinos do receive mental health/substance abuse services, they are more likely than Whites to obtain inappropriate diagnoses, 6,7 drop out of treatment early, 8 report less satisfaction with treatment, 9 and receive inadequate or substandard care. 10 Untreated, mental health/substance use disorders lead to economic instability, 11 disruptions in education and employment, 12,13 and premature mortality due to suicide, chronic disease and poor physical health outcomes.…”

Racial disparities in health conditions among prisoners compared with the general population

“…Prisons have been described as total institutions – “places of residence and work where a large number of like-situated individuals, cut off from the wider society for an appreciable period of time, together lead an enclosed, formally administered round of life” ( Goffman, 1961 , p. xii). Thus, prisons provide an important context because they “level the playing field” with respect to nutrition, exercise, health care access, and stress exposure, although evidence suggests that racial/ethnic disparities in utilization of care may exist even in this “equal access” system ( Nowotny, 2015 ). We are not suggesting that there is no stress exposure within prisons.…”