The changing picture of substance abuse problems among Finnish prisoners

Lintonen, Tomi; Obstbaum, Yaira; Aarnio, Jorma; Gruenewaldt, Virpi von; Hakamäki, Sirpa; Kääriäinen, Juha; Mattila, Aino K.; Vartiainen, Henriikka; Viitanen, Päivi; Wuolijoki, Terhi; Joukamaa, Matti

doi:10.1007/s00127-011-0390-8

Cited by 18 publications

(14 citation statements)

References 32 publications

(34 reference statements)

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“…Andersen, 2004). The 2006 clinical health study issued a diagnosis of drug or alcohol dependence for 84% of prisoners (Lintonen et al, 2012). Thus, there should certainly be a high need for interventions.…”

Section: Resultsmentioning

confidence: 99%

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Who receives substance abuse treatment in the ‘real world’ of the prison? A register-based study of Finnish inmates

Obstbaum

Tyni²

2015

jssccp

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Assessing and targeting substance abuse-related treatment needs according to evidence-based practice has become the norm in most prison administrations. Not everyone with a need will, however, receive support in practical settings. Drawing on Finnish prison registers, we show that of all prisoners released in 2011, 60% were assessed as having a need for substance abuse-related support. Of these, 22% received an intervention in prison. Two multivariate models were used to examine the factors related to selection into interventions. The main factors associated with receiving an intervention with evidence-based programmes were a longer sentence, Finnish nationality, younger age and treatment motivation. The predictors for any substance abuse interventions (including non-evidence-based) were the same, with the exception that motivation was no longer a significant predictor, and female gender remained significant. The selective use of motivation as an entrance criterion for interventions can be a means of systemic adaptation to a combination of a high prevalence of substance abuse problems and a lower prevalence of treatment motivation in the prison population. We discuss how our results might reflect a Scandinavian way of doing evidence-based, prison-based drug treatment-one that stresses rehabilitation as a goal in itself in addition to reducing recidivism. Most prisoners, however, do not receive any intervention at all.

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Section: Resultsmentioning

confidence: 99%

“…More comprehensive rehabilitative programmes were, in a way, introduced for the first time through the RNR thinking at the end of the 1990s (Tourunen et al, 2012). Simultaneously, substance abuse problems became drastically more common amongst Finnish prisoners in the 1990s (Lintonen et al, 2012).…”

Section: Societal and Policy Context In The Nordic Areamentioning

confidence: 98%

Who receives substance abuse treatment in the ‘real world’ of the prison? A register-based study of Finnish inmates

Obstbaum

Tyni²

2015

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“…Our study adds to a growing body of literature documenting a high prevalence of mental disorder in prisoners. [1][2][3]8,9,37,38 It is of note that those who reported a lifetime mental disorder comprised just under half our population-based sample, and for this large group, poor outcomes stretched across multiple domains. Our findings indicate that the process of incarceration and transition back to the community can exacerbate health inequity for people with a history of mental disorder.…”

Section: Discussionmentioning

confidence: 99%

“…P risoners are characterised by a high burden of mental disorder 1–3 to the extent that prisons have been referred to as the ‘mental health institutions of the 21 st century’ 4 . Many prisoners also have a history of disadvantage including poor education, 5,6 unemployment 5 and substance misuse, 7–10 poor or unstable relationships, economic hardship and histories of childhood abuse 11 . Following release from prison, these marginalised members of the community confront numerous new challenges.…”

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confidence: 99%

Poor health and social outcomes for ex‐prisoners with a history of mental disorder: a longitudinal study

Cutcher

Degenhardt

Alati

et al. 2014

Australian and New Zealand Journal of Public Health

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Objective: To examine the association between self‐reported lifetime diagnosis of mental disorder and health‐related outcomes in prisoners during the first six months after release. Methods: We interviewed 1,324 adult prisoners in Queensland, Australia, within six weeks of expected release and one, three and six months post‐release. Outcomes of interest included health service access, housing, employment, substance use and criminal activity. We used multivariate logistic regression to investigate the association between self‐reported, lifetime diagnosis of mental disorder and these health‐related outcomes post‐release, adjusting for pre‐existing disadvantage. Results: 43.4% of participants reported a lifetime diagnosis of mental disorder. This group had increased crude odds of poor outcomes across all evaluated domains. After adjusting for pre‐existing disadvantage, significantly increased odds of poor outcomes persisted in the substance use, mental health, crime and health service access domains. Conclusions: People with a history of mental disorder experience particularly poor outcomes following release from prison that are not fully explained by pre‐existing disadvantage. Implications: Evidence‐based transitional programs for prisoners with a history of mental disorder should be provided at a level commensurate with need.

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“…Finnish prisoners exhibit comparatively high amounts of substance abuse problems (for ex. Andersen 2004;Lintonen et al 2012). Additionally, Nordic prisons, with comparatively low prisoner rates and allegedly humane prison conditions, have been regarded as BExceptional,^frequently employing the principles of normality and universalism (Pratt 2008).…”

Section: Introductionmentioning

confidence: 99%

Not All Substance Dependence Problems are Recognized as Risks—Comparing a Medical Health Study with Prison Assessments

Obstbaum

Tyni²,

Mattila

et al. 2015

Eur J Crim Policy Res

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Substance abuse is viewed as one of the main factors (criminogenic needs) to be assessed and targeted in prison. Prison assessments of risk and needs are known to validly predict reoffending. However, there seems to be lacking research in how reliably the individual prisoner's problems, such as substance abuse, are represented in the assessments. In this study, we compare an independent medical health study (N=510) with in-prison assessments for the Eur J Crim Policy Res same persons to see whether some of the inmates' substance abuse disorders were overlooked in prison. We found that sentence plans (257) were in poor agreement with the health study (Kappa 0.315); they recognized only 65 % of all diagnoses. The risk and needs assessments (178) were in closer agreement with the health study, however, alcoholism diagnoses were recognized less accurately (Kappa 0.519) and less frequently (78 %) than drug diagnoses (Kappa 0.627, 87 %). The main factors predicting an assessment of substance abuse risks in prison, analysed through logistic regression were: longer stay in prison and one or more dependence diagnoses. We conclude that, a number of potentially criminogenic dependence problems remain unrecognized since some groups of prisoners are either completely left out from the more thorough instrument, the risk-and-needs assessment, or are not assessed thoroughly enough. This puts prisoners in unequal positions, since all interventions in prison are based on assessments. The study alerts us of the selectiveness of prisoner assessments in practical settings; the unrecognition of problems of shorter sentenced prisoners and prisoners with alcohol dependence.

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The changing picture of substance abuse problems among Finnish prisoners

Cited by 18 publications

References 32 publications

Who receives substance abuse treatment in the ‘real world’ of the prison? A register-based study of Finnish inmates

Who receives substance abuse treatment in the ‘real world’ of the prison? A register-based study of Finnish inmates

Poor health and social outcomes for ex‐prisoners with a history of mental disorder: a longitudinal study

Not All Substance Dependence Problems are Recognized as Risks—Comparing a Medical Health Study with Prison Assessments

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