A Real Second Chance

Amendments to the compassionate release provisions of the federal First Step Act and Second Chance Acts provide some opportunity for release for elderly and infirm federal inmates. This article examines the reentry successes of three Pennsylvania state inmates, all convicted of homicide, who won their release as re-sentenced juvenile lifers or through commutation. The author came to know them through a reentry group affiliated with a Pittsburgh university. Their success and scholarship about the low recidivism rates for violent offenders over the age fifty suggest that the criminal justice system should abolish the imposition of life sentences. More than avoid recidivism, each of these returning citizens has made positive contributions to their communities, both in and out of prison. They are working, obtaining educations, engaging in charitable work and political advocacy, and writing about their experiences. Their example and their description of many similarly-situated older inmates still in prison teach that society should not rest the argument for their release solely on compassion and pity. Rather, older inmates have learned coping skills that can help restore the communities that their crimes harmed and that they were taken from during their incarceration. For these reasons, the author suggests that prison sentences generally should provide for release after an inmate serves twenty-five years and attains the age of fifty.

ADDRESSING THE NEEDS OF INCARCERATED INMATES WITH DEMENTIA: CREATING DEMENTIA-FRIENDLY PRISONS

U.S. prisons are experiencing a graying of their population, with many older inmates experiencing chronic conditions, including dementia. Older prisoners now represent 10% of the U.S. prison population and 18% of Illinois’ prison population. Aging inmates cost more to incarcerate due to their medical needs. Bureau of Prisons data estimate $881 million (19%) of its budget was spent to incarcerate aging inmates. Prisons are seeking solutions to address the unmet needs of older inmates, especially those with dementia. These older inmates with dementia face discrimination and exploitation within the prison population, and Correction Officers and clinicians lack training to understand and address their complex needs. Utilizing the Alzheimer’s Association’s, ACT on Alzheimer’s Toolkit we implemented four phases guiding communities’ adoption of dementia-friendly practices: we convened meetings with Illinois Department of Correction leaders, assessed community strengths and gaps by surveying prison wardens, analyzed findings and created an action plan to provide dementia training of prison staff to create a dementia friendly community. Our “Dementia-Friendly Prisons” program trains prison staff on understanding and providing supportive care and management to inmates with dementia, enabling staff to meet inmates’ needs, thereby creating an environment where inmates with dementia are safe and treated respectfully. Our program used an Appreciative Inquiry Four-D cycle approach (Discover-Dream-Design-Destiny) to engage and empower learners from a highly diverse workforce to develop into collaborative teams. Our program remedies a problem in the delivery of prison healthcare, serving a particularly vulnerable population and creates an adaptable model for other prisons and communities.

SELF-RATED HEALTH AS A PREDICTOR OF DEPRESSION AND ANXIETY IN OLDER ADULT INMATES

Inmates age ≥50 years (older inmates) are a rapidly growing population within the U.S. correctional system with the highest suicide rate among adult prisoners. Although depression and anxiety are strong precursors of subsequent suicide, little is known regarding factors associated with these outcomes in older inmates. To inform suicide prevention efforts in this high-risk population, we evaluated the role of older inmates’ self-rated health (SRH) in relation to depression and anxiety. We utilized data from the ongoing Aging Inmates Suicidal Ideation and Depression study (Aging INSIDE). Participants (N=175) included men age ≥50 (M=56.5, SD=6.3, range=50-79 years) from eight correctional facilities in Connecticut who completed face-to-face interviews. The outcomes, depression and anxiety, were assessed using the PHQ-9 (range 0-27) and GAD-7 (range 0-21); higher scores on each scale indicated worsening severity. SRH, operationalized as a pseudo-continuous variable (1=excellent; 5=Poor), was correlated with depression (r=0.379; p <.001) and anxiety (r=0.260; p =.001) in unadjusted analyses. Two linear regression models were conducted to determine if SRH was associated with depression and/or anxiety after controlling for age, race (white versus non-white), years of education, visitors (yes versus no), and number of chronic conditions. Increasingly worse SRH was significantly associated with more depressive symptoms (β=1.92, SE=.43, p <.001) and higher anxiety scores (β=1.41, SE=.41, p=.001). SRH explained 10.0% and 6.2% of the variance in depression and anxiety scores, respectively. SRH may be useful for identifying older inmates who are more likely to have depression or anxiety, and thus may be at higher risk for suicide.

Causes of Aging in the Federal Prison Population and a Comparison to States

The unremitting growth of older inmates in prison populations is one of the most pressing concerns in federal corrections today; however, empirical research on the topic says little about the causes of these changes. This article addresses this gap by applying an established methodology to analyze and quantify the contributions of key factors driving the growth of aging federal prison populations. Specifically, we use data from the Federal Justice Statistics Program (FJSP) to determine how changes to prisoner age at entry, rate of entry, and rate of exit have shaped the prison population over recent decades. Overall, we find that from 1994 to 2004, rapid increases in the rate of prisoner admission explain the majority of growth in the elderly population, but that since 2004, age at admission has been much more important, with longer time served and rate of admission also playing a role. These influences appear to be quite different from those shaping state prison populations. Our results suggest optimal policy responses to aging populations will need to be tailored to their jurisdiction.

Comparing health status, disability, and access to care in older and younger inmates in the New South Wales corrections system

Purpose The purpose of this paper is to compare the rates of chronic illness, disability and access to care between older and younger inmates who took part in a large epidemiological study in New South Wales, Australia. Design/methodology/approach Data are presented from a cross-sectional study based on a sample of inmates from correctional sites in NSW. The inclusion of results here was guided by the literature with regard to their relevance to older people, and older inmates in particular. Findings Results indicate that a higher proportion of older inmates suffer a range of chronic illnesses, with prevalence often many times higher than that of younger inmates. Older inmates are more likely to be classified as disabled and have a disability which impacts their mobility. Older inmates also reported accessing medical services in prison more recently than younger inmates and were more likely to have seen both nurses and general practitioners. Practical implications Older inmates appear to be considerably more resource intensive than younger inmates. The increasing proportion of inmates who are classified as older thus poses a pressing challenge to those working in the carceral space and, in particular, those responsible for providing healthcare to incarcerated people. Originality/value The impact of aging prisoners on resource demand has yet to be effectively measured. This study provides an important first step towards that goal.

Where “Old Heads” Prevail: Inmate Hierarchy in a Men’s Prison Unit

Research on inmate social order, a once-vibrant area, receded just as U.S. incarceration rates climbed and the country’s carceral contexts dramatically changed. This study returns to inmate society with an abductive mixed-methods investigation of informal status within a contemporary men’s prison unit. We collected narrative and social network data from 133 male inmates housed in a unit of a Pennsylvania medium-security prison. Analyses of inmate narratives suggest that unit “old heads” provide collective goods in the form of mentoring and role modeling that foster a positive and stable peer environment. We test this hypothesis with Exponential Random Graph Models (ERGMs) of peer nomination data. The ERGM results complement the qualitative analysis and suggest that older inmates and inmates who have been on the unit longer are perceived by their peers as powerful and influential. Both analytic strategies point to the maturity of aging and the acquisition of local knowledge as important for attaining informal status in the unit. In summary, this mixed-methods case study extends theoretical insights of classic prison ethnographies, adds quantifiable results capable of future replication, and points to a growing population of older inmates as important for contemporary prison social organization.