Behind Bars and Beyond: Connecting People in Prison to Quality Care

 

More than 2 million people were held in correctional facilities across the United States in 2015, according to the Bureau of Justice Statistics, and many who are incarcerated suffer from significant health issues. Prison populations have higher rates of infectious diseases, substance use disorders, and mental illness, and an estimated 40% of incarcerated people reported at least one chronic health condition in a 2011–2012 survey. What’s more, research suggests that imprisonment causes or exacerbates health problems that can even extend to family members.

Tuesday, September 27, 2016

Benefits of Working Behind Bars

When Jennifer Clarke, MD, began working in prisons 20 years ago, correctional health was sorely limited. Many states even allowed doctors with limited licenses to work in prisons but nowhere else, notes Clarke, medical program director of the Rhode Island Department of Corrections. Today, she points to many advantages of working in correctional health.

For one, says Clarke in a videotaped interview, prisons offer great learning opportunities—minus the tight time pressures of hospitals and clinics. Also, patients usually are quite appreciative of the care and attention physicians can provide. In fact, she notes, prison comes as a relief for some individuals whose lives outside are even more unhealthy, chaotic, and dangerous.

“I can relate to almost every patient that I’ve had,” says Clarke. “They are human beings who have loved ones, they have passions, they have feelings. And just because they’re locked behind a wall does not mean that they are so different from you and me.”

At Learn Serve Lead 2017: The AAMC Annual Meeting, participants came together to envision how the academic medical community can improve the health and well-being of those currently or formerly incarcerated, their families, and their communities. After hearing from experts and watching videotaped interviews with imprisoned individuals, attendees brainstormed ideas for several audiences: medical students, researchers, care providers, and others. The session’s materials and techniques will become the core of a toolkit that academic medical centers can use to spark local conversations and generate action steps tailored to their specific communities. This effort is the latest in an ongoing AAMC project that creates community engagement toolkits for health and health equity. 

“Each place we hold the annual meeting, we think it’s important to ask local communities how academic medicine can be responsive to their needs,” explains Karey Sutton, PhD, AAMC lead specialist for health equity research and policy.

“We also want to tap into local resources that can benefit academic medical centers across the country in their efforts to address similar issues. In Boston,” Sutton says, “we have access to thinkers at the forefront of criminal justice and correctional health.” 

Warren J. Ferguson, MD, leads the Academic Consortium on Criminal Justice Health and is academic director of the Health and Criminal Justice Program at the University of Massachusetts Medical School. Ferguson, who moderated the Learn Serve Lead session, highlights some key correctional health issues in a videotaped interview.

“I think that being respectful of the patient in front of you, no matter what their background, is critically important.”

Warren J. Ferguson, MD
Academic Consortium on Criminal Justice Health

For one, Ferguson says, prisons and jails “are really at the bottom of the totem pole” in the ability to recruit health care providers. Moreover, correctional practitioners face a complex reality in which treatment plans often clash with security matters. But one of Ferguson’s main messages is simple: appreciate how tremendously dehumanizing incarceration can be. 

“I think that being respectful of the patient in front of you, no matter what their background, is critically important,” he explains. “We always mention that you never ask people about the crimes they committed. That’s none of your business,” he says. “You’re there to provide health care.”