De quels troubles psychiatriques souffrent les personnes détenues en France ?

The presence of detainees suffering from psychiatric disorders has been observed since the birth of the modern prison system, and the numbers have fluctuated since then, depending on the evolution of psychiatric facilities and the French legislative framework. As of January 1, 2022, almost 70,000 people were incarcerated in the 187 French correctional institutions in metropolitan and overseas France. Many psychiatric disorders are over-represented in the correctional population compared to the general population, and they include disorders such as depressive, psychotic, bipolar, post-traumatic stress, and substance abuse disorders together with neurodevelopmental disorders such as attention deficit disorder with/without hyperactivity. In this interview with Jean-Pierre Bouchard, Thomas Fovet and Marion Eck discuss this phenomenon based on recent epidemiological data and their personal experience. Some specific clinical aspects of psychiatry in the correctional environment are also discussed.     

De l’incarcération du corps au vécu d’enfermement. Le destin des pulsions contre les murs de la prison

ObjectiveThis article questions the impact of imprisonment on the subjective investment of the body of the drives. The author postulates the hypothesis of a reification of the object following the process of incarceration, which would have a direct impact on the subject's investment of his own body, as well as on the trajectories followed by his drives.MethodThe author exposes the case of psychotherapy with a patient in a medical care unit in a prison environment.ResultsThe analysis of this case illustrates how confinement artificially accentuates the outlines of areas left blank in the libidinal distribution of the erogenous body, and how, on the contrary, the source areas constrain the realization of the expression of the drives; an overinvestment of the intensity of the constrained thrust becomes itself the goal.DiscussionThe possibility of overcoming perceptual confinement in a clinical encounter is only present when there is a reversal on both sides of perceptual and affective elements, at a distance from successful representations. However, it would seem illusory to deny the very impact of representation in the associative process, if only through the narrative work that begins here, work that carries in itself the conditions for going beyond the perceptual in the transference.ConclusionThe drive, turned “upside down” by the ordeal of confinement, tends to come undone, in a way that recalls the undoing performed perverse processes. This can lead to a series of decompensations, themselves pretexts for the demand for care.     

Traumatic Brain Injury Among Newly Admitted Adolescents in the New York City Jail System

PurposeRelatively little is known about the prevalence of traumatic brain injury (TBI) among adolescents who come into contact with the criminal justice system.MethodsWe undertook screening for TBI among newly admitted adolescents in the New York City jail system using a validated TBI screening tool. A convenience sample of 300 male and 84 female screenings was examined.ResultsScreening revealed that 50% of male and 49% of female adolescents enter jail with a history of TBI. Incidence of TBI was assessed using patient health records, and revealed an incidence of 3,107 TBI per 100,000 person-years.ConclusionsElevated prevalence and incidence of TBI among incarcerated adolescents may relate to criminal justice involvement as well as friction in jail. Given the large representation of violence as a cause of TBI among our patients, we have begun focus groups with them to elicit meaningful strategies for living with and avoiding TBI.     

Recidivism in HIV-Infected Incarcerated Adults: Influence of the Lack of a High School Education

Recidivism is a pervasive problem facing the incarcerated. Incarcerated persons who are human immunodeficiency virus (HIV)-infected often have multiple risk factors associated with initial incarceration and recidivism, in particular, injection drug use. Yet, some jails provide case management for HIV-infected inmates to provide continuity of health care, which might have positive effects on reentry into the community. We sought to measure recidivism and factors related to recidivism in an HIV-infected cohort in an urban county jail with an active case management program. Fifty-two inmates surveyed in 1999 at the San Francisco County Jail were followed for rearrests through 2006. In follow-up, 73% were re-incarcerated on an average of 6.8 times for 552 days. Risk factors included nonwhite ethnicity, history of homelessness and crack use, common risk factors for incarceration. Less than high school education was associated with recidivism, shorter time to reincarceration, and more incarcerations. HIV-infected inmates spend a high proportion of time in multiple incarcerations, a reflection of the cyclical nature of incarceration despite comprehensive case management. Well-known risk factors for incarceration were associated with recidivism; in addition, lack of high school education played a prominent role. Education should be explored as a way to make further progress on breaking the cycle of incarceration.     

The Avowal of Motives for Marijuana Behavior

The present report is a comparative analysis of data from different studies on the motives avowed for the use and nonuse of marijuana. Qualitative data on the reasons given by users and nonusers for their behavior were first described and categorized according to 21 verbal patterns. Then these categories were utilized to analyze quantitative data by various investigators, i.e., were the means to compare the frequencies with which each kind of motive was verbalized. The results indicated that knowledgeableness is by far the most frequently expressed motive for the initial use of marijuana. Continued use, however, is largely explained either on the grounds of self-fulfillment or with an appeal to psychological drives. Habitual users in different studies mentioned almost all categories of reasons for smoking more often than did occasional users. Explanations for the two types of nonuse were also quite dissimilar. For the discontinued use of pot, lack of interest is claimed as the chief motivation; but for never use, appeals to illegality, injury, drug addiction, and morality are asserted more frequently. Several conclusions based on these findings are drawn.     

Jails, prisons, and the health of urban populations: A review of the impact of the correctional system on community health

This review examined the interactions between the correctional system and the health of urban populations. Cities have more poor people, more people of color, and higher crime rates than suburban and rural areas; thus, urban populations are overrepresented in the nation's jails and prisons. As a result, US incarceration policies and programs have a disproportionate impact on urban communities, especially black and Latino ones. Health conditions that are overrepresented in incarcerated populations include substance abuse, human immunodeficiency virus (HIV) and other infectius diseases, perpetration and victimization by violence, mental illness, chronic disease, and reproductive health problems. Correctional systems have direct and indirect effects on health. Indirectly, they influence family structure, economic opportunities, political participation, and normative community values on sex, drugs, and violence. Current correctional policies also divert resources from other social needs. Correctional systems can have a direct effect on the health of urban populations by offering health care and health promotion in jails and prisons, by linking inmates to community services after release, and by assisting in the process of community reintegration. Specific recommendations for action and reseach to reduce the adverse health and social consequences of current incarceration policies are offered.     

Reintegrating women leaving jail into urban communities: A description of a model program

Women are the fastest-growing population in the criminal justice system, and jails reach more people than any other component of the correctional system. About 1 million women pass through US jails each year. Most return to their communities within a few weeks of arrest, and few receive help for the substance abuse, health, psychological or social problems that contribute to incarceration. We describe a model program, Health Link, designed to assist drug-using jailed women in New York City to return to their communities, reduce drug use and HIV risk behavior, and avoid rearrest. The program operates on four levels: direct services, including case management for individual women in the jail and for 1 year after release; technical assistance, training, and financial support for community service providers that serve ex-offenders; staff support for a network of local service providers that coordinate services and advocate for resources; and policy analysis and advocacy to identify and reduce barriers to successful community reintegration of women released from jail. We describe the characteristics of 386 women enrolled in Health Link in 1997 and 1998; define the elements of this intervention; and assess the lessons we have learned from 10 years of experience working with jailed women.     

监狱警察工作倦怠、心理健康及两者的关系

目的 了解监狱警察的工作倦怠、心理健康状况及两者的关系。方法 采用李超平、时勘修订的Maslach倦怠量表一通用版（MBI-GS）、症状自评量表（SCL-90）对506名监狱警察进行调查。结果 不同教育程度的干警在玩世不恭方面有显著差异；不同年龄组、不同工作年限干警在玩世不恭和职业效能方面有显著差异；被试在SCL-90量表上有五个因子分数高于常模，一个因子分低于常模；情绪衰竭和玩世不恭两个维度与SCL-90各因子显著相关。结论 青年干警是工作倦怠的重点预防和干预对象，心理健康水平的提高和工作倦怠的降低密切联系。