PPN 302 Class 7: Incarceration, correctional health & social system

Levels of the correctional system 

• Federal correctional system

• Provincial/territorial correctional system

• Remand

• Community supervision

Federal correctional system (levels of the correctional system)

• More than 2 years sentencing

• 14,071 adults 

Provincial/territorial correctional system (levels of the correctional system)

• Less than 2 years sentencing 

• 23,783 adults

Remand (levels of the correctional system)

• Held in custody while awaiting trial 

• 14,778 adults 

Community supervision (levels of the correctional system)

• Parole, probation, and conditional sentences 

• 89,838 adults 

Who makes up the correctional system? 

• Within the provincial/territorial correctional facilities: 

  • Women= 15% 

  • Young male adults under 39 years old = 58% 

  • Overrepresentation of indigenous and black populations

Women in Prison 

• Women are among the fastest-growing incarcerated populations in Canada 

• 2022: 50% of women in the federal system were indigenous women 

Recidivism 

• The tendency of a convicted criminal to reoffend 

• Canada’s reconviction rate is unknown 

• It is estimated that 8:10 males and 7:10 female offenders have previous convictions

• Higher rate among indigenous and black offenders 

Incarceration and health 

• Higher levels of chronic illness/conditions

• Higher risks of mental illness, substance misuse/abuse

• Higher mortality rates than non-incarcerated individuals 

• Elevated rates of infection- Tuberculosis, HIV/AIDS, hepatitis, STIs

Levels of incarceration impact 

• Society

• Community

• Family

• Individual

Society (Levels of incarceration impacts)

• Sustained poverty, intergenerational race and class inequality,  and intergenerational trauma 

Community (Levels of incarceration impacts)

• Disrupted social ties increase poverty, increase infectious disease, childhood development 

Family (Levels of incarceration impacts)

• Strain and stress, lost family relations, divorce, lost family income

Individual (Levels of incarceration impacts)

• Increased risks of mental illness and poor health conditions, lost social support 

Breaking the cycle of Recidivism

• Community reintegration 

  • Education, empowerment and skills building 

    • Mental health and wellbeing 

    • Employment opportunities 

    • Social support and acceptance

  • Criminal justice system reforms 

  • Addressing structural causes 

Moral & ethical dimensions of corrections nursing: Competing priorities 

• Client safety & well-being

• Institutional security

• Build therapeutic relationships (consider the challenges of building relationships while in a high security environment) 

• Complete comprehensive health histories upon admission to identify past medical problems and risk behaviours 

• Deliver immunization programs 

• Provide treatment for chronic conditions and infectious conditions consistent with community standards 

• Deliver client education, including

• Intersectoral collaboration

• Collaborate with community residential facilities and agencies to ensure a safe release and transition of incarcerated persons 

Client safety & well-being (Moral & ethical dimensions of corrections nursing: Competing priorities)

• Patient safety 

• Nurse’s autonomy 

Institutional security (Moral & ethical dimensions of corrections nursing: Competing priorities)

• Order

• Control

• Discipline

Deliver client education, including (Moral & ethical dimensions of corrections nursing: Competing priorities)

• Infectious disease prevention and control 

• Substance use program 

• Suicide prevention

• Discharge care planning 

• Mental health interventions 

Intersectoral collaboration (Moral & ethical dimensions of corrections nursing: Competing priorities)

• not only with health care providers but also with other non-health sectors outside, such asthe  education system, social services and non-governmental organizations, to obtain:

  • Housing 

  • Community supports 

  • Employment (retraining/employer support) 

  • Reconnections with family 

Overall Considerations 

• Prisoners’ health is public health 

• Prisoners’ rights are human rights 

• Improving incarcerated/post-incarcerated health is an important step to improving health equity in Canada