CHAPTER TWELVE  Correctional Health Care
Juvenile Health Care• Youth held in juvenile facilities have elevated rates of communicable    diseases, high levels of me...
Juvenile Health Care• An initial medical assessment is critical in order to identify communicable diseases    and also to ...
Juvenile Health Care• A greater number of facilities test all youth for tuberculosis (46%)    compared to pregnancy (16%),...
Juvenile Health Care• 12% of admitted youth were obese at intake and after three    months of confinement, the percentage ...
Health Care Challenges Within Juvenile Corrections                                     Confidentiality• In some cases, hea...
Health Care Challenges Within Juvenile Corrections                         Medical Care Expenditures•   Providing appropri...
Health Care Challenges Within Juvenile Corrections                    Blood Borne Pathogens and Infectious Diseases•   Con...
Specific Health Needs of Female Juveniles• Females present unique health challenges for the juvenile justice    system•   ...
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Juvenile corrections pp week 10

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Juvenile corrections pp week 10

  1. 1. CHAPTER TWELVE Correctional Health Care
  2. 2. Juvenile Health Care• Youth held in juvenile facilities have elevated rates of communicable diseases, high levels of mental disorders or learning difficulties, involvement in substance abuse, and poor histories of community health care• These factors shape the type of medical and mental health care that these youth require when they are incarcerated• Milwaukee has high rates of chronic illnesses, including asthma, high rates of previous hospitalization, surgery, medication use, and some level of violent victimization• Oregon youth have been reported to have very high levels of chronic illnesses (77%), mental health disorders (87%), substance abuse issues (77%), and past suicide attempts (33%)• In Washington States, those in county facilities had higher rates of emergency room visits, a greater number of acute health issues, and more suicide watches than those in state facilities• Conversely, juveniles in state institutions were more likely to have chronic health needs, such as dentistry, dermatology, or nutrition
  3. 3. Juvenile Health Care• An initial medical assessment is critical in order to identify communicable diseases and also to check if the juvenile is under the influence, putting them at higher risk for overdose or poisoning• Newly admitted youth also need to be checked for injuries or existing health problems• The American Correctional Association (ACA) sets a one hour standard timeframe for intake assessments; staff conducting these evaluations should have comprehensive training in suicide assessment and medical care• The quality of health screening often depends on the type of facility to which the juvenile is placed• Most youth stay for only a few days in juvenile detention and this fact influence the types of health care they receive• Health assessment in state correctional facilities tend to be more comprehensive because youth will be there much longer; therefore, they are often screened for communicable diseases, chronic health conditions, and pregnancy• 68% of facilities reported providing physical health examinations to all youth; larger facilities tend to provide more extensive health screening and assessments
  4. 4. Juvenile Health Care• A greater number of facilities test all youth for tuberculosis (46%) compared to pregnancy (16%), sexually transmitted infections (14%), hepatitis B (10%) or HIV (4%)• One issue that facilities face in that youth in confinement may exaggerate their health care conditions or needs and because of this, correctional officers may fail to investigate any complaints of pain or distress• Correctional officers may also fail to abide by treatment plans, follow- up on medical advice or ensure that youth receive their medications• A nutritionally sound diet is an important component for all individuals – improper diets can lead to health problems, exacerbate existing medical conditions, and may be associated with acting-out behaviors• Youth with chronic illnesses such as diabetes, prenatal care, or obesity may require special diets• Correctional food is notorious for being unhealthy – high in fat and starch content
  5. 5. Juvenile Health Care• 12% of admitted youth were obese at intake and after three months of confinement, the percentage of obese or overweight juveniles increased to two-thirds• Juveniles often resist efforts to increase their hygiene• Access to daily recreation, exercise, and fresh air is important and idleness often results in higher rates of misconduct• Incarcerated juveniles tend to have high rates of asthma, hypertension, diabetes, tuberculosis, and dental problems• They also exhibit higher rates of risk behaviors, including alcohol and tobacco use, assaultive behavior, gang membership, and sexual activity• Providing effective health care services for incarcerated youth may also contribute to success in the community once they are released
  6. 6. Health Care Challenges Within Juvenile Corrections Confidentiality• In some cases, health care providers are not legally able to disclose to other facility staff or parents about the health status of the juveniles in their care• Staff members who disclose the confidential health information of inmates without proper authorization may be placing themselves in jeopardy of being sued or prosecuted• Facilities must develop comprehensive information systems that track health- related issues that medical staff can have access to Dental Care• Many youth fear dental exams, have poor dental hygiene, and may ignore what appear to be minor dental problems• Dental emergencies such as impacted wisdom teeth or injuries resulting from recreational activities, unintentional causes, or assaults also occur behind bars• It is important that juveniles receive some preventative care and, if possible, health education about proper dental care
  7. 7. Health Care Challenges Within Juvenile Corrections Medical Care Expenditures• Providing appropriate correctional health care for juveniles is costly, especially with unpredictable costs such as emergency care, dentistry, and prescriptions• A single case of HIV/AIDS represents a cost of $13,900 to $36,500 for medication per year• Juvenile correctional facilities must provide comprehensive health care treatment that tackles the problems of chronic medical conditions, past injuries, psychological problems, and dental and optometric services• At a minimum, facilities must treat the most obvious or emergent conditions, bring immunizations up-to-date, and provide educational information about risk behaviors affecting the minor• Telemedicine, or the use of telephones, internet services, or television conferences, allows specialized health care professionals to assist in the diagnosis of patients without having to transport the youth has decreased costs associated with transportation of youth but has significantly increased overall medical costs
  8. 8. Health Care Challenges Within Juvenile Corrections Blood Borne Pathogens and Infectious Diseases• Controlling the spread of blood borne pathogens and infectious diseases is a key issue in the operation of youth facilities• Communicable diseases such as sexually transmitted infections, HIV/AIDS, and hepatitis must be detected and treated• The likelihood of transmission is increased because inmates are usually housed in close quarters• Engaging in consensual sex, assaults, and rape increase the risk of transmitting diseases• AIDS education can increase juveniles’ willingness to be tested and increase their levels of fear about the disease, but education does not appear to significantly impact decision-making to engage in risk behaviors• Females experience significantly higher rates of Chlamydia and gonorrhea than males; each tested positive for both over 50% of the time• Incarcerated juveniles have lower hepatitis infection rates than the adult population• Staff members receive orientation training about blood borne pathogen
  9. 9. Specific Health Needs of Female Juveniles• Females present unique health challenges for the juvenile justice system• Correctional health care has typically been delivered on models created for male populations• Incarcerated juveniles have high percentages of sexually transmitted infections, past pregnancies, suicide attempts, anorexia, bulimia, depression, and substance abuse• Females are more likely to suffer from coexisting disorders and are 15 times more likely to have been the victim of unwanted sexual advances• Detained females were found to have the following family problems: mental health (21%), alcohol abuse (27%), drugs (26%), and criminal justice system involvement (58%)• A vast majority of female detainees experienced a major trauma, such as witnessing a death or being threatened with a weapon• High percentages also reported having mental health or substance abuse problems and being sexually active

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