“It was like rescue, not arrested”: Experiences of correctional treatment services by prisoners and their families Megan Comfort, PhD Behavioral Health and Criminal Justice Division, RTI International Department of Medicine, University of California, San Francisco 41st Annual AMERSA National Conference November 2, 2017 – Washington, DC

Conference disclosure The work presented was supported by the National Institutes of Health: R01 MH078743 (Comfort, PI), R01 DA033847 (Comfort, PI), R01 MH094090 (Kral, PI) We have no actual or potential conflict of interest in relation to this presentation.

Mass incarceration and public health Glaser, J. B. and R. B. Greifinger (1993). "Correctional Health Care: A Public Health Opportunity." Annals of Internal Medicine 118(2): 139-145.

Mass incarceration and public health

Protected rights to healthcare

Seeking care in correctional settings

Seeking care in correctional settings Int: What was your motivation in telling [correctional medical staff about your HIV status]? Participant: I wasn’t taking care of myself. … I wanted to know where my t-cells was at and stuff so they started drawing my blood. You know, I was in jail was when I started taking care of myself. Just like every time I went to jail it was like a life saver, it was like God was saving me from myself. That’s the way I looked at it, it was like rescue, not arrested.

Surviving in the community

Motivation to engage in care Int: What advice would you give to other folks who are HIV positive who go to jail or prison, what would you tell them? Participant: I would tell them, “See your doctor,” because he’s the most powerful man there in jail. Everywhere, wherever, period…. He can get you whatever. … I’ll tell you, the doctor is more powerful than a judge. … The doctor can send you wherever you need to go. … Yeah, the doctor is powerful, trust me.

Burden on family members

Burden on family members You know you have some people on drugs and they go and leave for four or five days? He wasn’t that type. But, it was days when it was like, ‘I wish you would go for four or five days!

Family members as social workers

“A 20-hour a day job” I think maybe a lot of his mental health issues do stem from his drug use… Most of his therapists are too scared to deal with him, because of his anger management issues. So how the hell do we get him, if nobody’s willing to help him, how do we get him the help?

Incarceration as a public health opportunity HL Cooper, CD Clark, T Barham, V Embry, B Caruso & M Comfort (2014) “He Was the Story of My Drug Use Life”: A Longitudinal Qualitative Study of the Impact of Partner Incarceration on Substance Misuse Patterns Among African American Women, Substance Use & Misuse, 49:1-2, 176-188, DOI: 10.3109/10826084.2013.824474

Acknowledgments National Institutes of Health: R01 MH078743 (Comfort, PI), R01 DA033847 (Comfort, PI), R01 MH094090 (Kral, PI) Jennifer Lorvick, Andrea Lopez, Christina Powers, Tazima Jenkins, Askia Muhammad, Alex Kral, Lynn Wenger And all of our past and present participants, who have been so generous and patient with our efforts to better understand their lives Megan Comfort mcomfort@rti.org (415) 848-1375