Mischief, Mayhem, and Remediation.

Institutional rules are necessary to preserve safety and security in correctional systems. An assessment of relevant mental health problems is a key element of a fair disciplinary process. Though these hearings are administrative in nature, we recommend that mental health evaluations related to disciplinary matters be completed by qualified and well-trained professionals using consistent standards.

Prescribing for Women in Corrections.

Prescribing for women in jails and prisons requires special consideration and should be informed by extant evidence. Incarcerated women have higher rates of mental illness than both females in the community and incarcerated men. Medication administration concerns that may disproportionately affect female prisoners include drug-drug interactions with contraceptives, intermittent dosing schedules, and concerns about metabolic side effects.

Characteristics of Inmates Who Initiate Hunger Strikes.

A hunger strike is a common, expensive, and potentially lethal event within a correctional institution. In this study, we describe the characteristics of inmates who initiated hunger strikes in a state prison system. Electronic medical records for a state prison system were reviewed for documentation of hunger strikes from January 2005 through September 2015.

Characteristics of Inmates Who Misuse Prescription Medication.

Substance use disorders are common among incarcerated individuals, and prescribed medications have been reported as abused, diverted, or otherwise misused in correctional settings. We conducted a retrospective chart review of electronic medical records and reports on institutional charges for misuse of authorized medication by inmates in the New Jersey Department of Corrections between 2003 and 2013. The most frequently cited medications for misuse were gabapentin, diphenhydramine, clonidine, and ibuprofen.

Better Prescribing in Correctional Facilities.

Serious mental illness is highly prevalent in jails and prisons, and treatment with psychiatric medications is often required. However, operational factors and patient characteristics make prescribing in correctional settings uniquely challenging. The American Academy of Psychiatry and the Law has approved the formation of a working group to create a Resource Document examining best practices for prescribing psychiatric medications in these settings.

The prevalence of delusional disorder in prison.

Delusional disorder has important implications for forensic psychiatrists, as delusions are not infrequently related to criminal behavior. Thus, we hypothesized that delusional disorder is over-represented in correctional populations. We conducted a retrospective chart review of the electronic medical records from 2000 to 2012 of New Jersey Department of Corrections inmates who remained incarcerated as of March 2012.

Commentary: bridging the gaps for former inmates with serious mental illness.

Serious mental illness is a prominent and vexing problem within the correctional systems of North America. Simpson and colleagues draw attention to the epidemiology, special characteristics, and management problems relevant to Canadian inmates with serious mental illness. Of great interest to those in the forensic psychiatric field is the matter of continuation of care for mentally ill prisoners, in that untreated or undertreated psychiatric problems are strongly associated with poor social functioning and criminal recidivism.

Successful removal of quetiapine from a correctional formulary.

The abuse of medications in prison is a phenomenon well known among correctional health care professionals, and quetiapine has emerged as a drug of abuse in these settings. Considering the risks of abuse and diversion and the high cost compared with effective alternative antipsychotic medications, the New Jersey Department of Corrections (NJDOC) Pharmacy and Therapeutics Committee voted to remove quetiapine from the formulary. In a retrospective chart review, clinically relevant outcome measures were evaluated in patients prescribed quetiapine at the time of this change.

Diversion to the mental health system: emergency psychiatric evaluations.

In Maryland, any citizen may petition to have individuals brought against their will for an examination by a physician. In this retrospective chart review, we evaluated the characteristics of 300 persons referred to the Johns Hopkins Hospital on emergency petitions. Sixty-one percent of petitions described individuals who made verbal or physical threats of self-harm.