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7 Health & Just. 1 (2019)

handle is hein.journals/hlthjs7 and id is 1 raw text is: Semenza and Grosholz Health and Justice
https://doi.org/1 0.1186/s40352-018-0082-5

(2019) 7:1

Health and Justice

Mental and physical health in prison: how
co-occurring conditions influence inmate

and Jessica M. Grosholz

Due to the deinstitutionalization of mental health hospi-
tals across the United States (U.S.) over the last fifty years,
the U.S. prison system has witnessed an increase in the
number of those in prison with mental disorders (see
Primeau et al., 2013) with research suggesting that there
are 10 times more individuals with a mental disorder in
prison or jail than housed in mental hospitals (Haney,
2017; Torrey et al., 2014). In addition to this significant
rise in mental disorders behind bars, rates of co-occurring
disorders are striking.1 Past investigations find that of
those in jail with severe mental disorders, there is a 72%
rate of co-occurring substance abuse (Abram & Teplin,
1991). More recent evidence also suggests that people in
*Correspondence: Danielsemenza@rutgers.edu
Department of Sc ology, Anthropo ogy, & Crminal Justice, Rutgers
University, 405-7 Cooper Street, Camden, NJ 08102-1521, USA
Full list of author information is available at the end of the article


prison with a mental disorder are more likely to experi-
ence substance abuse than those without (Mumola &
Karberg, 2006). Corrections scholars find that people in
prison who suffer from co-occurring disorders are more
likely to engage in violence and misconduct, as well as be-
come victims of such aggression (Friedmann et al., 2008;
Houser et al., 2012; Houser & Welsh, 2014; Wood, 2012,
2014; Wood & Buttaro Jr., 2013). Researchers typically de-
scribe an individual as suffering from a co-occurring dis-
order if they experience both a mental disorder and
substance use disorder. However, no research has exam-
ined how suffering from a mental disorder combined with
a physical condition influences prison behavior despite the
fact that those in prison have worse physical health than
their non-institutionalized counterparts (see Aday, 2003;
Loeb et al., 2008; Williams & Abraldes, 2007).

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http//creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license. and indicate if chanoes were made.

Daniel C. Semenza

Background: Research has shown that inmate misconduct is related to a range of demographic factors and
experiences with the criminal justice system. Poor mental and physical health has also been associated with inmate
misconduct, although no research has examined the relationship between co-occurring conditions and misconduct
in prison populations.
Methods: We rely on data from the 2004 Survey of Inmates in State Correctional Facilities (N= 14,499) and use
negative binomial regression models to examine the relationship between types of co-occurring mental and
physical conditions and misconduct.
Results: The results demonstrate that people in prison dealing with concurrent mental and physical health
problems are significantly more likely to engage in prison misconduct than healthy incarcerated individuals. After
accounting for physical and co-occurring health conditions, mental conditions are not associated with serious
Conclusions: Enhancements in prison healthcare may not only improve the general health of those in prison, but
also contribute to a decrease in misconduct. Research that examines the relationship between mental health and
deviant behavior in and out of prison should consider the multifaceted elements of a person's health, including
acute and chronic physical ailments.
Keywords: Inmate misconduct, Physical health, Mental health, Co-occurring disorders, General strain theory

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