Over the recent past the number of inmates in the penitentiary system has significantly increased. Once convicts are sentenced to prison, they depend on prison authorities to provide quality healthcare services. Inmate populations have, however, been underserved, leading to an increase in the cases of chronic medical conditions, infectious diseases and other cases. Access to quality medical care, pharmacotherapy, prescription medication and other services is still a problem in the penal system. The purpose of this essay is to provide a comprehensive of healthcare in prison populations, the impact of policies and efforts being made to improve pharmacology therapy in the system.
A Research done by Fernandes, Alvarenga, Santos & Filho, 2014) shows that in the contemporary world, the cost of providing health care for inmates in both state and local prisons has gone up by a significant amount over the past couple of years. Since many penitentiaries are secure facilities, they operate far away from the public view and as such, the issue of inadequate health care in these systems is invisible. Many governments have many issues to concentrate on and the healthcare of inmates is not a priority. They have, therefore, neglected healthcare sectors for prisoners because the current cost of financing the penal system has gone up as a result of the increase in the number of convicts.
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In many nations, prisoners in the penal system receive health care services that are far inferior to the standards that are offered to individuals in the outside communities. In other cases, this population has been neglected to a point that they receive no medical services during their stay in prison. Møller & World Health Organization (2007) observe that with existing health care problems are normally ignored whereas others develop new complications after incarceration due of poor health conditions and inadequate control of transmittable diseases. Healthcare in the penal system has become a very serious issue since most states ignore its influence on the inmates they harbor. In many cases, prisons serve as a breeding ground for diseases such as tuberculosis, and HIV/AIDS among other critical ailments. For instance, many prisons have reported an increase in the number of tuberculosis cases among their inmate population because of the overcrowded conditions where there is inadequate room for accommodating prisoners.
Lack of Social/Public policy, Healthcare Policy, and past decisions
Over the recent past, there has been an increase in the number of prison-based pharmaceutical therapy programs ( Rich, Allen & Williams, 2015 ). Despite this fact, many correctional facilities still offer poor health care services to their inmate population. Policymakers have failed to solve this issue, thinking drug treatment programs would be too lenient for convicted felons. Unprecedented incarceration rates coupled with a limited access to mental and health care services have also increased the rate of complicated health profiles among the inmate population.
A research conducted by the Center for Substance Abuse Treatment (2005) shows that many states and federal prisons do not provide proper treatment for inmates with mental conditions. Inmates who were previously addicted to certain drugs may find it hard to cope with rehabilitation conditions in prisons. If penitentiary systems adopted pharmaceutical therapy programs for these convicts so that they could start taking methadone during their incarceration period, their likelihood of drug use and engaging in risky behavior may be significantly lowered. Lack of such policies in prisons hinders the provision of substitute treatment programs that are aimed at improving the overall health and well-being of an inmate.
Lack of healthcare policies to improve the quality of healthcare services in the penitentiary system has contributed to the growing numbers of sexually transmitted infections and other infectious diseases. A research conducted by Rich et al. (2014) shows that only 25% of HIV infected inmates are aware of their status. This alarming issue increases the risk of transmitting this disease to others due negligence by the prison authorities. Moreover, Hepatitis C was found to be ten times more prevalent in prison populations as a result of failed treatment programs. Other sexually transmitted diseases such as syphilis were also very common in female convicts. Whenever governments fail to implement social and health policies in the penal system, inmates are deprived of their right to access proper health care during their incarceration period ( Dumont, Brockmann, Dickman, Alexander & Rich, 2012 ). Consequently, the chances of this population spreading infectious diseases such as HIV, hepatitis C, and tuberculosis, among others, to the outside community increases. In addition, failure to address mental illness cases among inmates has also increased the rate of drug use and criminal activity in the society after the inmates return home.
According to the National Research Council. (2013) , the Supreme Court provided a ruling in 1976 that stated the government was obligated to provide medical care to the prison population and failure to do so violates a prisoner’s constitutional rights. However, most systems tend to fail to obligate this policy. All inmates rely on prison authorities to treat their medical needs. Therefore, failure to provide proper medical treatment may lead to some certain forms of physical and mental torture or death in some cases.
There is a higher rate of chronic ailments such as hypertension, asthma, cancer, hepatitis, cervical cancer, and arthritis among others in prisons as compared to the outer population ( Rich, Allen & Williams, 2015 ). Moreover, neglecting this population has also increased the rate of drug dependence in correctional facilities with higher rates being recorded among the female population. This shows that pharmaceutical therapy has failed in these systems because its use would have reduced drug abuse and drug-related crimes on the streets. Despite the adoption of pharmaceutical therapy programs in prisons, only 15% of the inmate population needs this treatment receives it during their years behind bars ( Greifinger, 2007 ). This has greatly increased the number of deaths that are recorded in prisons every year due to poor medical attention.
Efforts to improve access, equity, and affordability related to Pharmacologic Therapy
From the discussion provided above is the evidence that something needs to be done to improve the pharmacologic therapy programs that are available to inmates. Penitentiary systems must to develop strategies that will enable them to detect, prevent and offer proper treatments for convicts with mental disorders as well as those who suffer from chronic diseases ( Fernandes, Alvarenga, Santos & Filho, 2014 ). Many prisons are implementing public health goals that will provide room for their facility to offer medical services despite the scarcity of funds and resources from federal governments. It is crucial to provide synergistic health education to inmates as an intervention program to encourage them to avoid risky behaviors. This serves as a significant step in assessing the needs of the prison population since it would be adopted as an integrated policy for the entire criminal justice system.
The criminal justice system has made efforts to divert convicts with mental disorders to mental health facilities. According to the National Research Council (2013) , prison systems have been turned into a dumping site for mentally challenged felons even though this is not the right place for them. A correctional facility is focused on punishment and incarceration as opposed to care and treatment. Some federal governments are in the process of passing policies that will allow prisoners to be transferred to public psychiatric facilities for treatment during arrest, prosecution, trial, and imprisonment. In addition to this, it is necessary for mentally challenged felons to mental health facilities before they are sent to prison. Not only will this reduce the burden of offering health services to mentally challenged, but also ease the overwhelming prison population and help to deal with the imprisonment of mentally challenged individuals as a result of inadequate public mental alternatives. Consequently, this solution will provide room for pharmacology therapy to inmates who resort to drug abuse as a result of social, cultural or economic factors.
According to Anaraki, Plugge & Hill (2003) prison authorities need to introduce programs that will foster the provision of quality health care services in their facilities. In some systems, mentally challenged prisoners have access to pharmacology therapies and treatment programs. Inmates who suffer from other diseases, as well as substance abusers, are also included in the initiatives. A sizable number of prisons have gone an extra mile to provide comprehensive medical training to prison workers. Mental health teams frequently visit these facilities to assure prisoners gain full access to good quality health services. This helps to improve pharmacology therapy programs in prisons and increase the overall health of the prison population.
Research studies on the quality of healthcare in penitentiaries have shed light on the challenges that many inmates face during their years of incarceration. Interviews with inmates, prison staff, wardens, and health practitioners have shown that medical care in prison populations has been neglected by both state and federal governments ( Ramaswamy & Freudenberg, 2007 ). Consequently, the findings have been examined by relevant authorities so that effective policies can be initiated to counter this problem in prisons. These studies have also helped in the implementation of prison management systems in correctional facilities, which have ensured that the health needs of the prison population are met ( Smith & Braithwaite, 2016 ). Staff and prisoners have also been included in the policy reforms that will be made as a means of providing accountability for the health plans to be developed. These will pave way for the adoption of better pharmacology therapy programs for prisoners who require medical attention.
Role of the Nurse in issues of Social Justice
In the medical arena, nurses have a responsibility of ensuring that they advocate for social justice by supporting laws, policies, and procedures that are designed to bring equity in the health care system ( Paquin, 2011 ). The scope of the practice requires one to become a patient advocate by safeguarding the latter’s autonomy and making decisions on behalf of those who are not able to make decisions for themselves. Working in prison environment, nurses are required to campaign for social justice by tackling issues that affect the health care system. These may include drug abuse, addiction, poverty, homelessness, and penitentiary health systems. Nurses must raise their political voices on critical issues that may require immediate attention in the community ( Grace & Willis, 2012 ). For instance, there is a need for nurses to advocate for a better healthcare program for the prison population so that they can reduce the cases of infectious diseases, addiction cases, criminal activities and deaths in prisons. In short, they are expected to move beyond their scope of responsibility and work outside the walls of their institutions to ensure that everyone receives equal healthcare treatments ( Pearson Education, 2015 ).
From the discussion provided above, it is evident that something needs to be done to improve the availability and access of quality healthcare in prisons. The prison population is underserved in this sector as a result of inadequate policies to oversee the improvement of pharmacology therapy programs. Consequently, this has increased the rate of drug dependence and chronic ailments in penitentiaries. Efforts have been made to improve the affordability of pharmacology therapy in prisons even though this has not helped to reduce the overall situation in penitentiaries.
References
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National Research Council. (2013). Health and incarceration: a workshop summary . National Academies Press.
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