The number of refugees and people seeking asylum worldwide has risen significantly over the past 10 years. These individuals are often placed in immigration detention facilities following their migration journey. Previous studies, including a systematic review conducted in 2018, indicate that detention may be associated with an increase in mental health difficulties. The present review aimed to update the 2018 review by reporting on more recent studies investigating the prevalence of mental disorders and symptoms in immigration detainees, and whether the length of detention increases the likelihood of such disorders. Six databases were searched for quantitative, peer-reviewed studies reporting on the prevalence of psychiatric symptoms or disorders in adults and children who had experienced immigration detention. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The findings were presented narratively. Fourteen studies were included, reporting on a total of 2777 participants. The prevalence of significant mental health problems was high in both adults and children subjected to immigration detention. The most common disorders reported were post-traumatic stress disorder (PTSD), anxiety, and depression. Children also experienced high levels of emotional dysregulation and behavioural symptoms. In adults, longer durations of detention were consistently associated with a higher likelihood of experiencing mental health difficulties. Factors related to detention environments were also associated with the prevalence of psychological symptoms and diagnosable mental health conditions. Overall, this review confirms that immigration detention has negative mental health consequences across a variety of immigration detention facilities and detainee characteristics. Recommendations based on findings are presented, including eliminating child detention, imposing upper limits to the duration of adult detention, improving mental health screening pre-detention, and providing evidence-based psychological care during detention. CRD42023487205.
Swales and detention basins represent novel engineered ecosystems dominated by ruderal plants tolerant of inundation, drought, and extreme heat. In this study, we documented the plant species coverage and biomass in swales and detention basins. In total, we documented 115 plant species (89 native and 26 non-native) in the swales, and 94 plant species (68 native and 26 non-native) in detention basins. Spontaneous plant communities in swales and detention basins are distinct, sharing only a 33% similarity. Swales exhibited higher mean species richness (ranging from 8.6 to 11.0) and higher mean vegetation cover (58 to 129%) compared to detention basins. Dry above-ground biomass was higher in swales, largely driven by graminoids. Graminoid biomass dominated swales, whereas forbs/herbs were more prevalent in detention basins, though all biomass exhibited high variability. While there was no significant difference in overall diversity, detention basins had significantly higher species evenness. However, no significant difference was found among the top 5 native and non-native species for biomass. Swales and detention basins were dominated by perennial herbs and graminoids during both summer and winter, and upland, facultative upland, and facultative species with few obligate wetland plants. Spontaneous plants in this study have adapted to harsh local conditions, such as drought, extreme heat (>36 °C), and pollution runoff. Although initial planting in newly constructed swales and detention basins should utilize native grasses, allowing spontaneous native vegetation to establish following planting is recommended. These species form resilient novel ecosystems that are inherently adapted to environmental changes.
This study examines the key determinants of ship detention duration under Port State Control (PSC) within the Black Sea Memorandum of Understanding (MoU) region, comparing pre-pandemic and pandemic inspection outcomes. Using 756 PSC detention cases retrieved from the Black Sea Information System, a Tree-Augmented Naïve Bayesian Network (TAN) and Association Rule Mining (ARM) were applied to identify both probabilistic dependencies and frequent co-occurrence patterns. The TAN analysis revealed that PSC Authority exerted the strongest influence on detention duration, with its impact increasing notably during the pandemic. ISM Code-related deficiencies also became more critical, while traditional technical deficiencies such as Fire Safety and Life-Saving Appliances declined in significance. ARM results further highlighted that ISM non-compliance on older Ro-Ro vessels, were closely associated with detentions longer than two days in Russian and Romanian ports. These findings underline the necessity of authority-specific, risk-based inspection strategies and improved standardisation of ISM audits to minimise operational disruptions. This study is the first duration-focused analysis for the Black Sea MoU using an integrated TAN + ARM framework.
Involuntary psychiatric detentions have been increasing in Ontario, raising concerns about patient rights and health equity. Social determinants such as immigration status, indigeneity, housing instability, and socioeconomic disadvantage are known to contribute to this trend. However, population-level evidence on how these factors influence involuntary admissions remains limited. Using data from the Ontario Mental Health Reporting System (2013-2023), the authors analyzed 53,088 adult psychiatric detentions. Sociodemographic and clinical variables from the Resident Assessment Instrument-Mental Health were assessed by logistic regression, adjusted for age, sex, psychiatric diagnosis, and previous psychiatric admissions. Joinpoint regression was used to evaluate temporal trends. Involuntary admission and psychiatric assessment accounted for 28.2% and 25.2% of hospitalizations, respectively. Recent and long-term immigrants had significantly higher odds of involuntary admission (adjusted OR [AOR]=1.37 and 1.51, respectively). Indigenous identity was associated with increased odds of psychiatric assessment (AOR=3.06) but not involuntary admission. Postsecondary education lowered the risk for involuntary psychiatric admission (AOR=0.84). Homelessness and no income were associated with increased odds of psychiatric assessment (AORs=1.73 and 1.11, respectively) and with involuntary admission (AOR=1.87 and 1.43, respectively). Recent and long-term immigrants also had lower odds of psychiatric assessment (AOR=0.81 and 0.95, respectively). Annual involuntary admission rates increased by 3.3% over the decade. Immigrants, homeless individuals, and those with lower education or income face disproportionate risks for involuntary psychiatric detention in Ontario. Policies that address upstream social determinants, such as housing and income support, and ensure culturally safe preventive care are needed to reduce coercion and promote equity.
Detained youth are disproportionately affected by sociostructural determinants of health and consequently experience substantially higher rates of behavioral health (i.e., mental health and substance use) concerns than their similarly aged peers. Although the juvenile legal system is purportedly grounded in a rehabilitative model, gaps in access to timely behavioral health services during incarceration are common and undermine this goal, highlighting confinement itself as an additional sociostructural determinant of health. Brief, intensive, and concentrated (BIC) interventions have been proposed as a promising approach for addressing behavioral health needs among detained youth; however, empirical evaluations of such approaches are limited in correctional settings. One type of BIC intervention, single-session interventions (SSIs), holds significant potential for short-term youth detention settings but must be contextually adapted to support ethical, feasible, and effective implementation. In this commentary, we outline key ethical, cultural, and implementation considerations for SSI delivery and identify strategic points across the detention trajectory where SSIs may address unmet behavioral health needs (e.g., entry into detention, following disciplinary incidents, before and after court hearings, and before reentry). We conclude by discussing implications for future research aimed at expanding access to developmentally responsive behavioral health supports for detained youth.
The Columbia Suicide Severity Rating Scale (Posner et al.; C-SSRS) is a widely used measure, both in research and clinical practice, for the detection of suicide risk. The current study examines responses to the C-SSRS by individuals who attempted suicide in the 30 days before pre-trial jail detention. Data were analyzed from the Suicide Prevention Intervention for at-Risk Individuals in Transition (SPIRIT) trial, which was conducted from May 2016 to November 2018 and included 800 individuals in pretrial jail detention with the primary inclusion criterion being endorsement of suicidal ideation with some intent to act (endorsement of C-SSRS C4 or C5) and/or a suicide attempt in the past month. This paper focuses on the first five screener items of the C-SSRS, which assess the highest level of suicidal ideation in the past month. Most (65%) individuals who reported making a past 30-day suicide attempt indicated their highest level of suicidal ideation at the time of attempt was at the C4 (active suicidal ideation with some intent to act, without a specific plan), rather than the C5 level (active suicidal ideation with a specific plan and intent). Fewer than one-third of individuals who had made at least one past 30-day suicide attempt in our sample had made specific plans. Findings highlight the unplanned nature of many suicide attempts and the risk for suicide among individuals without detailed suicide plans. The SPIRIT (Suicide Prevention Intervention for at-Risk Individuals in Transition) trial is registered at clinicaltrials.gov (NCT02759172), Registered 3 May, 2016.
Anxiety among adolescents has increased globally during the COVID-19 pandemic. Adolescents in juvenile detention centers (JDCs) may be particularly vulnerable due to restricted liberty and social isolation. Movement-based interventions such as Dance/Movement Therapy (DMT) have been studied as approaches to support emotional regulation. This exploratory study investigated the psychophysiological effects of a structured DMT intervention on anxiety reduction among adolescents in JDCs, focusing on anxiety-related changes in dopamine (DA) levels and body temperature. This quasi-experimental study included 55 female adolescents from a single juvenile detention center. Participants were allocated to either a non-DMT control group (n = 30, 16.17 ± 1.73 years), which maintained their usual institutional routine throughout the 8-week study period, or a DMT group (n = 25, 16.23 ± 1.68 years) that completed 24 DMT sessions over the same period. Anxiety and physiological measures were assessed before and after the intervention. Anxiety was measured using the Beck Anxiety Inventory (BAI). Physiological measures included mean body temperature (mTb), calculated from tympanic (core) and skin temperature measurements, and plasma DA levels measured using high-performance liquid chromatography (HPLC). Following the intervention, the DMT group showed a significant reduction in BAI scores (-16%, p < 0.001), along with significant increases in mTb (0.11 ± 0.07 °C, p < 0.001) and DA levels (+ 30%, p < 0.001). BAI scores were negatively correlated with mTb and DA levels, whereas mTb was positively correlated with DA levels. This study provides preliminary evidence that DMT may help alleviate anxiety and support psychophysiological regulation among adolescents in JDCs. However, the exploratory design, single-center setting, and all-female sample may limit generalizability. Future multi-center studies with more diverse samples are needed to confirm these findings and clarify the underlying mechanisms.
Pregnant and postpartum individuals in immigration detention may experience barriers to accessing timely and appropriate perinatal care. The existing literature remains fragmented across global settings. This scoping review protocol aims to map the extent, range, and nature of evidence on health outcomes and healthcare delivery systems for pregnant and postpartum individuals in immigration detention. Following the Arksey and O'Malley framework and PRISMA-ScR guidelines, peer-reviewed studies and relevant grey literature will be included without language restrictions, after January 2000. Two reviewers will independently screen sources, and a third will perform full text review and extract data. Findings will be synthesized descriptively and thematically.
People incarcerated experience significant health inequities compared to the non-incarcerated population, including higher rates of many diet-related diseases. Despite widespread acceptance of the association between diet and health, research documenting the dietary intake and nutritional status of individuals incarcerated in jail is limited. Food intake is notoriously difficult to measure, and current measurement tools are not designed for the jail setting. This study aimed to assess the acceptability and feasibility of a comprehensive tool to assess food intake during incarceration. The cycle menu and commissary list from a rural county jail in the Southwest United States were used to design a dietary assessment questionnaire tailored to the carceral setting. The instrument included structured tables listing all menu items by meal (breakfast, lunch, and dinner), allowing participants to indicate the foods and proportions consumed (none, less than half, about half, more than half but not all, all, or more than one serving). Additional items captured the type and quantity of foods obtained and consumed from the commissary. Participants completed the food intake questionnaire over a 4-day period. At the end of the four days, participants provided feedback on the questionnaire's appropriateness and feasibility during group listening sessions. Verbal and written feedback was compiled and coded to identify common themes. Daily total and mean caloric, macronutrient, and micronutrient intakes were estimated using NutritionCalc Plus® and compared to appropriate Dietary Reference Intakes. Of the 65 people recruited, 64 agreed to participate in the study and 61 participants completed all four days of the questionnaire. Participants reported that they enjoyed reflecting on their diets and recommended several modifications to the questionnaire design to improve accuracy when documenting intake. Women reported consuming excess total calories and men reported consuming deficient total calories. Macronutrient consumption was within the recommended ranges for men and women, while sodium exceeded healthy recommendations. Participants also reported consuming inadequate amounts of fruits, vegetables, and minerals. With specific modifications to improve documentation accuracy, the food intake questionnaire can be used in future research assessing nutritional status in jails, prisons, and other controlled food environments.
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Over the course of 10 weeks, 12 first-year medical students from our institution designed and implemented an educational service initiative at a federal detention center. The project sought to enhance incarcerated individuals' academic preparedness for the General Educational Development (GED) exam while integrating health-related learning to promote well-being. Medical students provided weekly 4-hr sessions that covered anatomy, nutrition, mathematics, English, and Spanish, along with short lessons on sexually transmitted diseases, arthritis, and skin cancer. Educational strategies included bilingual instruction, visual aids, and post-class quizzes. Among the 1,053 incarcerated individuals housed in a federal detention center, students were able to impact a total of 814 individuals (77% of the population). Using Kern's six-step model for curriculum design, the initiative addressed both general and targeted educational needs, ensuring structured planning, implementation, and evaluation. This collaborative effort enriched the students' communication and teaching skills, strengthening their empathy toward incarcerated and marginalized populations. Despite logistical and security challenges, the project illustrated how medical education can extend beyond clinical spaces to foster community rehabilitation and health promotion. The partnership between our medical institution and federal detention center highlights the transformative potential of service-based learning to improve educational equity, promote social reintegration, and cultivate medical students' sense of professional responsibility. This initiative demonstrates how structured service-learning can inform public health education and policy by integrating medical training with detention center rehabilitation.
Suicide is a major public health concern, disproportionately impacting society's most vulnerable, including people in prison. Given the multifactorial etiology of suicide within correctional settings, a comprehensive investigation is critical. We aimed to examine timing of suicide according to imprisonment and associations with sociodemographic, criminological, and clinical factors, in a national prison population over two decades. We used cohort data from the Norwegian Prison Release study (nPRIS) including all individuals incarcerated in Norwegian prisons in the period 1.1.2000 to 31.12.2022, linked with national registry data. The primary outcome was suicide mortality during imprisonment. We calculated crude mortality rates (CMR) to explore timing of suicide and estimated Cox proportional-hazards models to investigate factors associated with suicide in prison. During the study period, 95 suicides were observed, the majority among men (94.7%), by hanging (83.2%), during pretrial detention (64.2%), and in high-security prisons (88.4%). Suicide risk was highest in the initial phase of incarceration, with a CMR of 414 (95% CI: 211-617) in the first week, more than triple the rate for the total period (CMR: 134, 95% CI: 107-161). Adjusted models showed strong associations with being incarcerated in a high-security prison (aHR: 3.82, 95% CI: 1.06-13.69), being on pretrial detention (aHR: 2.22, 95% CI: 1.72-2.86), and being diagnosed with severe mental illness (SMI) (aHR: 2.75, 95% CI: 1.51-5.02). To reduce the risk of prison suicide, prevention efforts should target incarcerated individuals in the initial period of incarceration, individuals in pretrial detention and with severe mental illness.
Receipt of violence (victimisation) is associated with a higher risk of severe mental illness and with worse illness severity; however, associations with routine clinical outcomes are less clear. To investigate associations between victimisation and subsequent clinical outcomes in people presenting with severe mental illness, using a south London health records data resource. Data were extracted for 16 372 patients presenting between January 2007 and October 2022, aged 18+ years and receiving diagnoses of schizophrenia-related disorders, mania or bipolar disorder. Recorded victimisation and subtype (any, physical, domestic or sexual) were ascertained via natural language processing from the first 3 months of the record following presentation. Cox regression models were deployed to investigate subsequent risk of mental health emergency care assessment, crisis intervention, in-patient care, Mental Health Act (MHA) detention and mortality. Poisson regression models investigated the numbers of attended healthcare events and antipsychotic agents received. Covariates included sociodemographic characteristics and clinical status (service receipt, medication, symptom profile). All victimisation exposures were associated with a higher risk of all outcomes, apart from mortality and number of antipsychotics, following adjustment for sociodemographic factors, and with emergency assessment (hazard ratio for any victimisation 1.17, 95% CI 1.09-1.27), in-patient/MHA detention (hazard ratio 1.32, 95% CI 1.06-1.65/1.82, 95% CI 1.31-2.55) and higher numbers of attended events (incidence rate ratio 1.17, 95% CI 1.16-1.19) following full adjustment. Associations were similar for subtypes of victimisation and exposures, and between men and women following sociodemographic adjustment, but the associations were slightly weaker for women following full adjustment. Experiences of violence, to the extent to which patients report their experiences and these are recorded, are risk factors for worse outcomes in severe mental illness, only partly accounted for by clinical status around the time of presentation. More systematic ascertainment and recording of victimisation needs to be considered if interventions are to be appropriately targeted.
Immigrants experience poorer HIV outcomes and poor mental health. How immigration-related stressors affect engagement with HIV care and mental health care is unclear.This study aimed to use community-based participatory research (CBPR) approaches to explore how immigration-related stressors impact HIV and mental health care for immigrants living with HIV. We conducted a qualitative interview study with semi-structured interviews of immigrants in New York City with or at risk of HIV. A Community Advisory Board of immigrants aided in study development and interpretation of findings. Purposive sampling was used to balance HIV status and immigration detention experience. Interviews focused on experiences accessing health care and social resources. We analyzed the data using an iterative, grounded theory approach. We conducted 19 interviews. 17/19 participants were from Latin America, 12/19 were trans or genderqueer, 10/19 were living with HIV and 9/19 had immigration detention experiences. Key themes included: stress from resource scarcity was partially addressed by services specific to people with HIV; entry into medical care was facilitated by targeted services for people with HIV; structural barriers limited engagement in mental health services, and community-based connections were instrumental in overcoming structural barriers. Our findings show how structural barriers to social and health-related resources impact those living with and at risk of HIV, which are partially addressed by resources specific to people with HIV and community-based support. This study highlights the need for status-neutral, structural level approaches to improve access to resources for immigrants.
Incarceration has vast and unequal impacts on public health beyond prison walls. Research from the United States documents these collateral consequences, including elevated mental illness and morbidity for the children and partners of incarcerated individuals, alongside community-level effects such as increased rates of teenage pregnancy and multidrug-resistant tuberculosis. In Latin America, however, these broader health impacts remain critically understudied. A significant barrier is the absence of data collection efforts or theoretical frameworks for mapping how Latin America's prisons affect the health of families and surrounding communities. This scoping review synthesises existing evidence on the collateral health consequences of incarceration in Latin America by conducting a comprehensive search in 2025 that included English, Spanish and Portuguese language peer-reviewed studies. From 17 included documents, prisons emerge as epicentres for tuberculosis transmission to visiting families and surrounding communities. The evidence reveals significant mental and physical health burdens on families. Women with incarcerated partners experience depression and anxiety whilst managing economic strain and expanded caregiving responsibilities, often neglecting their own health. Children of incarcerated parents show marked emotional distress, and incarcerated mothers alongside their young children face severely inadequate healthcare access within detention spaces. Despite collecting demographic data, most studies overlook how these burdens fall unequally across racialised populations. Future research must centre ethnoracial disparities and situated knowledge. Incarceration in Latin America has far-reaching effects on partners, children, families, and communities beyond prisons walls. While we know prisons’ health impacts on incarcerated people, we know far less about these broader impacts on families and communities. Most research comes from the United States, but Latin American prisons face different challenges, from severe overcrowding to limited healthcare access. In this study, researchers searched for all available evidence on incarceration’s health consequences for people outside prison walls in Latin America, finding 17 studies published in English, Spanish, and Portuguese examining impacts on partners, children, families, and communities. The evidence reveals that Latin American prisons act as amplifiers of infectious diseases, particularly tuberculosis, which spreads to families during visits and to communities after release. Beyond infectious diseases, the research shows troubling patterns for families, especially women. Female partners of incarcerated men experience high rates of depression and anxiety, and some studies found elevated stress hormones and increased cardiovascular disease risk among these women. Many neglect their own healthcare while managing financial strain, emotional burden, and increased caregiving responsibilities for children and family. Children and families experience significant emotional distress, intensified during events like COVID-19 visitation bans. The review also identified inadequate prenatal and child healthcare for pregnant women and young children living with their mothers in prison due to poor detention conditions. Understanding incarceration’s impacts on family and community health is essential for developing effective public health policies. A significant limitation appeared in how studies handled ethnoracial diversity: although some collected this information, it rarely informed health impact analysis. This oversight is particularly troubling in a region with diverse Indigenous and Afro-descendant populations, where robust evidence demonstrates pervasive racial inequalities across health, criminal justice, and other socioeconomic metrics. Future research must compile ethnoracial data informed by Latin American and locally-situated knowledge.
With increasing emphasis and awareness of U.S. immigration enforcement actions against immigrant families, there have been contested assertions by political and medical leaders that these actions by government agents constitute a form of child abuse. Substantial research documents the health impacts of U.S. immigration enforcement on children's well-being; however, findings remain scattered across disciplines. This scoping review aims to (1) identify mechanisms through which immigration enforcement produces harm to children and (2) assess whether these harms align with child welfare definitions of child maltreatment, with the goal of developing a typology of government-sanctioned child maltreatment. Following PRISMA-ScR guidelines, we searched academic databases and identified 71 empirical articles. We identified three primary mechanisms of harm: parental detention and deportation, child detention and deportation, and intensified enforcement climate and threat. Of the studies examined, 79% described harms that aligned with federal child maltreatment definitions, and 93% of state-specific articles aligned with at least one component of state-level conceptualizations, including threat/risk of harm, neglect/failure to provide, neglect due to caregiver unavailability, and emotional abuse. While most documented harms align with definitions of child maltreatment, there are challenges in classifying these as such due to legal frameworks not recognizing the government as a potential perpetrator, despite the government's own contradicting acknowledgement of the responsibility for child safety within the child welfare system. These findings support conceptualizing immigration enforcement as government-sanctioned child maltreatment. Future research should build on this typology and develop actionable frameworks to inform policy, practice, and accountability.
Expert opinion about dangerousness or risk is common at sentencing, criminal commitment proceedings and some types of pretrial detention hearings. This article argues that such evidence must be (1) "material" (logically relevant, empirically generalizable, and epistemologically germane), (2) "probative" (a measure of accuracy, which is heightened when the evidence is from an expert), (3) helpful to the factfinder (through promoting "incremental validity"), and (4) presented in a non-prejudicial manner (i.e., in a way that minimizes the possibility it will be misused or misinterpreted).
In this paper, I advance a theorization of recursive racial cruelty by focusing on the suffering of racialized respondents in the US immigration courts and connecting it to the routine functioning of the US empire and colonial racial capitalism. Immigration courts operate within the US Department of Justice (DOJ), where immigration judges hear the government's removal (deportation) cases against non-citizen residents and adjudicate their right to stay in the US. As the legal avenue for settling questions of deportation and asylum, these courts are often posed as humane and just alternatives to the spectacular public displays of cruelty involving militarized raids, abductions, and expedited deportations (sometimes to third-country prisons) that have characterized Trump's two terms in office. Using ethnographic data from 42 cases in Boston from 2020-2022, which took place during both Trump and Biden's presidential terms, I argue that the immigration courts are in fact a parallel public-facing vehicle and staging ground for racial cruelty for the US empire-state. In the immigration courts, a combination of de jure and de facto practices work daily to reinforce a racialized politics of imperial membership. In the process, it also circulates money out of the hands of racialized respondents and their families, so that eventually profit can be made. Furthermore, the racial cruelty exercised in the immigration courts, is recursive in two ways. For each immigrant respondent, such cruelty recurs and builds in every stage of the court proceedings, from the initial hearing to the adjudication of bond to the final deportation order, and through their everyday experience in proximate institutions such as detention centers. As a result of the ongoing effects of US (and more broadly, Euro-American) imperialism in much of the world, racial cruelty also recurs generationally and sometimes transnationally during immigrant respondents' lifetimes. By advancing a theory of recursive racial cruelty, this article contributes to decolonial theory building and bridges sociological literature on US immigration, race, organizations, empire, and political economy.
This study aimed to evaluate the oral health and self-perceived status of juvenile female inmates. A cross-sectional study was conducted among 100 female juvenile inmates aged 11-14 years, selected through convenience sampling. Data were collected using a self-administered questionnaire covering sociodemographics, Decayed, Missing, and Filled Teeth (DMFT), Oral Hygiene Index-Simplified (OHI-S), and the Child Perceptions Questionnaire (CPQ11-14) for self-perceived oral health. Statistical analysis was performed using the Pearson correlation coefficient. Decayed, Missing, and Filled Tooth scores were significantly associated with CPQ categories, with 63.3% of caries-free children reporting excellent oral health-related quality of life (OHRQoL). As DMFT increased, OHRQoL declined-only 25.8% with DMFT = 2 reported excellent OHRQoL, while 12.9% rated it poor. Similarly, better oral hygiene was linked to higher OHRQoL: 55.6% of children with good hygiene reported excellent OHRQoL, compared to 40.6% with fair hygiene. Poorer clinical status correlated with lower self-perceived OHRQoL. The study highlights a clear link between poor oral health and negative self-perception among female juvenile inmates. Integrating oral health care with education and psychological support in detention settings is crucial to improve their overall well-being, self-esteem, and rehabilitation outcomes.