Nurses Play an Important, Perhaps Surprising Role in Prison Reform

April 2016
David Vlahov

When President Obama commuted the sentences of 61 inmates in March 2016, it was the most visible element in a flurry of prison reform activities aimed at relieving overcrowded prisons and finding alternatives for nonviolent offenders.

Among those activities: The federal prison system has been releasing thousands of individuals who received long sentences for low-level, drug-related, nonviolent crimes. Sentencing reform bills are making their way through Congress. The Releasing Aging People in Prison (RAPP) project – an advocacy campaign aimed at helping older, low-level offenders – is gaining momentum.  

This is important and humane work, but achieving the desired goal will not be easy. Studies have shown that the greatest period of risk for inmates is soon after release, with high rates of drug overdose and rearrest. This should surprise no one. Releasing individuals who have spent years behind bars to a new and challenging environment with little or no preparation is bound to present many challenges.

Nurses can play an important role in helping to ease these transitions.

While community reintegration programs already exist to help former inmates, they have had mixed results. Those focused solely or mostly on employment have tended to have little effect on recidivism. In contrast, those that have provided a more holistic, multimodal approach (e.g., employment, education and health care) have tended to do better, not just in reducing rearrests, but also by showing improvements in other dimensions. Our alumna and faculty member Elizabeth Marlow, for example, has been on the leading edge of shaping a humanistic approach to re-entry, with a particular emphasis on education. Her work demonstrates one way that nurses can play a crucial role in supporting effective reintegration.

Especially as the prison population has aged, sending people back into the community who are relatively healthy and who have the skills to maintain their health is another key challenge. Our doctoral student Doug Long not only uses direct care and patient education to better prepare prisoners for their arrival in civilian life, but is also doing important research about aging in prison. He is a fine example of how nurses can deliver both critical observations and academic research to support policy change and transitional care programs.

Reversing the excesses of prison sentencing that came into being during the War on Drugs has become a bipartisan issue, one of the few on which there appears to be widespread agreement. As nurses, we have an obligation to bring our expertise to this critical issue and help build healthy transitions for individuals and the families and communities to which they return.

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