Trauma and adversity, including criminal justice involvement, are significant social determinants of health. Criminal justice involvement is associated with increased rates of substance use, mental health needs, cardiovascular disease, hepatitis C, and HIV. Consequently, there is often an elevated risk of death immediately following release. Still, despite the unique health risks associated with incarceration, healthcare providers receive minimal training on how to support the distinct needs of this population.
Since 2013, the Reentry Education Project (REP) has worked to fill clinicians’ gaps in knowledge and improve their ability to engage people with criminal justice histories in HIV prevention, treatment, and care. We provide a training to healthcare providers across New York City that highlights rates of trauma, barriers to healthcare, and unique triggers and stressors among people within this population. We encourage healthcare providers to be compassionate toward individuals with justice histories, and build on the strengths their patients already possess.
REP’s training curriculum has been shaped by contributions from Fortune participants and people with a history of incarceration. In 2017, REP collaborated with several advocacy apprentices, working in Fortune’s David Rothenberg Center for Public Policy (DRCPP) to raise awareness and advance reform on critical issues impacting people living with HIV and AIDS. This work is supported by the MAC AIDS Fund.
In 2017, Advocacy Apprentices collaborated with Micaela Linder, Director of Health Policy and Practice, to create a list of health advocacy tips for people who are currently incarcerated. Here are five ways to maintain health while incarcerated:
– Keep your own record of dates, visits, and tests with doctors.
– Keep track of any symptoms you had, including when you experienced them, where in your body you experienced them, and how long they lasted.
– Ask for copies of all of your medical records, and keep track of who you asked.
– Store a copy of your prescriptions in your cell or on your person.
– Research the medication you are being prescribed by going to the law library. Keep copies of what you find.
Get to know your prison’s grievance process, and keep all required forms in your cell. The Prison Litigation Reform Act of 1996 requires you to go through all levels of the prison grievance system before filing a federal lawsuit. Keep grievances clear and concise. Keep copies of every complaint you write and the replies you get. In any future grievance, these will prove a pattern of “deliberate indifference.”
Sample Grievance: I am diagnosed with (condition) and have (relevant symptoms) associated with this diagnosis. (Treatment) is typically used to alleviate these symptoms. As an individual who is incarcerated, I do not have access to (treatment listed above). On (date), I saw (name of staff person) and requested (treatment listed above). I was denied and was not provided any other effective means of controlling my (symptoms). I am requesting (treatment) to control my (symptoms).
If you are having difficulties accessing your medication, ask someone outside the prison to make a phone call to the prison on your behalf.
If you have a doctor you trust on the outside, call them and ask for a second opinion. Ask this doctor to sign a waiver so they can see your medical records.
– Ensure the use of gloves by healthcare providers.
– Ask medical providers to remove instruments from their packaging in front of you. This way you can ensure that medical instruments are sterile.
– Ask your doctor to be screened for HIV and hepatitis C.
– Ask your doctor about PrEP and PEP. PrEP (pre-exposure prophylaxis) helps protect people from HIV infection. PEP (post-exposure prophylaxis) is a 28-day prescription that can prevent HIV transmission if it is taken within 36 hours of potential exposure.
Ask your doctor when your medications will be dispensed and when they need to be refilled.
This article was featured in The Fortune News issue on Policy and Advocacy. Learn more about our efforts to build an equitable and conscionable criminal justice system and the people whose lives are impacted by our Health Services program.
*Written by Micaela Linder, Director of Health Policy and Practice