Clinical and legal implications of gangs

Abstract Gangs are a fact of life in jails and prisons. The extent and impact of gang activity on a facility will depend on the size and geographic location of the facility. Smaller jails and prisons, or facilities in rural areas, are more likely to be involved with local or regional groups, also known as street gangs, while large facilities in urban areas will be affected more by nationally known or connected gangs. One survey of Florida prisoners found that incarcerated persons who were suspected or confirmed gang members were 35% more likely to commit violent acts than nonmembers. In a study of 2,158 male prisoners in the Arizona Department of Corrections, gang-affiliated individuals were more than twice as likely as nonaffiliated individuals to commit an assault during the first three years of confinement. Since institutional management often involves restriction of privileges, placement in long-term restrictive housing, or transfer to a control unit prison, advocacy groups and incarcerated people have filed suit against these policies based on First and Eighth Amendment, religious freedom, and antidiscrimination claims. Gang validation procedures themselves have been challenged as arbitrary and inaccurate, leading to inappropriate segregation or restrictions on prisoners who have exhibited no institutional violence. Psychiatrists need to be aware of the dynamics of gang leadership, membership, or involvement when working with any gang member, as that may affect their ability and interest in collaborative treatment. These issues and best practices for intervention will be presented in this chapter.