Foreword
The International Association for Correctional and Forensic Psychology (IACFP) takes immense pride in the professional contributions of our leadership, whose expertise continues to shape the global landscape of correctional mental health. In this issue, we are pleased to spotlight the recent work of long-time board member, Dr. Jeffrey Metzner – forensic psychiatrist, international consultant, and associate director of the Forensic Psychiatry Fellowship Program at the University of Colorado – Anschutz, based out of Denver, Colorado, United States. The release of the Oxford Textbook of Correctional Psychiatry, Second Edition, which was co-edited by Dr. Metzner, represents a significant scholarly achievement that warrants special attention. This edition provides progress and continuity to a text that has served as the fundamental resource for practitioners and administrators alike for over a decade.
In the following review, Dr. Melvin Hinton (IACFP Past President), Dr. William Puga, and Dr. Shane Reister explore how this comprehensive update addresses the evolving field and unique challenges of the correctional environment. This feature serves not only as a review of the strengths, limitations, and highlights of this definitive text, but as a testament to the high caliber of expertise within the IACFP board.
Tia Tourville
IACFP Interim Executive Coordinator
University of Texas at El Paso
A Review by Melvin Hinton, Psy.D., William Puga, M.D. and Shane Reister, Psy.D.
The Oxford Textbook of Correctional Psychiatry, Second Edition, edited by Reena Kapoor, Anthony C. Tamburello, James L. Knoll, and Jeffrey L. Metzner and published in 2025, represents a comprehensive update to the original 2015 publication. Dr. Jeffrey Metzner’s return as a principal editor provides important continuity across the decade separating the two editions. The text is clearly intended as a reference work for correctional mental health practitioners, administrators, and staff, as well as students and others seeking focused study in correctional psychiatry or correctional mental health more broadly. It is an excellent read for the new correctional clinician as it acknowledges the emotional experience of the clinician, the novelty of the environment, and begins to familiarize the reader with a new lexicon, both official and colloquial, which is unique to corrections and allows for more effective communication within carceral settings.
One of the book’s major strengths lies in its diverse group of contributing authors such as Drs. Robert Trestman, Dean Aufderheide, Thomas Kocienda, Joseph Penn and James DeGroot (Past IACFP Board Member), whose collective expertise spans scholarly, clinical, and administrative perspectives from carceral systems around the world. This breadth allows readers to explore a wide range of topic areas within correctional settings in a manner that is accessible, engaging, and aligned with the book’s stated purpose as a reference text rather than a procedure manual. The organization of the book is logical and effective, beginning with historical context and progressing through jurisdictional structures, environmental realities of correctional settings, and ultimately into specific clinical and operational topics routinely encountered in correctional psychiatry. Each chapter provides a solid overview while also directing readers to extensive references for deeper, more focused inquiry. This approach successfully maintains a broad target audience while encouraging continued engagement.
This book nicely explains the role of the major legal decisions that have led to the creation of the concepts of correctional psychiatry. A good review of Supreme Court decisions such as Sell v. United States (2003), Vitek v. Jones (1980) and Harper v. Washington (1990) are foundational to the understanding of the workings of the correctional milieu. Viewpoints from other sectors such as Veterans Administration, National Commissions on Correctional Health Care (NCCHC), American Correctional Association (ACA), American Academy of Psychiatry and the Law (AAAPL), and the Department of Justice (DOJ) add to the understanding that this is still a dynamic and evolving field.
Critiques & Recommendations
The book’s emphasis on breadth, however, also presents challenges. Because topics are introduced at a high level, opportunities for deeper analysis are necessarily limited. For example, when discussing staffing needs in jails versus prisons, the text appropriately emphasizes differences in acuity, supervision, and clinical demands, but stops short of fully exploring the operational implications of those differences. While readers are directed to references and related chapters, these sections often encounter the same limitation of broad coverage without sustained depth. At times, opposing viewpoints are presented, resulting in the reader needing to sit with the discomfort of a complex system in which all views need to be considered.
A similar issue arises in the discussion of evidence-based systems and programs. The authors convincingly argue that the use of proven treatment models can help correctional systems deploy limited human resources more effectively, particularly in environments where staffing shortages are chronic. They also note the ongoing tension between treatment, educational, vocational, and security demands—an especially salient issue given that incarcerated individuals present as “whole persons” with complex, overlapping needs. Although these competing demands are clearly identified, the discussion would have benefited from a more in-depth examination of how systems might better reconcile constitutional requirements, statutory mandates, accreditation standards, and internal policies with limited staffing and resources. Given the global expertise represented among the contributors, the inclusion of a synthesized set of aspirational recommendations or “wish-list” solutions might have strengthened the text.
Highlight #1: Substance Use in Correctional Settings
Despite these limitations, this book provides a particularly strong and comprehensive review of substance use disorders in correctional settings. The authors highlight the dual challenge of maintaining institutional safety while providing effective, therapeutic care to incarcerated individuals with addiction needs. Research examining the prevalence of illicit substances within jails and prisons is summarized, with findings indicating the use of opioids, stimulants, cannabis, alcohol, and hallucinogens. Notably, opioid use is emphasized as occurring at higher rates than cocaine and methamphetamine, underscoring the importance of targeted intervention strategies.
The authors identify both staff and incarcerated individuals as potential sources of illicit substances and describe common methods of drug trafficking within facilities, including the use of chemically treated paper, concealed balloons, and improvised alcohol production using available food items or hand sanitizers. These practices are linked to significant adverse health and criminal justice outcomes. Approximately one-third of incarcerated individuals report substance use during incarceration, with injection drug use posing heightened risks for needle sharing and bloodborne pathogen transmission.
The text offers a useful overview of the primary and secondary effects of specific substances, withdrawal syndromes, and ways psychiatrists can use this information for patient education. Particularly noteworthy is the discussion of botulism risk associated with the use of raw potatoes in the production of intoxicants—an example of the text’s attention to clinically relevant but often overlooked hazards. The chapter on misuse of commonly prescribed non-controlled medication also highlights important considerations that would easily be overlooked.
Opioid use receives appropriately significant attention, given the heightened risk of overdose and infectious disease transmission. The authors examine barriers to medication-assisted treatment within correctional settings and note how reduced access to methadone or other medications may inadvertently encourage smuggling behaviors to avoid withdrawal. The text strongly supports expanded access to medications for opioid use disorder and the availability of naloxone as essential harm-reduction strategies. Emerging threats, such as the use of novel psychoactive substances—including pyrethroid-containing insecticides—are also addressed, with attention to their associated behavioral and medical risks.
Highlight #2: Comprehensive Practice & Collaboration
The authors propose a consultative role for correctional psychiatrists that extends beyond direct patient care. This includes staff education, diagnostic clarification, treatment planning, interpretation of toxicology results, collaboration with other medical providers, and participation in policy development.
Some time is spent helping the reader understand the nuances of the collaborative relationship between clinician and security and concluding that this alliance is what helps provide the best clinical care for the incarcerated person. The added benefit of the collaboration is having the insights and observations of many different people as well as having a longitudinal view of symptom pathology development. It is an opportunity not to be squandered.
The chapter on treatment models highlights the persistent gap between need and service utilization, noting that despite more than half of incarcerated individuals meeting criteria for substance use disorders, only a portion participate in treatment programs during incarceration. While the historical review of treatment needs is informative, more current research is needed to understand if participation rates remain low.
The overview of cognitive-behavioral treatment models is particularly helpful, providing concise descriptions and effectiveness assessments of programs such as Strategies for Self-Improvement and Change, Moral Reconation Therapy, Reasoning and Rehabilitation, and Start Now. These sections offer practical value for clinicians and administrators considering program implementation.
Beyond substance use, the text emphasizes the social barriers faced by many incarcerated individuals, particularly as they relate to reentry and the risk of recidivism. These barriers are framed as critical considerations for effective correctional mental health care and discharge planning.
Highlight #3: Special Populations – Gender & Sexual Orientation
The book devotes substantial attention to distinct populations within correctional systems, beginning with a thorough review of women in corrections. The authors trace the dramatic rise in women’s incarceration due to the War on Drugs and examine gender differences in offense patterns, sentence length, and overrepresentation of minorities. Trauma emerges as a central theme, with women reporting higher rates of physical and sexual abuse prior to incarceration and strong associations between childhood victimization and adult revictimization. These findings are linked to increased engagement in high-risk behaviors.
In response, the text outlines gender-responsive treatment models that emphasize physical and psychological safety, comprehensive case management, and attention to childcare, financial needs, and family relationships. The importance of maintaining maternal contact with children through facility design and technology is highlighted, as is the role of effective discharge planning in sustaining treatment gains achieved during incarceration. The authors also underscore the need for integrated treatment approaches addressing substance use disorders, post-traumatic stress disorder, and comorbid conditions, with therapeutic communities presented as an alternative to crisis-driven interventions.
Special consideration is given to lesbian, gay, bisexual, and transgender (LGBT) populations in correctional settings. The authors explore minority stress as a contributor to higher rates of mental illness and examine the unique vulnerabilities faced by transgender individuals, who experience disproportionately high rates of incarceration. The discussion includes findings related to depression, anxiety, suicidal ideation, and the compounded effects of stigma, victimization, and institutional barriers. The authors recommend comprehensive assessment strategies that include evaluation of staff attitudes and knowledge, as well as targeted interventions to reduce victimization.
Resilience is presented as a critical protective factor for LGBT individuals in custody, with attention to strategies that may mitigate the chronic stressors inherent in carceral environments. Substance use patterns within LGBT populations are also explored, including the psychological functions of intoxication and differences in commonly used substances across subgroups.
The text concludes by challenging correctional psychiatrists to reflect on their own biases and how these may influence diagnosis, treatment planning, and clinical interactions. Practical guidance is offered for conducting interviews that avoid biased assumptions related to sexual orientation or gender identity. An introductory overview of transgender-specific needs highlights the importance of developmental history, the impact of gender-related stressors on clinical presentation, and the implications for institutional policy, treatment planning, and environmental design.
Conclusion
Overall, The Oxford Textbook of Correctional Psychiatry, Second Edition succeeds as a comprehensive and accessible reference that balances clinical, administrative, and policy perspectives. While its broad scope occasionally limits depth, the text offers substantial value through its organization, diversity of contributors, and extensive references. It serves as a strong foundation for practitioners, administrators, and students seeking to understand the complexities of correctional psychiatry and mental health care within carceral systems.
Melvin Hinton, Psy.D., William Puga, M.D. & Shane Reister, Psy.D.
