By U.S. National Institute of Justice

In a complex system, like a hospital system or a criminal justice system, an unexpected, negative occurrence or outcome is rarely the result of a single act, event, or slip-up. More likely the bad outcome is a sentinel event — a significant negative outcome that indicates fundamental weaknesses in the system and which is likely the result of multiple factors. A systematic review of the sentinel event can identify system gaps and opportunities that improve the system and reduce the risk of future bad events. For this reason, the fields of aviation, medicine, and the military conduct a Sentinel Event Review (SER) to assess the processes that resulted in the sentinel event. A SER seeks to identify systemic opportunities for improving processes. NIJ has made investments over the years in applying the SER process in the criminal justice field. The implementation of SER in criminal justice has involved the review of negative outcomes along with “near misses” and even successful outcomes to better understand the specific conditions contributing to negative outcomes. This report discusses the application of the SER process to the Successful Transition and Reentry Together (START) program in the Eastern District of Wisconsin, the first SER in the federal criminal justice system. The SER of START reviewed four cases of individuals who participated in the program. The reviews took reentry failure as their sentinel event, although two of the four cases were successes that the SER team defined as “near misses.

Washington, DC: National Institute of Justice, 2024. 72p.

By Switchback

The report focuses on prison-leavers’ mental health. We know that the experience of prison-release can cause high levels of anxiety. At the same time mental health care in prison and especially after release is minimal and worsening.

Meanwhile at Switchback, over the last two years we have seen a 15% rise in the number of our Trainees with identified mental health needs (from 29% to 44%).

This report highlights the urgent need for us to reshape the way we release people from prison. We are calling for better mental health support for people leaving prison and for a prison release system that responds to the emotional challenges that people leaving prison are facing. A system that supports people to live life differently.

The experiences included within the report demonstrate inequities in access to care for people from ethnic minority backgrounds, with 90% of Switchback Trainees being from an ethnic minority background. Importantly mental health was a repeated topic of discussion in our Experts by Experience meetings, and together we decided we wanted to do something about it.

London: Switchback, 2024. 24p.

By Matthew S Johnston , Rosemary Ricciardelli

Public safety personnel are at an elevated risk for suicidal thoughts and behaviors relative to the general public. Correctional workers in particular report some of the highest prevalence of suicidal thoughts and behaviors. To better understand this phenomenon, the current study draws on qualitative, open-ended survey response data (n = 94) that explores three distinct themes (occupational environment, lack of support, social silence) and how entrenched notions of mental health stigma and occupational culture inform how Canadian correctional workers understand their experiences with suicidal thoughts and behaviors. We conclude with a brief discussion of the research and policy implications, with an emphasis on mobilizing efforts to normalize mental health discussion in correctional workplaces, bolstering peer support resources, and collaboration, and assessing the limited organizational supports available to struggling staff.

Front Psychol.. 2023 Jan 4:13:1026821. doi: 10.3389/fpsyg.2022.1026821. eCollection 2022.

By Matthew S. Johnston, Rosemary Ricciardelli and Laura McKendy

Researchers illuminate the mental health plight of correctional workers by demonstrating a high prevalence of mental health disorders among the group. yet, structural barriers persist in preventing correctional staff from accessing treatment and support—barriers that may result in more prolonged and pronounced symptoms. we consider correctional staff perspectives on how mental health policies at the organizational level can foster better well-being outcomes for employees. Data are drawn from open-ended survey responses from provincial and territorial correctional employees (N = 870) in Canada. Responses collectively highlight the need for a correctional staff mental health paradigm that reflects the sources of stress among correctional workers, including access to specialized mental health services that are easily accessible, immediately available, and comprehensive in nature. Additional aspects of the work environment were identified as venues for important change, including improvements in work and schedule structures, improved manager–staff relations, and changes to the physical environment.

CRIMINAL JUSTICE AND BEHAVIOR, 2022, Vol. 49, No. 7, July 2022, 951–970.

By Jingxuan Zhao; Jessica Star; Xuesong Han, et al

IMPORTANCE People with a history of incarceration may experience barriers in access to and receipt of health care in the US. OBJECTIVE To examine the associations of incarceration history and access to and receipt of care and the contribution of modifiable factors (educational attainment and health insurance coverage) to these associations. DESIGN, SETTING, AND PARTICIPANTS Individuals with and without incarceration history were identified from the 2008 to 2018 National Longitudinal Survey of Youth 1979 cohort. Analyses were conducted from October 2022 to December 2023. MAIN MEASURES AND OUTCOMES Access to and receipt of health care were measured as self reported having usual source of care and preventive service use, including physical examination, influenza shot, blood pressure check, blood cholesterol level check, blood glucose level check, dental check, and colorectal, breast, and cervical cancer screenings across multiple panels. To account for the longitudinal study design, we used the inverse probability weighting method with generalized estimating equations to evaluate associations of incarceration history and access to care. Separate multivariable models examining associations between incarceration history and receipt of each preventive service adjusted for sociodemographic factors; sequential models further adjusted for educational attainment and health insurance coverage to examine their contribution to the associations of incarceration history and access to and receipt of health care. RESULTS A total of 7963 adults with 41 614 person-years of observation were included in this study; of these, 586 individuals (5.4%) had been incarcerated, with 2800 person-years of observation (4.9%). Compared with people without incarceration history, people with incarceration history had lower percentages of having a usual source of care or receiving preventive services, including physical examinations (69.6% vs 74.1%), blood pressure test (85.6% vs 91.6%), blood cholesterol level test (59.5% vs 72.2%), blood glucose level test (61.4% vs 69.4%), dental check up (51.1% vs 66.0%), and breast (55.0% vs 68.2%) and colorectal cancer screening (65.6% vs 70.3%). With additional adjustment for educational attainment and health insurance, the associations of incarceration history and access to care were attenuated for most measures and remained statistically significant for measures of having a usual source of care, blood cholesterol level test, and dental check up only. CONCLUSIONS AND RELEVANCE The results of this survey study suggest that incarceration history was associated with worse access to and receipt of health care. Educational attainment and health insurance may contribute to these associations. Efforts to improve access to education and health insurance coverage for people with an incarceration history might mitigate disparities in care.

JAMA Health Forum. 2024;5(2):e235318. doi:10.1001/jamahealthforum.2023.5318

By Valerie A. Clark and Grant Duwe

Research from the past few decades has highlighted the long- and wide-reaching effects of adverse childhood experiences (ACEs). These experiences can negatively affect mental and physical health, as well as behaviors and interpersonal relationships well into adulthood. While it is generally understood that ACEs are prevalent in correctional populations, no prior studies have measured this issue using a large representative and racially and ethnically diverse sample of both male and female adult correctional populations in the United States. The data used for this study were collected via an assessment administered to more than 2,100 adults in Minnesota’s prison system. Descriptive findings revealed that multiple and varied forms of ACEs were common in the histories of this state’s incarcerated population, particularly among females and incarcerated persons who identified as Black, White/non-Hispanic, and American Indian/Alaskan Native. The multivariate results revealed that past exposure to ACEs increased the likelihood and speed of disciplinary convictions after admission to prison for males, but not for females. Overall, the results underscored the importance of assessing for responsivity factors upon admission to prison, including ACEs.

St. Paul, Minnesota: Minnesota Department of Corrections, 2024. 35p.

By Susan McNeeley, Mark Morgan and Matthew W. Logan , et al.

The physiological effects of imprisonment are well-documented and include a heightened risk for various forms of mortality post-release. The incarceration-mortality nexus does not apply equally to all groups, however, and research shows that some demographics (i.e., vulnerable populations) confer a greater likelihood of death. In the current study, we analyze correctional data over a 10-year period (2010-2019; n = 36,716) from Minnesota to assess the extent to which formerly incarcerated military veterans differ from non-veterans in their relative risk of mortality, net of relevant control variables. We also examine whether specific risk factors for post-release mortality differ between these groups. Findings indicate that veteran status is not a significant predictor of all-cause, natural, or unnatural mortality among released offenders, though several notable within-group differences were observed. Policy implications of the current study are discussed in relation to the provision of veteran-centric healthcare services and directions for future research are given.

St. Paul, MN Department of Corrections , 2023. 27p

By The Reducing Reoffending Third Sector Advisory Group (RR3)

   The Reducing Reoffending Third Sector Advisory Group (RR3) provides the key interface between the voluntary sector, and the Ministry of Justice (MoJ) and His Majesty’s Prison and Probation Service (HMPPS), in order to increase mutual understanding and build a strong and effective partnership. The group is made up of senior leaders from the voluntary sector and meets quarterly with civil servants to provide guidance and feedback on MoJ policy developments. The RR3 convenes Special Interest Groups (SIGs) to advise on specific areas of policy and practice as the need arises. This Employment SIG has focused on the barriers to employment faced by people, both in prison and on their release into the community. This focus has been caveated with the acknowledgement that there are many people in prison who require additional, pre-employment support in order that they can gain the skills and the confidence that they need to secure employment at an appropriate juncture. For this group, the focus has been not on the immediate steps needed to secure employment, either in prison or in the community, but on addressing more complex needs that present obstacles to gaining employment in the future. Following an introduction into the current employment situation faced by people leaving prison and recent initiatives implemented in prisons to boost employment outcomes, the paper focuses on the following areas: 1) Prison workshops 2) The financial security of people in prison 3) Employer and training provider engagement 4) Addressing complex needs 5) Service coordination

Suffolk, UK: Clinks. 2024, 17pg

By Rachael Arietti 

Purpose

Real-Time Crime Centers (RTCCs) integrate a variety of technologies and information with the goal of helping police to more efficiently identify and respond to crime. A growing number of law enforcement agencies have implemented RTCCs in recent years, but few studies have evaluated their impact on crime control or investigative outcomes. This study uses a quasi-experimental design to examine whether RTCCs improve rates of case clearance for violent, property, and overall crime in Chicago, IL.

Methods

RTCCs were established in different police districts over the course of a three-year period. Difference-in-differences estimation with Poisson panel regression models are used to estimate the effect of RTCCs on case clearance, while controlling for other policing factors and neighborhood characteristics that may influence case clearance at the district level.

Results

On average, RTCCs were associated with a 5% increase in clearance rates for violent crime (IRR = 1.05, p = .004), a 12% increase for property crime (IRR = 1.12, p = .003), and an 11% increase for overall crime (IRR = 1.11, p < .001). These findings were robust across various model specifications.

Conclusions

RTCCs may provide investigative benefits to police through the integration of technologies and data, thus enhancing case solvability.

Journal of Criminal Justice, Volume 90, January–February 2024, 102145

By Tom Smith

Deprivation of liberty as part of the criminal process is always a significant step, and arguably even more so when the person so deprived has not yet been convicted of an offence. Remand decision making – that is, granting bail or requiring detention of a defendant prior to trial – in the courts of England and Wales is a common and important part of modern criminal procedure, yet has been under-examined in the last two decades. This article presents some of the findings of the first empirical study of remand law and practice in this jurisdiction in many years. It concludes that, notwithstanding that the rate of pretrial detention is comparatively low and practice is broadly in line with domestic and regional standards, there remain significant issues – particularly in relation to the time spent on such decisions and the information provided to courts when considering remands on bail or in custody.

Howard Journal of Crime and Justice Volume60, Issue, March 2021, 29 pages

By The Council of State Governments Justice Center

This report highlights the significant progress made in reducing recidivism across the country over the past 15 years. Since its passage in 2008, the Second Chance Act has invested in state and local efforts to improve outcomes for people leaving prison and jail, with a total of nearly 1,200 grantees from 48 states and 3 territories administering programs that have served more than 400,000 people.

For the past 15 years, federal, state, local, and Tribal governments, as well as community-based organizations across the country, have been focused on reducing recidivism like never before. This report answers three critical questions:

What progress has been made?

• State-level reincarceration rates are 23 percent lower since 2008.

• Fewer returns to custody mean that more people can rejoin their families and contribute in their communities. States are achieving these rates with changes in policy and by increasing opportunities and resources to support employment and connections to behavioral health care and housing.

How much could states save by reducing recidivism further?

• Despite the progress made, states will spend an estimated $8 billion on reincarceration costs for people who exited prison in 2022.

• Scaling effective policies and reentry models can reduce the economic and human costs of recidivism, while creating meaningful opportunities for returning people to contribute to the workforce and their families and communities.

Are states ready to expand their efforts?

• In the past year, leaders in Missouri, Alabama, North Carolina, and Nebraska have set bold goals for reducing recidivism and improving reentry outcomes further by 2030.

• The goals include increasing access to treatment, mental health services, and medical care; improving individuals’ economic independence by ensuring they are better prepared for work and have access to employment; and increasing access to stable housing.

New York: Council of State Governments Justice Center, 2024.

By Penal Reform International and the Life Imprisonment Worldwide Project

This briefing, co-published by Penal Reform International and the Life Imprisonment Worldwide Project, therefore examines informal life imprisonment worldwide, drawing on key findings from international research. It places these findings in the context of the UN Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules) and other relevant criminal justice and human rights standards.

This briefing calls on policymakers and practitioners to reflect on informal life sentences and to include within them the more general constraints that should apply to the use of all forms of life imprisonment. It also provides specific recommendations on the imposition and implementation of informal life sentences.

There is growing recognition that life imprisonment is a severe sentence that, if it is used at all, should be imposed sparingly, implemented humanely and give people serving life sentences hope of release when they cease to pose a danger to society. Informal life imprisonment can be as harsh, and in some cases even harsher, than formal life imprisonment. Whilst attention has been given to formal life imprisonment, little is known about informal life sentences. Failure to examine the imposition and implementation of informal life sentences allows for a further class of harsh sanctions and their shortcomings to go unnoticed.

London: PRI. 2024, 24pg

By Shirin Bakhshay

The American public has complex views on criminal punishment. They are driven primarily by retributive motivations. But they have other justice considerations, such as restoration and rehabilitation, that can be activated in different ways. Laypersons are also motivated to psychologically distance and dissociate from those they perceive to be criminal “others” and to see punishment itself as a kind of dissociation, embodied by the prison form. The psychological processes that produce these beliefs lead to an insistence on prison as a necessary criminal justice outcome, despite reservations about its effectiveness and concerns about the state of mass incarceration and punitive penal policy more generally.

This Article builds on the psychology of punishment literature to offer a deeper understanding of the dissociative theory of punishment and how it produces the belief in the necessity of prison. Drawing on original, qualitative focus group data and analysis, this Article identifies the specific psychological mechanisms that motivate dissociation, explains the role of the belief in retributive justice as part of this process, and offers nuanced insights into the contours of the dissociative theory and the way people psychologically reason about criminal punishment.

Georgetown Law Journal, Vol. 111, No. 6, 2023, 84pg

By Craig S. Lerner

For over 250 years, Western intellectuals have been pronouncing capital punishment a barbarity doomed to be swept into the dustbin of history. The death penalty, we have repeatedly been told, is an “anachronism” inconsistent with the spirit of the modern age—a relic that would, in a generation or two, fade away. What is distinctive about recent decades is the confidence and monolithic quality of elite opinion, at least in the West. There is a swelling confidence that the death penalty is, at last, at the cusp of extinction.

This Article questions the descriptive claim that the death penalty is dying, either in the United States or in the world at large. Simply counting the number of nations that have technically abolished the death penalty fails to capture the apparent permanence of capital punishment. Many non-Western civilizations retain the death penalty with a vigor that surprises and disappoints Western intellectuals. And even within the United States, given the prohibitive cost of imposing a death sentence, it is remarkable how determined so many Americans are to continue to execute the worst of criminals.

As argued in this Article, the simplest answer to the puzzle of capital punishment’s persistence is that the retributive impulse is, as Justice Potter Stewart observed, “part of the nature of man.” The answer is so obvious that what is puzzling is not the persistence of the death penalty but that some people regard this persistence as puzzling. The dismay of modern Western intellectuals at the recurring failure of abolitionist efforts points to defining features of that intelligentsia. Since the Enlightenment, many intellectuals have regarded nature as a weak and even nonexistent constraint on human progress. It is from this perspective that the persistence of capital punishment, so seemingly rooted in human nature, comes to sight as such a puzzling disappointment.

Lerner, Craig S., The Puzzling Persistence of Capital Punishment. 2024, 48pg

By Bryce E. Peterson, KiDeuk Kim, and Rochisha Shukla

This document provides a technical summary report of the Urban Institute’s research on contraband in jails and prisons in the United States, as well as the interdiction strategies that correctional agencies use to prevent, detect, and removed contraband from their facilities. The study employed a mixed-methods design which consisted of field testing the National Survey of Correctional Contraband (NSCC) in the six state Departments of Correction, and conducting in-depth case studies in 11 prisons and jails, including facility walk-throughs, observations, and semi-structured interviews with correctional facility leadership and staff. Key findings are organized based on four themes: entry points; interdiction strategies; prevalence of contraband; correlates of contraband levels. The summary concludes with a discussion of the implications of key findings for criminal justice policy and practice, as well as recommendations for future research on contraband issues and interdiction strategies.

Washington, DC: Urban Institute, 2024. 37p.

By United States Department of Justice, Civil Rights Division and United States Attorney’s Offices, Northern and Southern Districts of Mississippi Civil Divisions

The Department of Justice has reasonable cause to believe that the State of Mississippi and Mississippi Department of Corrections (MDOC) violate the constitutional rights of people incarcerated at Central Mississippi Correctional Facility (Central Mississippi), South Mississippi Correctional Institution (South Mississippi), and Wilkinson County Correctional Facility (Wilkinson).

• MDOC fails to protect incarcerated persons from violence. MDOC does not adequately supervise incarcerated people, control contraband, and investigate incidents of harm and misconduct. These basic safety failures and the poor living conditions inside the facilities promote violence, including sexual assault. Gangs operate in the void left by staff and use violence to control people and traffic contraband.

• Restrictive housing practices create a substantial risk of serious harm. MDOC holds hundreds of people at Central Mississippi and Wilkinson in restrictive housing for prolonged periods in appalling conditions. Restrictive housing units are unsanitary, hazardous, and chaotic, with little supervision. They are breeding grounds for suicide, self-inflicted injury, fires, and assaults.

These violations are systemic problems that have been going on for years. In April 2022, we found conditions at another MDOC facility, Mississippi State Penitentiary (Parchman), violated the Constitution. Many of the conditions we identified at Parchman exist at Central Mississippi, South Mississippi, and Wilkinson. Across all these facilities, MDOC does not have enough staff to supervise the population. The mismatch between the size of the incarcerated population and the number of security staff means that gangs dominate much of prison life, and contraband and violence, including sexual violence, proliferate. Prison officials rely on ineffective and overly harsh restrictive housing practices for control. This Report begins by explaining the methodology and scope of our investigation. It then describes the facilities we investigated. Next, the Report identifies the constitutional violations. We grouped the violations into two sections: failure to protect from violence and substantial risk of serious harm from restrictive housing practices. In each section, we highlight particular incidents of violence, gang activity, and misconduct as examples of the type of incidents that give rise to constitutional violations and to show the severity of the harm. We also examine MDOC’s recent steps to address these concerns and why their efforts fall short. We end by outlining the minimum measures needed to remedy the violations.

Washington, DC: U.S. Department of Justice, 2024. 60p.

By Columbia Legal Services

  Washington’s prisons are public institutions run by the state Department of Corrections (DOC). The purpose of state correctional institutions is ostensibly to rehabilitate individuals, and to do so without a profit motive or by facilitating profit-seeking behavior. However, the state realizes enormous cost-savings from underpaying its captive labor force as little as $1.00 per hour. People incarcerated perform essential operations jobs like cleaning units and bathrooms or working in food service, all for meager pay far below Washington’s statewide minimum wage. People in prison also often perform unpaid labor as DOC fails to approve all jobs as paid positions. Washington State has recognized in other settings that underpaying detained workers is wrong. In 2017, Washington State sued the GEO Group—a for-profit corporation running the private immigration detention center in Tacoma—for failure to pay its workers (people in custody in the detention center) in accordance with Washington’s minimum wage law. At the time, the GEO Group was paying workers in custody $1.00 per day. The State brought this lawsuit – and has so far prevailed – on the basis that private prisons must comply with Washington State wage laws. And yet, the State has not taken similar steps to protect people in state, local, or municipal prisons and jails. Instead, state law currently exempts people housed in public carceral facilities from the definition of “employees” for the purposes of Washington’s minimum wage and labor standards laws. Further, people in Washington state prisons face severe consequences if they refuse to work, including lengthier prison sentences. This system of coerced and underpaid labor within DOC is nothing short of modern-day slavery. And, in keeping with this sordid legacy, people in prison face ongoing discrimination on the basis of race, ethnicity, gender, sexual orientation, ability, and immigration status—all of which are barriers to gaining and maintaining the employment people need to avoid punishment and to earn enough to pay for basic necessities. Correctional Industries (CI) is the division within DOC that operates businesses and employs people in custody in Washington prisons. CI reported over $133 million in revenue and over $38 million in assets in fiscal year 2023. The majority of CI workers fall into one of two classes of employment: Class II and Class III. Class II jobs are generally referred to as “CI jobs,” and entail working outside the prison unit, either in an operations role (e.g., food production, laundry, etc.), or producing other goods and services (e.g., furniture manufacturing) that CI then sells to various government agencies and nonprofit organizations. Class II workers usually earn between $0.80 and $2.85 per hour and are eligible for overtime pay.6 Class III jobs are generally considered “unit jobs,” and include porters, facility maintenance, and other essential tasks around the prison units. Despite the wide range of prison jobs, DOC fails to provide people in prison with sufficient opportunities for real-world job training or skill acquisition, leaving people in custody unprepared to gain employment after release.   In response to growing awareness and concern over labor exploitation in prisons, in 2023, the state legislature allocated funds to increase the wage floor for Class III jobs from $0.42 to $1.00 per hour. However, DOC then capped worker earnings at $40 per week.7 Even with this raise, people in DOC custody are paid far below the 2024 state mandated minimum wage of $16.28 per hour, and meanwhile the cost of living in prison is rising.

Seattle: Columbia Legal Services. 2024, 62pg

By Kesha A. Moore

As the coronavirus continues to spread in the U.S. and surge in an increasing number of states, it is critical that we consider the role of jails in the transmission of the virus. Even with highly effective social distancing outside of the jails, our national rates of COVID-19 deaths are projected to rise by 98% due to infections in jails. Jails act as a revolving door for the spread of COVID-19 in our communities. Inhabitants of the jails — both staff and incarcerated persons — come from our communities and soon return to them. Thus, the strategy of social distancing to limit the spread of COVID-19 can only be effective if it includes jails, which are a primary vector for the infection. 

New York: NAACP Legal Defense and Educational Fund, Thurgood Marshall Institute, 2020.

By  Sandhya Kajeepeta

After four decades of growth, the size of the U.S. incarcerated population has been declining for the past decade, and racial disparities were beginning to shrink. The start of the COVID-19 pandemic triggered immediate calls for decarceration (i.e., reducing the number of people incarcerated), given the high risk of the virus spreading in congregate settings like jails and prisons and subsequent, inevitable spread to the neighboring community. Although the majority of incarcerated people were left behind bars to face potential illness and death, the U.S. incarcerated population experienced its largest recorded one-year population reduction in U.S. history. This large-scale decarceration undoubtedly saved lives and will have long-term benefits for those who were diverted out of jails and prisons, as well as their families and communities. However, not all benefited from the decarceration equally: racial disparities in jail and prison worsened during the COVID-19 pandemic, and Black people represented a larger percentage of the incarcerated population as it declined. In this brief, we examine the drivers of pandemic-related decarceration, interrogate its impacts on racial disparities, and draw lessons to inform policy recommendations for racially equitable decarceration.

New York: NAACP Legal Defense and Educational Fund, Thurgood Marshall Institute, 2023. 21p.

By Christina Das and Jackie O’Neil

Across the country, thousands of elected officials wield considerable power over the function and outcomes of the criminal legal system. Each year, in some states and districts, voters elect state attorneys general, district attorneys, sheriffs, state supreme court judges, and trial court judges. These elected officials make choices and take actions that formatively influence the functions of the criminal legal system. For example: district attorneys have considerable discretion when deciding whether to file criminal charges against someone accused of committing a crime, and trial court judges make decisions that significantly impact the outcomes of criminal trials, such as determining what evidence can be shown to a jury. However, millions of Americans who have a vested interest in the fairness of our criminal legal system – those who are detained while awaiting their criminal trial – are denied a meaningful opportunity to vote, despite their right under the law to do so. Most individuals held in city or county jail at any given time have not been convicted of any crime and are awaiting a trial, meaning they retain their legal right to vote, but procedural and logistical barriers make it difficult or impossible for them to do so. Reforms that make it easier to vote from jail, up to and including the establishment of polling locations inside jail facilities, will help eligible incarcerated voters to actualize their right to vote from jail.

New York: NAACP Legal Defense Fund and Educational Fund, Thurgood Marshall Institute, 2023. 15p.