Emerald Group Publishing Limited
Article Type: Editorial From: International Journal of Prisoner Health, Volume 10, Issue 4.
Morag MacDonald, Robert Greifinger and David Kane
Welcome to Issue 10 (4) of the journal. As usual, we have assembled a selection of papers from around the world that address various aspects of the prisoner health experience. Geographically, this issue includes contributions from Denmark, Indonesia, Nigeria, Sweden and the UK while subjects considered include suicidality, treatment of juveniles in institutional care and self-catering in prison.
To begin, Lucy Reading and Erica Bowen explore the perceptions, beliefs and abilities that support adult male prisoners in overcoming suicidality. The authors note that research into prison suicide has burgeoned in recent years following recognition that suicide is the leading cause of death in custodial settings, accounting for approximately 50 per cent of all prison deaths. Data was collected from eight participants serving life sentences aged between 30 and 58 recruited from a male Category B prison in HM Prison Service estate, UK. Selection criteria included those with a past experience of suicidal thoughts, feelings or attempts; those whose suicide risk was not being monitored under the Assessment, Care in Custody, Teamwork (ACCT) care plan and those who were willing to participate in the study. Five major themes of recovery were identified from subsequent analysis; sense of self, presence of meaning, connectedness, shift of perspective and re-establishing control. The authors note that findings confirm the existence of previously identified “preventive” factors or factors that made a difference in female prisoners whilst furthering our understanding of other factors that supported the men in overcoming suicidality. Research limitations are noted by the authors that include a sole focus on suicidality and the reliance that participants have upon factors that have helped them to overcome suicidality that may not accurately capture the factors that supported them in this process. In addition, the focus on adult men serving life sentences may not be representative of the wider prison population. The authors conclude that the qualitative approach adopted allowed prisoners to subjectively discuss the factors they felt supported them in overcoming suicide, revealed a greater depth of content and captured the unique and individual aspects involved in overcoming suicidality. They note that the findings support and significantly extend previous research in prison populations, are reflective of broader suicidological research and provide an avenue for the refinement of suicide prevention strategies.
In our second paper, Linda Kjaer Minke reports on a study that describes and analyses the principle and practice of a self-catering system in a Danish prison. The author notes that in Denmark, a principle of normalization is one of the tenets of the correctional system, which means that conditions within the walls of the prison more or less resemble conditions outside. In accordance with this principle, prisoner self-catering was introduced on a trial basis in 1976 in connection with the commissioning of a new closed prison. The self-catering system requires all prisoners (except prisoners held in remand centres and isolation units) to buy and prepare their own meals. Data for the study was collected by participant observation and in-depth individual interviews undertaken during a 13-month ethnographic study that took place in a maximum secured (Category A) prison. Analysis of the data indicates that, in general, all participants are extremely satisfied with the self-catering system expressing appreciation for the control over the composition of their diet it affords. Self-catering was also perceived as bolstering a desire for autonomy. One of the interesting findings reported is the system of “food groups”, which are self-created teams of prisoners that pool food resources and cook with and for each other. Participants described forming food-groups for several different reasons. Consideration for taste and different food preferences, for example, had a bearing on group membership as did status within the prison as affiliation with a food-group, and the prisoner's position within these groups, was an expression of social capital and allegiances. Specific roles within the food groups were also ascribed with social meaning and power. The author concludes that the majority of prisoners are pleased with the self-catering system, while prison authorities view it as a positive way of putting the principle of normalization into action. It is also seen as an effective strategy for providing meals to prisoners. The formation of food groups within the self-catering system are used to construct relationships among prisoners and form social identities. The author acknowledges, however, that roles within these groups were viewed as beneficial by some prisoners and exploitative by others.
Lia Ahonen and Jürgen Degner examine, from an organizational perspective, staff's formal and informal competence that directly influence the treatment of juveniles placed in institutional care. Their hypothesis is that functioning of the staff group is constituted by a combination of formal education, attitudes towards the use of theory and method in treatment, view of how to achieve behavioural change, and view of how to prevent negative peer cultures from interfering with treatment processes. Using a mixed method approach, questionnaire and interviews, data were obtained from six state-run institutions (eight wards) for young people, operated by the Swedish National Board of Institutional Care, in central and southern Sweden. Results indicate great variety in the clearly defined target groups (juveniles with certain types of problem behaviours that the institution officially are trained to deal with), in the participating institutions and the extent to which staff have the necessary theoretical knowledge to cope with the juveniles’ different problems and individual needs. Results obtained from questionnaires indicate that almost all staff members consider themselves lacking sufficient competence to work with complex behaviours, while in interviews, respondents intimated that they had not been offered enough training. The authors conclude that the levels of formal education and informal competence differ between the cohorts studied and that in some cases, training offered concentrated on focused interventions that did not inform staff members being taught how to use taught skills or relate them to developmental processes. The level of informal competence, in terms of professional experience, is also diverse and can be dependent on the location of the institution. The author(s) acknowledge limitations of their study but argue there is a need to further investigate the organization as a whole and, in particular, how juveniles’ treatment outcomes are related to staff competence, treatment climate, and the functioning of the organization. In particular, attention should be given to the constitution of target groups and the key issue of matching clients/juveniles to an adequate intervention.
In our fourth paper, Amala Rahmah, James Blogg, Nurlan Silitonga, Muqowimul Aman and Robert Power explore the health needs and health-coping strategies of female prisoners, with a focus on sexual and reproductive health, in six prisons and one detention centre in Indonesia. The purpose of the investigation was to make recommendations to improve the health status of female prisoners. Data were collected from female prisoners, clinical officers, clinic heads, wardens, heads of prisons and a representative from the Director General of Correctional Services using a qualitative approach. Analysis of the data highlighted both “formal” and “informal” coping strategies around health many of which depended on a number of factors, both internal and external to the prison or detention centre. In respect of formal strategies, study participants indicated they were not confident the service provided by the prison clinic was of high quality. In addition, participants indicated that referral for illnesses related to HIV and AIDS appeared complex even though almost all prisons have a referral hospital designated to provide treatment with antiretroviral therapy. Informal strategies employed included women asking their friends in their prison block for help with health-related matters while others bought off-the-shelf medicines or consulted a hospital or doctor outside prison. The data also indicated that women giving birth in the prison are helped by their fellow prisoners and it is common for all of the cellblock to participate in the raising of a baby. It was also evident that women had an open attitude towards health officers, which was in contrast to their reluctance to be open with prison guards, often because they considered health officers to be more concerned with prisoners’ wellbeing. The authors conclude that women in Indonesia's prisons and detention centres currently adopt a range of health-seeking behaviours to meet their health needs and often resort to a range of coping strategies, including informal networks of support within the prison or cellblock. Although these strategies might be beneficial in terms of prisoner morale and solidarity, a health system is needed that can provide women prisoners with the level of care available in the community.
In our final paper of this issue, Kayode A. Alao and Olusegun Fatai Adebowale examine the attitudes of prisoners and warders (prison staff) to rehabilitative counselling in Nigerian prisons and the correlation between prisoners’ educational attainment and attitude towards rehabilitative counselling. The study sample comprised 123 prisoners and 110 warders selected by stratified random sampling from Osogbo prison headquarters and Ilesa and Ile-Ife prisons in southwestern Nigeria. Data were collected from a questionnaire, which was designed to elicit demographic information and attitudes towards rehabilitative counselling: data were analysed using percentages and χ2 statistics. The analysis indicated that most prisoners and prison staff possess a positive attitude towards rehabilitative counselling and no significant difference was found between the attitudes of prisoners and staff members on the basis of their prison status. However, a significant relationship between prisoners’ attitude to rehabilitative counselling and their educational attainment was noted, i.e. the better educated a prisoner was, the more favourably disposed s/he was towards rehabilitative counselling. The authors conclude that their study indicates a need for prisoners to receive rehabilitative counselling administered by trained personnel to facilitate re-integration into society and that prisoners are generally favourably disposed to the process. Moreover, prison officials were of the opinion that rehabilitative counselling should be available to prisoners in addition to the vocational education currently provided.