Search results

Purpose – Prison health is public health. Yet, efforts to protect against as well as slow the spread of COVID-19 are virtually impossible in prison settings where “what we know” may not match with policies. As the COVID-19 pandemic continues, incarcerated people are uniquely at risk as correctional facilities are “super-spreader” sites for prisoners and staff alike. The purpose of this chapter is to explore the impact of COVID-19 in prisons along with the additional personal and social costs associated with the pandemic (e.g., lockdowns, limited visitation, etc.) that can also impact the health status of those “doing COVID time.”

Methodology/Approach – This chapter examines the multifaceted impact of the COVID pandemic on those (in)directly impacted in correctional settings. It is not an empirical work.

Originality/Value – This chapter provides insight into the often taken-for-granted impact of the COVID pandemic on those who live and work in prison settings. The recommendations may be of interest to those who “do the time,” those who work in such settings, and social justice advocates and others involved in policy-making.

The strongest international recognition of the importance of women’s health in prisons and the urgent need for radical change was highlighted of a WHO Conference held recently in Kiev, Ukraine.

This paper seeks to understand relationships between prison healthcare and integrated care systems (ICS), including how these affect the delivery of new healthcare interventions. It also aims to understand how closer integration between prison and ICS could improve cross system working between community and prison healthcare teams, and highlights challenges that exist to integration between prison healthcare and ICS.

The study uses evidence from research on the implementation of a pilot study to establish telemedicine secondary care appointments between prisons and an acute trust in one English region (a cross-system intervention). Qualitative interview data were collected from prison (n = 12) and community (n = 8) healthcare staff related to the experience of implementing a cross-system telemedicine initiative. Thematic analysis was undertaken on interview data, guided by an implementation theory and framework.

The research found four main themes related to the closer integration between prison healthcare and ICS: (1) Recognition of prison health as a priority; (2) Finding a way to reconcile networks and finances between community and prison commissioning; (3) Awareness of prison service influence on NHS healthcare planning and delivery; and (4) Shared investment in prison health can lead to benefits.

This is the first article to provide research evidence to support or challenge the integration of specialist health and justice (H&J) commissioning into local population health.

In 1999, the national health service (NHS) was made responsible for the commissioning of prison health care. Mental health inreach teams (MHIT) were set up to mirror community mental health teams and provide secondary care to prisoners diagnosed with severe and enduring mental illnesses (SEMI). Since then, the provision of mental health care to prisoners without a diagnosis of a SEMI has been variable. A rapid review of NHS health care in prisons conducted by Public Health England (PHE) (2016) highlighted the need for provision to be more integrated and meet the needs of prisoners without a diagnosis of a SEMI. In response, an integrated mental health and substance misuse service was implemented within her majesty’s prison/young offenders institution Pentonville. This study aims to evaluate its impact and share lessons learned.

Routinely collected and anonymised data were reviewed for prisoners referred between 1 May 2018 and 31 December 2019. Data are presented on the quantity of referrals over time, and the type of support offered. Chi-square goodness of fit tests was conducted to determine whether the prisoners referred to the service were representative of the wider prison population in terms of age and ethnicity.

Referrals showed a general pattern of increase over time and were representative of the wider prison population in terms of age and ethnicity, indicating equitable access. Lessons learned are discussed. Demand for therapeutic and substance misuse services was higher than that for SEMIs. Notable was the high quantity of referrals which provides further evidence for the disparity between high need and limited provision within prison settings, particularly for therapeutic interventions.

To the best of the author’s knowledge, this is the first service evaluation of a recently implemented integrated and holistic model of prison mental health care in line with recommendations from PHE (2016).

The rate of female committals to prison has grown rapidly in recent years. Women in prison are likely to have trauma histories and difficulties with their mental health. This paper aims to synthesise the findings of qualitative literature to gain a deeper understanding of the experiences of women in the context of prison-based mental health care.

A systematic search of five academic databases, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, Psychological Information Database (PsycINFO), Excerpta Medica DataBASE (EMBASE) and Medline, was completed in December 2020. This study’s search strategy identified 4,615 citations, and seven studies were included for review. Thomas and Harden’s (2008) framework for thematic synthesis was used to analyse data. Quality appraisal was conducted using the Joanna Briggs Institute Checklist for Qualitative Research (Lockwood et al., 2015).

Four analytic themes were identified that detail women’s experiences of prison-based mental health care: the type of services accessed and challenges encountered; a reduction in capacity to self-manage mental well-being; the erosion of privacy and dignity; and strained relationships with prison staff. There is a paucity of research conducted with women in the context of prison-based mental health care. The findings suggest there is a need for greater mental health support, including the need to enhance relationships between women and prison staff to promote positive mental health.

To the best of the authors’ knowledge, this is the first systematic review conducted on the experiences of women in the context of prison-based mental health care.

Prisoners are at greater risk of developing mental health problems compared with people of a similar age and gender in the community. They are less likely to have their mental health needs recognised, are less likely to receive psychiatric help or treatment, and are at an increased risk of suicide. Prison mental health in‐reach services have been developed in the UK to address these problems. An organisational case study method was used to generate theory about the links between the aims, processes and impacts of the introduction of mental health in‐reach teams to prison contexts. Case studies were undertaken on six sites and included interviews and focus groups with in‐reach team staff, prison healthcare staff, and discipline staff. The aims of prison mental health in‐reach were related to providing an equivalent service to a Community Mental Health Team, with a primary focus on serious mental illness, but a widening role. Achievement of these aims was mediated by the organisational context, active relationship development and leadership. Overall effects were positively reported by all stakeholders. Successful development was not just a function of time in post, but also a function of the effectiveness of leadership within the in‐reach teams. The more effective teams were having a wide impact on the response to mental health problems in the prison setting

Advocacy is an important tool for translating population health objectives and research findings into policy and practice, as well as for enhancing stakeholder support for programmes and activities with a potential to improve the health of populations. At the inception of modern prisons, health advocacy approaches focused on appealing to humanitarian and religious sentiments of stakeholders to improve the well‐being of prisoners. This approach achieved limited results, not least because of persistent apathy of custodial authorities and the public to prisoners’ wellbeing. From the mid twentieth century onwards, a constitutional and human rights approach evolved, with courts becoming actively involved in mandating minimum health standards in prisons. Penal populism eroded public support for a judicial recourse to improving prison health services, and encouraged governments to institute procedural barriers to prisoner‐initiated litigation. The author proposes an approach premised on public health principles as an appropriate platform to advocate for improvements in prison health services in this era. Such an advocacy platform combines the altruistic goals of the humanitarian and constitutional rights approaches with an appeal to community’s self‐interest by alerting the public to the social, financial and health implications inherent in released prisoners suffering from major communicable and chronic diseases re‐entering the community.

The growing numbers of terminally ill and dying in prison has high economic and moral costs as global correctional systems and the society at large. However, to date little is known about the extent to which palliative and end-of-life care is infused within global prison health care systems. The purpose of this paper is to fill a gap in the literature by reviewing and critically appraising the methods and major findings of the international peer-reviewed literature on palliative and end-of-life care in prison, identify the common elements of promising palliative and end-of-life services in prison, and what factors facilitate or create barrier to implementation.

A content analysis was conducted of the existing peer-reviewed literature on palliative and end-of-life care in prison. English-language articles were located through a comprehensive search of peer-reviewed journals, such as Academic Search Premier Literature databases using differing combinations of key word search terms, “prison,” “palliative care,” and “end-of-life care.” A total of 49 studies published between 1991 and 2013 met criteria for sample inclusion. Deductive and inductive analysis techniques were used to generate frequency counts and common themes related to the methods and major findings.

The majority (n=39) of studies were published between 2001-2013 in the USA (n=40) and the UK (n=7). Most were about US prison hospice programs (n=16) or barriers to providing palliative and end of life care in prisons (n=10). The results of the inductive analysis identified common elements of promising practices, which included the use of peer volunteers, multi-disciplinary teams, staff training, and partnerships with community hospices. Obstacles identified for infusing palliative and end-of-life care in prison included ethical dilemmas based on custody vs care, mistrust between staff and prisoners, safety concerns, concern over prisoners’ potential misuse of pain medication, and institutional, staff, and public apathy toward terminally ill prisoners and their human rights to health in the form of compassionate and palliative care, including the use of compassionate release laws.

Implications for future research that foster human rights and public awareness of the economic and moral costs of housing the sick and dying in prisons. More research is needed to document human rights violations as well as best practices and evidence-based practices in palliative and end-of-life care in prisons. Future studies should incorporate data from the terminally ill in prison, peer supports, and family members. Future studies also should employ more rigorous research designs to evaluate human rights violations, staff and public attitudes, laws and policies, and best practices. Quantitative studies that use experimental designs, longitudinal data, and multiple informants are needed. Qualitative data would allow for thick descriptions of key stakeholders experiences, especially of the facilitators and barriers for implementing policy reform efforts and palliative care in prisons.

This review provides a foundation on which to build on about what is known thus far about the human right to health, especially parole policy reform and infusing palliative and end-of-life care for the terminally ill and dying in prisons. This information can be used to develop or improve a new generation research, practice, policy, and advocacy efforts for that target terminally ill and dying in prison and their families and communities.

There are significant social implications to this review. From a human rights perspective, the right to freedom from torture and cruel and unusual punishment is a fundamental human right along with prisoners’ rights for an appropriate level of health care. These rights should be guaranteed regardless of the nature of their crime or whether they are in a prison placement. The information provided in this review can be used to educate and possible transform individual's and society's views toward the terminally ill and dying who are involved in the criminal justice system.

This paper extends the extant literature by using both quantitative and qualitative analysis methods to organize, summarize, and critically analyze the international literature on palliative care and end of life care in prison. This review is designed to increase awareness among the international community of the pain and suffering of the terminally ill in prison and the facilitators and barriers to providing them compassionate care while in custody.

This paper aims to analyze the COVID-19 pandemic response in prisons, focusing on the USA, which imprisons a higher percentage of its population than any other country in the world.

This paper evaluates the current pandemic response in prisons based on legal and ethical imperatives for providing health care to prisoners.

Themes of best practices identified include increasing rapid detection of new cases, reducing transmission and advocating for both short- and long-term ethical health care policies. Halting progress now could risk dire consequences and is unacceptable on legal, ethical and public health grounds.

This paper does not involve primary research with prisoners; rather it focuses on reviewing the pandemic response in prisons. Although it may be possible to translate findings in this study to similar environments (e.g. jails and detainment centers), there are unique characteristics pertaining to each that deserve separate, focused analyses.

Outbreaks that occur within prisons are likely to spread to the community and vice versa. Analyses based on ethics, law and public health point to the same conclusion: preventing significant outbreaks within prisons will benefit not only prisoners but also the general public. Furthermore, even though the scientific understanding of the pandemic may change with future research, the ethical and legal principles highlighted in this paper will continue to be foundational when considering just care for prisoners.

Sub-Saharan African prisons have seen a substantial increase in women prisoners, including those incarcerated with children. There is very little strategic literature available on the health situation and needs of women prisoners and their circumstantial children in Malawi. The study aims to explore this issue.

A qualitative exploratory study using in-depth key informant interviews with senior correctional stakeholders (commissioner of prison farms, senior correctional management staff, senior health officials and senior officers in charge) (n = 5) and focus group discussions (FGD) with women in prison of age between 18 and 45 years (n = 23) and two FGD with correctional staff (n = 21) was conducted in two prisons in Malawi, Chichiri and Zomba. Narratives were transcribed and analysed using thematic analysis.

Three key themes emerged and are as follows: “hygiene and sanitary situation across multiple prison levels and subsequent health implications for women”; “nutritional provision and diets of women and children in prison”; and “women’s access to prison-based and external health services”. Divergence or agreement across perspectives around sanitation and disease prevention, adequacy of nutrition for pregnant or breast-feeding women, health status and access to prison-based health care are presented.

Garnering a contemporary understanding of women’s situation and their health-care needs in Malawian prisons can inform policy and correctional health practice change, the adaptation of technical guidance and improve standards for women and their children incarcerated in Malawi.

There is a strong need for continued research to garner insight into the experiences of women prisoners and their children, with a particular emphasis on health situation.