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There is interest in promoting health in prison from governmental levels, but, to date, understanding how best to do this is unclear. This paper argues that nuanced understanding of context is required to understand health promotion in prison. The purpose of the paper is to examine the potential for empowerment, a cornerstone of health promotion practice, in high-security prison establishments.

Independent prison inspections, conducted by Her Majesty’s Inspectorate of Prisons for England and Wales, form a critical element in how prisons are assessed. Documentary analysis was undertaken on all eight high-security prison reports using framework analysis.

Analysis revealed elements of prison life which were disempowering and antithetical to health promotion. While security imperatives were paramount, there were examples where this was disproportionate and disempowered individuals. The data show examples where, even in these high-security contexts, empowerment can be fostered. These were exemplified in relation to peer approaches designed to improve health and where prisoners felt part of democratic processes where they could influence change.

Both in the UK and internationally, there is a growing rhetoric for delivering effective health promotion interventions in prison, but limited understanding about how to operationalise this. This paper gives insight into how this could be done in a high-security prison environment.

This is the first paper which looks at the potential for health promotion to be embedded in high-security prisons. It demonstrates features of prison life which act to disempower and also support individuals to take greater control over their health.

This paper aims to examine knowledge production and problem representation with regard to new psychoactive substances (NPS) in Her Majesty’s Chief Inspector of Prisons (HMCIP) annual reports.

Seven annual reports published by HMCIP for England and Wales between 2014 and 2020 have been systematically reviewed drawing on thematic analysis.

This paper demonstrates how framing in HMCIP annual reports produced a characterisation of NPS in prisons that inadvertently obstructed gender-sensitive knowledge production and problem representation. The framing formalised knowledge silences about spice in women’s prisons.

HMCIP annual reports monitor drugs in prisons and this affects how these spaces are represented to government and other stakeholders. This paper provides theoretical and practical insights into how gender-blind knowledge is produced by discussing examples of gender-blind drug representations in a specific policy context.

The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales.

A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017).

Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison.

Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.

Correctional healthcare should promote the protection of human rights. The purpose of this paper is to bring a discussion of human rights into debates on how such policy should be best organized.

The paper achieves its aim by providing an analysis of European prison law and policy in the area of prison health, through assessing decisions of the European Court of Human Rights, as well as policies created by the European Committee for the Prevention of Torture.

The paper describes the position of the European Court of Human Rights on the topics of access to healthcare, ill health and release from prison, mental illness in prison, and the duty to provide rehabilitative programming for those seeking to reduce their level of “risk.” It also argues that human rights law can be a source of practical reform, and that legal frameworks have much to offer healthcare leaders seeking to uphold the dignity of those in their care.

This paper will provide a rare example of the engagement of human rights law with correctional health policy. It provides practical recommendations arising out of an analysis of European human rights law in the area of prisons.

The first case of COVID-19 in the Malawi prison system was reported in July 2020. Human rights organisations raised concerns about the possibility of significant COVID-19 outbreaks and deaths in the prison system, because of the poor infrastructure, lack of healthcare and adequate COVID-19 mitigation measures, existing co-morbidities (tuberculosis, HIV and hepatitis C), malnutrition and poor health of many prisoners.

The authors conducted a legal-realist assessment of the Malawian prison system response to COVID-19 during state disaster measures, with a specific focus on the right to health and standards of healthcare as mandated in international, African and domestic law.

The Malawi prison system was relatively successful in preventing serious COVID-19 outbreaks in its prisons, despite the lack of resources and the ad hoc reactive approach adopted. Whilst the Malawi national COVID plan was aligned to international and regional protocols, the combination of infrastructural deficits (clinical staff and medical provisions) and poor conditions of detention (congestion, lack of ventilation, hygiene and sanitation) were conducive to poor health and the spread of communicable disease. The state of disaster declared by the Malawi Government and visitation restrictions at prisons worsened prison conditions for those working and living there.

In sub-Saharan Africa, there is limited capacity of prisons to adequately respond to COVID-19. This is the first legal-realist assessment of the Malawian prison system approach to tackling COVID-19, and it contributes to a growing evidence of human rights-based investigations into COVID-19 responses in African prisons (Ethiopia, South Africa and Zimbabwe).

This chapter offers an insight into library provision and user engagement at a Secure College in Northern Ireland. It draws on findings from doctoral research carried out by Finlay (2020) which examined the role of the library in the learning experiences of people in prison. The case study described in this chapter took a multi-method qualitative approach to exploring engagement with the space, resources and informal learning programmes offered by the library. Acknowledging the many roles and functions of a prison library, this chapter focuses particularly on its relationship to formal and informal prisoner education. The strong educational ethos of Hydebank Wood College made it an ideal setting to explore the transformative educational possibilities of a well-managed and well-funded library. Following a description of the library and its services, the chapter will consider first steps into learning, informal and self-directed learning opportunities, library services in a divided society, and the importance of interpersonal relationships.

Since the completion of this doctoral research, a newly renovated Learning and Skills Centre has opened at Hydebank Wood College. This chapter includes findings from recent interviews with staff members which reveal the impetus for these changes and how the redesign of the library space has impacted upon the learning experiences of both the women and young men held at Hydebank. Taken alongside the doctoral findings, this discussion helps to show how the library space is valued within the institution and the significant role played by the library and library staff in the lives of incarcerated individuals.

This chapter draws on data from young men¹ interviewed on two occasions; first as ‘children’ aged 17 years within juvenile Young Offenders’ Institutions (YOIs); and then again as ‘adults’ aged 18 years within young adult/adult prisons about their experiences of transitions. Ethical reviews typically reflect age-determined constructions of child/adult status and those aged under 18 years are deemed to be more ‘vulnerable’, thus attracting more scrutiny from research ethics committees (Economic and Social Research Council [ESRC], 2020). This concern heightens the methodological difficulties of prison research, as incarceration renders children ‘doubly vulnerable’ (Jacobson & Talbot, 2017). Such institutions may be obstructive and access must be obtained from a series of gatekeepers. Negotiating the balance between participants’ rights and their best interests (Heptinstall, 2000; Thomas & O’Kane, 1998), along with gatekeepers’ priorities can be challenging. This chapter outlines how tricky ethical tensions were balanced with participants’ best interests in line with the United Nations Convention on the Rights of the Child (CRC) (United Nations, 1989). Despite the difficulties encountered, the researcher (J.P.) took the view that there would be ‘ethical implication[s] of NOT conducting the research’ (Girling, 2017, p. 38). The chapter offers recommendations for how researchers might conduct ethically sensitive research with similar cohorts of young people.

Informed by primary interviews and observational research conducted by the authors with women prisoners in Northern Ireland, this article focuses on prison as an institutional manifestation of women’s powerlessness and vulnerability, particularly those enduring mental ill‐health. It contextualises their experiences within continua of violence and ‘unsafety’. It also considers official responses to critical inspection reports and those of the Northern Ireland Human Rights Commission based on the authors’ research findings. Finally, the primary research demonstrates that three decades on from publication the first critical analyses of women’s imprisonment, the conditions of gendered marginalisation, medicalisation and punishment remain. This is brought into stark relief in the punitive regimes imposed on those most vulnerable through mental ill‐health.