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Training in the prison settings is a mandatory part of higher training in forensic psychiatry. Violence in prisons is a recognised issue, which can impact on trainee safety and overall training experience. The Royal College of Psychiatrists have produced guidelines regarding the safety of the environment in inpatient mental health settings, but there is currently no such guidance regarding the prison setting. The purpose of this paper is to report on a survey of UK-based ST4-6 trainees in forensic psychiatry regarding their training experience in prisons, focusing on supervision and safety.

The authors constructed an electronic survey which comprised of 18 items. This was sent to each UK training programme director in forensic psychiatry, who were asked to distribute the survey to trainees in their region.

There were 36 unique responses, out of an approximate total of 100 trainees. The questions fell into two broad categories: trainee safety and trainee supervision. The main themes that arose were that the majority of trainees (59 per cent) reported that they had not received a formal induction at their prison and had not received training in using the Assessment, Care in Custody and Teamwork framework (58 per cent) and serious incident review protocol (83 per cent). The vast majority (76 per cent) reported not being allocated a personal safety alarm, and 27 per cent reported having received a direct threat from a patient in prison. Responses with regards to consultant supervision were varied. The majority indicated that they received weekly supervision (62 per cent).

The findings indicate that there are a number of areas where both safety and supervision within the prison environment may be improved. This is concerning given the standards outlined by Promoting Excellence (General Medical Council), which highlights the importance of a safe and supported learning environment, and suggests the need for further analysis locally of training opportunities within prisons.

There has been growing attention given to the concept of social climate as an element of prison practice. Research has indicated that more positive social climates can improve safety, psychological well-being, quality of life and contribute towards reduced reoffending. The purpose of this paper is to consider how the more positive social climates found in democratic therapeutic communities are constructed and how these practices can be replicated in other settings.

This paper adopts a reflective practice approach. The intention is to look back at the concept of social climate in prisons and in particular within a prison-based democratic therapeutic community (DTC); draw upon research and theory in order to critically evaluate the nature and effectiveness of that social climate, and; draw wider lessons about the nurturing and maintenance of social climates that may have broader relevance in prisons.

It is concluded that understanding and managing social climate is an essential aspect of improving the safety and effectiveness of prisons. Developing practices that enhance social climate requires looking beyond mainstream prison practices, towards niches such as specialist units and prisons, including DTCs and other therapeutic communities, and psychologically informed environments, as well as looking at practices in other settings including forensic mental health. Taking this wider perspective can be source of ideas and practice that could inform a profound culture change.

The paper offers an attempt to understand the distinct practices that create a more positive social climate in DTCs and consider how elements of this could be exported to other prisons. This has implications for both penal theory and practice.

Those in prison have expert knowledge of issues affecting their health and wellbeing. The purpose of this paper is to report on work undertaken with male prisoners. This paper presents learning and findings from the process of engaging imprisoned men as peer researchers.

The peer researcher approach offers an emic perspective to understand the experience of being in prison. The authors established the peer research role as an educational initiative at a long-stay prison in Wales, UK to determine the feasibility of engaging imprisoned men as peer researchers. Focus groups, interviews and questionnaires were used by the peer researchers to identify the health and wellbeing concerns of men in prison.

The project positively demonstrated the feasibility of engaging imprisoned men as peer researchers. Four recurring themes affecting health and wellbeing for men in a prison vulnerable persons unit were identified: communication, safety, respect and emotional needs. Themes were inextricably linked demonstrating the complex relationships between prison and health.

This was the first prison peer-research project to take place in Wales, UK. It demonstrates the value men in prison can play in developing the evidence base around health and wellbeing in prison, contributing to changes within the prison to improve health and wellbeing for all.

The Life in Custody (LIC) Study is a nationwide prospective cohort study examining the quality of prison life in the Netherlands. The purpose of this paper is to describe Dutch prisoners’ perceptions of prison climate, as well as differences across regimes.

The target population of the study consisted of all male and female adult prisoners in the Netherlands who were incarcerated in various regimes in a total of 28 prisons, between January and April 2017. An intensive and personal recruitment strategy was employed. Participants completed a detailed survey, the prison climate questionnaire (PCQ). Self-reported information on a variety of topics was collected, including perceived prison climate, well-being and self-reported behaviour.

In total, 4,938 prisoners participated in the survey, which amounts to a high response rate of 81 per cent. Analyses show that respondents’ characteristics are almost identical to those of non-respondents. Ratings of prison climate vary across domains and regimes, with more positive scores for minimum-security regimes.

A detailed methodological approach is described that can be adopted to achieve a high response rate with survey research among prisoners. The paper alerts researchers and practitioners to a large ongoing study and first findings on prison climate in the Netherlands. The PCQ can be requested from the authors and used in future research (internationally) to gain information about the perceived quality of prison life. The paper gives insight in how different regimes are associated with differences in perceived prison climate. Collaboration on the research project can be sought with the authors.

Findings of the LIC study illustrate the value of having data on prison climate. Results of the study will contribute to more knowledge on imprisonment and what can be done to improve the humane treatment of offenders by the criminal justice system. Moreover, knowledge about the methodology of the study may enable future comparative research on prison climate.

Transgender prisoners are subject to violence of many kinds. They are tortured, beaten, sexually assaulted, raped, and denied access to qualified public health services. This is because legal and justice systems in most countries disregard the unique conditions, needs, and requirements of transgender people. Transgender prisoners around the world suffer from mental health issues and lack of continuous access to sexual health services and hormone treatment. Like most countries in Southeast Asia, and regardless of a significantly large population of transgender prisoners, Thailand still provides no standard policies on how transgender prisoners should be managed, and transgender prisoners’ experiences remain under-researched. Through an anthropological and gendered lens, this chapter theoretically and practically examines transgender prisoners’ gendered life experiences behind bars in Thailand, debates transgender prisoners’ vulnerabilities and the myths behind them, identifies challenges around gendered-housing, analyses cultural nuances of Thai (trans)gender performativity in prisons, discusses the impact of heterosexual-binary prison management, and offers real-world policy recommendations, which are urgently needed by the Thai justice and correctional system.

The purpose of this paper is to present a preliminary study exploring the perception of prison officers in England and Wales regarding violence in their workplace.

Data were gathered through questionnaires administered to 152 of Her Majesty’s Prison establishments throughout England and Wales, ranging from high secure to open prisons where officers are affiliated to the Prison Officers Association. In total, 45 officers responded, seven from women’s prisons and the remainder from male adult and youth prisons. In addition, descriptive data from the Ministry of Justice statistical data set on incidents of violence are incorporated where possible.

Results indicated that violence, both prisoner on staff and prisoner-to-prisoner, is a major concern among prison officers, across all prison categories. The prison officers who took part considered there to be an absence of what they perceived to be serious measures to prevent and manage violence. Officers view the prison disciplinary system as ineffective, with reluctance for external charges to be considered against prisoners committing acts of violence within the prison.

The research is limited by a lack of external measures being obtained (e.g. observation of aggressive incidents) and the fact that the participants were self-selecting, with only a small proportion of respondents. However, it suggests a need for more detailed research into prison violence, one that integrates the views of prison staff as well as prisoners, with the former lacking in the research base to date. It also indicates a need for more focussed action from management, staff representatives and reform lobbies to explore collectively how to prevent violence in prison. Only by adopting a multidisciplinary and multifaceted approach can a comprehensive attempt at management be achieved.

Prison violence has a negative impact on correctional settings and their mission to provide a safe working environment for staff and safe environment for prisoners. Consequently, a focussed management approach on the problem is required, one that captures the view of a range of staff and prisoners. Prisoner’s violent conduct, whether assault on staff or peers, constitutes further criminal conduct. This has to be addressed through formal processes such as prison reports, police charges and potential prosecution. The latter has been under-applied. Determining the barriers to pursuing police charges and possible prosecution would be valuable to pursue. Violence against staff needs to be more thoroughly understood and not considered solely as an occupational hazard, but as a means of safe-guarding both staff and prisoners.

This study is the first that has sought to incorporate prison workforce perception on the problem of escalating levels of prison violence, using a sample from a wide set of prison environments.

This rapid evidence assessment (REA) study aims to synthesise what is known about food refusal within male prison populations to aid a better understanding of why this occurs. By looking at the various functions of food refusal for this population, it is hoped that professionals can better support prisoners’ needs in this area.

A rapid review of available data within the published literature was completed. Searches were conducted on two databases (PsychInfo and MedLine), and a total of 328 articles were screened using a three-stage process. This resulted in 13 articles being identified for the final sample, which were reviewed and synthesised into themes by looking for commonalities.

Five themes were identified: “to protest”, “to achieve goals or demands”, “to manage interpersonal difficulties with prison/custodial staff”, “to end life” and “mental health and personality disorder”. The findings appear to suggest that food refusal in this context may be predominantly driven by a need to communicate or gain control.

To help prevent and cease food refusal, it will be beneficial for prison staff to use approaches that support prisoners feeling a sense of fairness, transparency, control and autonomy, as well as problem-solving skills and establishing a sense of purpose and motivation.

This REA confirmed there is a lack of good-quality research into the functions of food refusal among prisoners in the UK. Future research should involve contact with prisoners who have engaged in food refusal to understand motivations firsthand.

Despite overall reductions in levels of smoking in the UK, rates of offender smoking remain high. In 2016, it was announced that prisons in England and Wales would gradually introduce a smoking ban. The purpose of this paper is to explore offenders’ perceptions around the upcoming smoking ban.

A total of eight focus groups were conducted in four prisons across the North of England. Both smoking and non-smoking offenders participated in the focus groups, and thematic analysis was used to explore the findings.

Themes generated from the data were “freedom and rights”, “the prison environment” and “guiding support”. Participants discussed how the smoking ban was viewed as a punishment and restricted their freedom, with perceptions as to why the ban was being implemented centring around others trying to control them. Participants expressed concerns around the financial implications of the smoking ban on already stretched prison resources. Participants also recommended improving the nicotine replacement therapy on offer, and increasing the range of leisure activities within the prison to prepare for the smoking ban.

Overall, it was apparent that participants’ awareness of the smoking ban was generally poor. It is recommended that offenders need to be made more aware of the smoking cessation support they will receive and given the opportunity to ask questions about the smoking ban. Increasing offenders’ awareness of the ban may reduce stress associated with a perceived lack of choice around their smoking behaviours.

For 28 years Alaska, like the vast majority of the nation, has struggled with growing prison populations and shrinking budgets. In 1995, the Alaska Department of Corrections, faced with sanctions unless they ameliorated their crowded prison conditions, looked to the popular practice of contracting out its correctional operations by sending 650 prisoners to a private out-of-state prison. But, as the costs of prisoner litigation and transportation mounted, the state began to consider building its own private prison, a decision which many state lawmakers and business entrepreneurs argued would allow the state to stretch scarce dollars by providing cheaper and better quality prisons, return millions of dollars to the state economy, and create permanent jobs. In this decision case, students are required to put themselves in the role of the Alaska Legislature to determine whether they should permit the building and operation of a private prison in one of Alaska's remote communities. The students must analyze and juggle the complex and often competing set of objectives, values, and political tensions intrinsic to all privatization decisions.

Since the early 1990s, various countries have introduced HIV prevention programmes in prisons. Such programmes include education on HIV/AIDS, HCV and on drug use for prisoners and for staff, voluntary testing and counselling, the distribution of condoms, bleach, and needles and syringes, and substitution therapy for injecting drug users. Other forms of drug‐dependence treatment, as well as drug demand reduction and drug supply reduction measures may also be relevant to managing HIV/AIDS and HCV in prisons, and may facilitate HIV prevention measures ‐ or have unintended negative consequences for such measures. Prison systems in a growing number of countries are implementing such programmes. However, many of them are small in scale and restricted to a few prisons. Provision of care and treatment for people living with HIV or AIDS has become a priority worldwide, and it is considered to be a basic human right. This includes the provision of antiretroviral therapy (ARV) in the context of comprehensive HIV/AIDS care. Providing access to ARV for those in need in the context of correctional facilities is a challenge, but it is necessary and feasible. Studies have documented that, when provided with care and access to medications, prisoners respond well to ARV. Part 3 of the select annotated bibliography on HIV/AIDS and HCV in prisons contains selected “essential” articles and reports that provide information about (1) substitution treatment and other forms of drug‐dependence treatment; (2) other drug demand and drug supply reduction measures; and (3) care, treatment, and support for prisoners living with HIVor AIDS and/or HCV. Each section also contains a brief review of the evidence, based on recent work undertaken by the World Health Organization (WHO).