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Opioid agonist treatment (OAT) programmes in prisons play a significant role in preventing the human immunodeficiency virus (HIV). Despite its proven effectiveness, both the availability and coverage of prison OAT programmes remain low. This Indonesian study explores facilitators of, and barriers to, the delivery of methadone programmes in prisons using the social ecological model (SEM).

The study used a qualitative case study approach comprising two prisons with, and one prison without, methadone programmes. Purposive and snowball sampling was used to recruit study participants. In total, 57 in-depth interviews were conducted with prison governors, health-care staff, prison officers and prisoners. Data was analysed thematically.

The study findings identified facilitators of and barriers to the delivery of prison OAT programmes at all three levels of the SEM as follows: intrapersonal barriers including misperceptions relating to HIV transmission, the harm reduction role of OAT programmes, methadone dependency and withdrawal symptoms; interpersonal barriers such as inflexible OAT treatment processes and the wide availability of illicit drugs in prisons and; social-structural barriers, notably the general lack of resources.

The findings highlight the importance of and overlap between, organisational and inter-personal, as well as intrapersonal factors. Such an approach is particularly important in the context of the implementation and delivery of methadone programmes in low/middle income countries, where the lack of resources is so significant.

Three main strategies for improvement were suggested as follows: the development of comprehensive education and training programmes for prisoners and all prison staff; the re-assessment of practices relating to the delivery of methadone, and a comprehensive review of harm reduction strategy in prisons, that should consider the role of prisoners’ families to increase support for prisoner participation; the re-assessment of prison policies to support the delivery of methadone programmes in prisons.

The author suggests that ongoing international support and national drug policies are vital to the continuation and sustainability of methadone programmes in prisons.

This study contributes to the overall evidence base for OAT programmes in middle-income prison contexts.

In Kyrgyzstan the prevalence of injecting drug behaviour is among the highest found throughout the world. Health promotion training, improved health care and needle/syringe exchange (NSE) programmes have been shown to decrease risk behaviour among injecting drug users. In Kyrgyzstan, an intervention study with training of prison staff and prisoners was performed in one prison. Before and after the training, a random selection of the prisoners answered a questionnaire about drug use, risk behaviour and health care. The survey was carried out in both the intervention prison and in a reference prison. The number of drug users, the use of drugs and risk behaviour were improved significantly within half a year and, especially, the injection and use of drugs decreased in the intervention group. The study clearly shows that increased focus, improved healthcare and training of prisoners and staff on drug use and harm reduction can reduce both use of drugs and risk behaviour.

In spite of the effectiveness of opioid antagonist treatment (OAT) in reducing injecting drug use and needle sharing, programmes in prison continue to be largely stigmatised. This affects programme participation and the quality of programmes delivered. This study aims to explore how Indonesian prison staff and prisoners perceived and experienced stigma relating to prison OAT programmes and identify potential strategies to alleviate this stigma.

Three prisons in Indonesia were selected as part of a qualitative case study. Two of the prisons provided OAT, in the form of methadone maintenance treatment (MMT). Purposive and snowball sampling were used to recruit study participants. In total, 57 semi-structured interviews were conducted with prison governors, health-care staff, prison officers and prisoners. Prisoners included both participants and non-participants in methadone programmes. The data were analysed thematically.

MMT programme participants were perceived by both prison staff and other prisoners to be engaged in illicit drug use, and as lazy, poor, dirty and unproductive people. They were also presumed to be HIV-positive. These multi-layered, intersectional sources of (inter-personal) stigma amplified the effects on prisoners affecting not only their quality of life and mental health but also their access to prison parole programmes, and therefore the possibility of early release. In addition, organisational factors – notably non-confidential programme delivery and lack of both family and institutional supports for methadone prisoners – exacerbated the stigmatisation of MMT programme participants.

Effective strategies to alleviate stigma surrounding OAT programmes such as MMT programmes are urgently needed to ensure participation in and the quality of programmes in prisons.

Many prisoners reported experiencing stigma relating to their participation in MMT programmes in both the methadone prisons studied. They often emphasised the ways that this stigmatisation was amplified by the ways that MMT programme participation was associated with drug use and HIV infection. However, these intersecting experiences and concerns were not recognised by health-care staff or other prison staff. Effective strategies to alleviate stigma surrounding OAT programmes such as MMT programmes are urgently needed to ensure participation in and the quality of programmes in prisons.

Drug use in prisons remains a public health concern because it is often the place of drug initiation. The purpose of this study was to analyze the drug use in prison in Burkina Faso.

We conducted cross-sectional study in the prison of Ouagadougou. The adult prisoners (male and female) incarcerated for more than one month at the largest prison of Burkina Faso were included in the study. Participants were selected using a systematic random sampling. Data were collected from October 28 to November 26, 2018. The face-to-face interviews were conducted in the prison grounds. Logistic multivariate regression was used to identify factors associated with in prison drug use. All analysis was done using Stata.

A total of 379 prisoners were included in this study. Approximately one-third inmates (32.71%; n = 124) experienced illicit drug in lifetime. Nearly one-third (28.76%; n = 109) of the prisoners were drug users before incarceration and 11.87% (n = 45) used drug inside the prison, of which 33.33% (n = 15) initiated drug use in the prison. Cannabis was the first drug used by the prisoners (71.11%) followed by tramadol (62.22%), diazepam (13.33%) and cocaine (2.22%). Four prisoners (3.63%) had reported Heroin use before incarceration. Cannabis was mainly smoked. Tramadol, diazepam and amphetamines were swallowed or mixed with food. Cocaine is smoked and snorted. Case of injection of cocaine and heroin was reported before incarceration. Main factors independently associated with drug use in prison is drug use before prison and young age of inmates. Indeed, inmates who had reported drug use before prison had 4.01 time {adjusted odd ratio (AOR: 4.01 [95% CI: 1.91–8.41])} higher odds to use drug in prison.

To conduct the interviews in the prison grounds could be a limitation due to social desirability bias. Indeed, the prisoners may understate drug use in prison for the fear of likely additional sentence. Availability of biological tests for drug markers might help addressed this bias. Nevertheless, the findings of this study should help to plan effective drug use prevention and care programs for prisoners.

The actions must include the implementation of a medical and psychological care in continuum of healthcare system in Burkina Faso. This system should include screening at entry and adequate health and psychological care in prison for drug users for an effective control of drugs use in prison.

Most of these drug users in prison have a low level of education and are unemployed. Education activities and training on occupational activities to prepare drug users for a successful social reintegration less dependent on drugs is essential. This study can be a basis to explore more possibilities and find out what is available to help those with substance use disorder, manage these cases in prison and prevent relapse on release.

To the best of the authors’ knowledge, this study is the first study on drug use in prison in Burkina Faso. It indicates that the repressive strategy against drug use seems ineffective because former users continue their consumption inside and also new users are initiated to use drugs in prison.

The purpose of this paper is to assess the level of psychological distress of offenders newly brought into prison custody in a Nigerian prison and investigate the relationship with socio-demographic and penal characteristics.

A cross-sectional study involving 236 new prison entrants who were assessed for psychological distress using the 12-item General Health Questionnaire (GHQ-12) and the Hospital Anxiety and Depression Scale (HADS).

A total of 267 prison inmates were newly brought to prison custody over a three-month period. Out of this, 236 (88.4 per cent) of them participated in the study. Majority of the inmates were males 225 (95.3 per cent), awaiting-trial inmates 208 (88.1 per cent), single 144 (61 per cent), Christian 224 (94.9 per cent), first time offenders 218 (92.4 per cent) and charged with violent offences 136 (57.6 per cent). Majority of the inmates scored above cut-off points on the GHQ-12 and the HADS. In total, 157 (66.5 per cent) on HADS anxiety subscale, 201 (85.2 per cent) on HADS depression subscale and 199 (84.3 per cent) on GHQ-12. Significant relationship was observed between GHQ-12 “caseness”, prison category and type of offence. Prison situation and type of offence were significantly associated with HADS depression subscale, whereas age was associated with HADS anxiety subscale.

Some limitations were encountered in the course of the study. First, the study relied on self-report questionnaires for collection of data. Second, information given by the respondents could neither be corroborated by family members, who were not present during the interview, nor by the officers and men of the Nigeria Prisons Service, who knew little or nothing about the respondents. Participants in this study had spent maximum of three days in prison during the interview, thus certain levels of distress within three days after incarceration may not entail “caseness” in the sense of the presence of a psychiatric disorder. Therefore assessment over a longer period is needed.

Screening prison inmates on reception into prison custody provides a vista of opportunity to identify mental health problems and socio-demographic and forensic correlates of psychological distress among new entrants into prison custody. This will facilitate early identification and management of prison inmates with health needs. Health screening on reception will also help in identifying the various penal or forensic characteristics of prison inmates, which will be put into consideration during selection of appropriate rehabilitation and reformation activities that best fit a particular prison inmate. Early screening of prison inmates upon reception in the prison will also help in identifying prison inmates who have high risk of suicide and self-harm, thus preventing cases of death that may arise as a result of these mental health problems. Findings from this study will also enrich the body of knowledge on mental health problems of prison inmates entering the prison; this will also help the criminal justice system in decision making, especially with emphasis on psychological evaluation of prison inmates before dispensing judgment. On the part of the prison authority, the prison inmates identified to have psychological distress and some forensic characteristics can be properly classified, and kept in cells that will not aggravate their distress. Finally, this is the first study of prison inmates on reception into Enugu Maximum Security Prison, Enugu State Nigeria. The implication of this is that findings from this research will form a baseline on which further research on prison inmates upon reception in the prison can be conducted.

This study demonstrated that prison inmates are faced with high level of psychological distress during their early days in prison, and that some socio-demographic and forensic variables had significant association with psychological distress as itemised in Tables III and IV. Therefore, screening new inmates on prison reception will help in early identification and treatment of vulnerable groups. This will also help in proper classification and allocation into appropriate cells of prison inmates by the prison authority.

Professional boundary violations – intentional blurring, minimising or exploiting of institutions’ ethical and legal frameworks – have the potential to cause significant harm to prisoners, staff, prison systems and the public. There has been little empirical research on the nature, extent and impact of boundary violations in UK prisons. The purpose of this paper is to synthesise and critically review studies which have sought to explore, measure and predict boundary violative behaviour, with a view to direct future research and inform prison policies and practices.

Four internet-based bibliographic databases were used for this review. Inclusion and exclusion criteria were applied. Twenty studies published between 2001 and 2022 were included in this review.

There is a lack of comprehensive self-report measures around prison boundary violations. Staff and prisoner characteristics, as well as prison-specific conditions, are linked with boundary violations. Staff training, improved working conditions and amnesty programmes as well as bolstered surveillance and restricted cross-sex staff deployment were among recommendations to reduce boundary violations. “Insider” researchers offer insight and access opportunities, but they also pose ethical implications. Current studies have research design, participant sampling and measurement scale limitations which compromises the applicability of findings. Prisons need robust policies on defining, reporting, punishing and recovering from boundary violations. Collaboration between prison institutions and academics, using individuals with experience of both professions, is essential to understand, predict and reduce boundary violations.

To the best of the authors’ knowledge, this is the first review of empirical studies on professional boundary violations in prison.

The purpose of this paper is to examine the well-being of UK prison officers by utilising a benchmarking approach.

The Health and Safety Executive (HSE) Stress Indicator Tool is widely used in the UK to assess key psychosocial hazards in the workplace encompassing demands, control, support from managers and co-workers, relationship quality, role and change management. This study utilises this approach to examine the extent to which a sample of UK prison officers meets the HSE recommended minimum standards for the management of work-related well-being. Levels of mental health and job satisfaction in the sector are also assessed using measures with extensive occupational norms. The psychosocial hazards that make the strongest contribution to mental health and job satisfaction are also considered.

Respondents reported lower levels of well-being for all of the hazard categories than recommended. Moreover, mental health and job satisfaction were considerably poorer among prison officers than other occupational groups within the emergency and security services in the UK. Considerable variation was found in the psychosocial hazards that predicted mental health and job satisfaction.

The high levels of stressors and strains experienced by UK prison officers gives serious cause for concern. Priority areas for interventions to enhance well-being in the sector are considered and areas for future research discussed.

This study highlights the wide-ranging benefits of a benchmarking approach to investigate work-related stressors and strains at the sector level.

This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.

This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.

From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01).

A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.

This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.