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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.

In a health survey of Finnish prisoners in 2006, the authors aimed to study frequency and gender differences in childhood physical and sexual abuse, and the connections of maltreatment in childhood to substance abuse and mental health among female and male prisoners.

The sample consisted of 101 female prisoners, with 309 male prisoners for comparison. The subjects participated in a comprehensive field study consisting of several questionnaires, interviews, the Structured Clinical Interview for DSM‐IV Axis I and II Disorders (SCID I, II) and a clinical medical examination including ICD‐10 diagnoses.

Both forms of abuse were more common among females than males (childhood physical abuse 25 per cent versus 15 per cent and childhood sexual abuse 32 per cent versus 7 per cent). Associations of childhood abuse with substance abuse and mental health were different among males and females. Family integrity was important only for males and in connection with drug dependence and antisocial personality disorder. The gender differences did not concur with those reported in studies on general populations.

This is a part of the first comprehensive health survey of Finnish prisoners.

This chapter aims to examine the ways in which gender has featured in Hong Kong’s prison system from its colonial origins to its contemporary form as a politically autonomous region of China. We conclude with a discussion on the reasons for these recent trends of imprisonment.

We draw from the concepts of patriarchy and colonialism to examine how gender has operated and shaped Hong Kong’s prison system. Our analysis is based on historical and contemporary government reports and other documents and secondary data.

Similar to other locales around the world, Hong Kong’s prison system was designed for and by men in its early colonial days, as expected given that most prisoners were male. Although a few prison administrators attempted to provide some programs for women and voiced concern over the conditions of women’s imprisonment to colonial authorities during the latter part of the 1800s, it was not until the 1930s that the first female prison was established. Since then, Hong Kong prison authorities have faced the challenge of a phenomenal and rapid growth in women’s imprisonment, which resulted in a historical reversal of shifting male prisoners to alternate accommodation to make room for their female counterparts.

This study is among the few which have examined how gender operates in the context of imprisonment in a colonial and postcolonial context. This chapter does this by examining how colonial authorities managed competing political debates about the purpose of punishment and cultural understandings of race and difference, and the limited recognition of gender and difference. It also examines how, in postcolonial Hong Kong, authorities have placed gender center stage and the reasons for this in coping and dealing with the growth in women’s imprisonment.

This article reports findings from interviews conducted with 120 officers working within medium to high security prisons in England. It presents part of a project designed to test whether the impact of women officers in male prisons was similar in England to that described elsewhere. In total, 120 officers and 120 prisoners participated.

Prisons in the sub-Saharan African region face unprecedented challenges during the COVID-19 pandemic. In Malawi, the first prison system case of COVID-19 was notified in July 2020. While prison settings were included in the second domestic COVID-19 response plan within the Law Enforcement cluster (National COVID-19 preparedness and response plan, July–December 2020), they were initially not included in the K157bn (US$210m) COVID-19 fund. The purpose of the study was to assess prison preparedness, prevention and control of COVID-19 in Malawi..

A multi-method situation assessment of the COVID-19 response and human rights assurance of prisoners and staff was conducted in a large prison complex in Malawi. Qualitative research underpinned by the Empirical Phenomenological Psychological (EPP) framework consisted of interviews with key informants such as prison health personnel, senior prison staff, penal and judicial policymakers, government and civil society organisations (n = 14) and focus group discussions with consenting male (n = 48) and female prisoners (n = 48) and prison wardens (n = 24). Prison site visits were supported by detailed observations based on the World Health Organisation Checklist for COVID-19 in prisons (n = 9). Data were collected and analysed thematically using the EPP stepwise approach and triangulated based on Bronfenbrenner’s model conceptualising COVID-19 as a multi-level event disrupting the prison eco-system.

The results are presented as MICRO-MESO level individual and community experiences of incarceration during COVID-19 spanning several themes: awareness raising and knowledge of COVID-19 in prisons; prison congestion and the impossibility of social distancing; lack of adequate ventilation, hygiene and sanitation and provisions and correct use of personal protective equipment; MESO-MACRO level interplay between the prison community of prisoners and staff and judicial policy impacts; medical system COVID-19 response, infrastructure and access to health care; COVID-19 detection and quarantine measures and prisoner access to the outside world.

This unique situation assessment of the Malawian prison system response to mitigate COVID-19 illustrates the dynamics at the micro-level whereby prisoners rely on the state and have restricted agency in protecting themselves from disease. This is due to severe structural inadequacies based on low resource allocation to prisons leading to a compromised ability to prevent and treat disease; an infirm and congested infrastructure and bottlenecks in the judicial system fuelling a continued influx of remand detainees leading to high overcapacity. Multi-pronged interventions involving key stakeholders, with prison management and line Ministry as coordinators are warranted to optimise COVID-19 interventions and future disease outbreaks in the Malawian prison system.

The use of exercise as an intervention to improve health in the general population is well documented. The purpose of this paper is to explore whether an exercise referral scheme can be an effective health promotion tool for male prisoners in Ireland, presenting with mental health symptoms.

This mixed methods study with a pre- and post-intervention design was conducted in Mountjoy Prison, Dublin, which has a capacity for approximately 790 prisoners. Reliable and validated symptom assessment scales were used to assess levels of depression, anxiety, stress, self-esteem and anger amongst a sample of 40 prisoners pre- and post-intervention. The scales used were the Depression, Anxiety and Stress scale or DASS-42 (Lovibond and Lovibond, 1995), the Novaco Anger Scale (Novaco, 1994), the Rosenberg Self-Esteem Scale (Rosenberg, 1965) and the Zung Self-Rated Anxiety Scale (Zung, 1971). Semi-structured interviews were also conducted with a subset of the participants post-intervention to further test and contextualise the symptom ratings. The data gathered from the self-rating scales were imported into SPSS 22 for statistical testing for significance. Wilcoxon’s signed-rank test was then used to measure significance of changes. Thematic analysis was performed on the qualitative data.

In the post-intervention, significant levels of improvement were achieved in the levels of depression, anxiety (DASS), anxiety (Zung), stress, anger, and self-esteem for 29 of the 30 prisoners who completed the study. The incidence of normal mood scores rose from 33 to 90 per cent after the intervention; the incidence of extremely severe scores for anxiety changed from 40 to 7 per cent, severe stress scores changed from 27 to 3 per cent, normal stress levels rose from 17 to 73 per cent, marked anger ratings reduced from 40 to 3 per cent and low self-esteem levels reduced from 20 per cent of participants pre-intervention to 7 per cent post-intervention. In the main, participants perceived the experiences and outcomes of the intervention positively.

There are some limitations to the design of this study. Operational circumstances within the prison at the start of this study prevented the authors from accessing a larger sample. A control group would add greatly to the study but this was not possible within a single prison setting. The possible influence of extraneous variables such as increased attention and social contact, and more time out of one’s cell may have contributed to improved symptom scores as much as the exercise intervention in this study. This possibility was recognised from the outset but the authors proceeded because the aim was to test if an exercise referral package (and all that inevitably goes with that) would make a difference for symptomatic prisoners.

The organisation and smooth running of the intervention and the positive results therein underpinned the practicality of this project. The significantly positive results contribute new knowledge to the profile of Irish male prisoners’ mental health.

This study could be the foundation for a larger study or set of studies which should include a control group and one or more female prisoner cohorts. The impact of positive changes in prisoners’ mental health on the prison staff and environment could also be researched. This type of study could lead to important social implications in relation to its impact on prisoner rehabilitation.

This study was the first of its kind to explore the effectiveness of exercise referral as a health promotion intervention for Irish male prisoners presenting with mental health symptoms.

The purpose of this paper is to assess the work ability and employment history of Finnish female prisoners and their need for treatment.

The sample consisted of 101 female prisoners, with 309 male prisoners for comparison. The methods included interviews, the Structured Clinical Interview for DSM‐IV Axis I, II Disorders and medical examination including ICD‐10 diagnoses.

Among women, 78 per cent were unemployed and only 6 percent were employed whereas among men, the proportion of those employed was four times greater than for women. Of women, 42 per cent were unable to work; of men 11 per cent. Substance abuse disorders were the most common reason for impaired work ability (over 70 per cent in both genders). Among women, other mental disorders were the second most common reason (39 per cent), somatic diseases caused impairment in 23 per cent. Basic socio‐demographic factors were not associated with impaired work ability among women. Violent crime as the present main offence was significantly more common among prisoners with limited working capacity. Need for treatment was found in 94 per cent of women and 90 per cent of men. In both genders, the majority of treatment needs were for mental disorders. Finnish female prisoners have serious problems with substance abuse, of both alcohol and drugs, which impairs their work ability, employability and is the cause of their need for treatment. In addition, female prisoners have other mental disorders commonly complicating their situation.

This paper is a part of the first comprehensive health study of Finnish female prisoners.

The treatment and placement of transgender individuals within the UK prison system has garnered considerable political and media attention. The purpose of this paper is to present an analysis of the experiences of three transgender women located within a male, category C prison in England.

Participants were interviewed and their accounts analysed using interpretative phenomenological analysis.

Three overarching themes emerged from the data set: participants’ experiences of transition; their identity within custody and the challenges associated with presenting as female within a male establishment; and what they perceived as their fight against the prison system which encompassed a fight for their rights alongside a daily struggle against harassment, victimisation and discrimination.

Three participants were interviewed which impacts the generalisability of the findings. Implications link to the care and management of transgender prisoners.

The care and management of transgender prisoners is a complex issue. This paper contributes to the discussion on how best to support and care for this group of service users who are arguably amongst the most vulnerable within the prison system.

Findings are discussed in relation to policy, management and safeguarding of transgender prisoners within the UK prison system. Recommendations are made regarding their placement and management in prison.

There are limited accounts from transgender prisoners regarding their experiences in prison. This paper aims to address that gap.

The poor health of prisoners was highlighted in the results of two comprehensive health surveys conducted with prisoners in New South Wales (NSW), Australia. The capacity of a dedicated service to address the health needs of prisoners was tested through analysis of the health of two prisoner cohorts: a continuously serving cohort, and a cohort of prisoners who had been incarcerated and released during the period of interest, 1996‐2001. It appears that mental health services best addressed the needs of a stable prisoner population. Short‐stay prisoners do not gain any degree of benefit. Primary health and drug and alcohol services address the needs of prisoners less effectively, irrespective of their duration of stay. Women’s health was very poor on all measures that were assessed. With the exception of mental illness, the health inequalities that prisoners experience are not addressed by existing prisoner health services. This may be due to the magnitude of the burden of ill health among prisoners, or due to inadequate resources ‐ or some combination of both. While these results should not be taken as supportive of coercive institutionalisation (i.e. imprisonment) as a therapeutic option, there may be benefit in more humane and compassionate institutions for some of society’s most vulnerable individuals. The results highlight the potential for prisoner health service providers in redressing years of health neglect and the low levels of service utilisation by this group while in the communi

The purpose of this paper is to determine the extent of autism spectrum disorder (ASD) traits among prisoners. The authors tested the hypotheses that ASD traits would: be continuously distributed among prisoners; be unrecognised by prison staff; and predict whether a prisoner met diagnostic criteria for ASD.

ASD traits were measured among 240 prisoners in a male prison in London, UK using the 20-item Autism Quotient (AQ-20). Further diagnostic assessment was carried out using the Autism Diagnostic Observation Schedule. Results were compared with ASD data from the 2007 Psychiatric Morbidity Survey.

There were 39 participants with an AQ-20 score=10; indicating significant autistic traits. The distribution of ASD traits among participants appeared to be normal and was not significantly higher than the rate found in a population-based sample from England.

Few studies have explored ASD traits among prisoners. The authors identified high levels of unrecognised ASD traits among a group of male prisoners, many of whom went on to meet diagnostic criteria for ASD. The study highlights the need for specialist assessment within the criminal justice system for individuals with neurodevelopmental disorders including ASD. The authors discuss the process of carrying out an ASD assessment project in a prison.