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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 past years, Zuclopenthixolacetate as well as Flupentixoldecanoate have each proven to be reliable and efficient in the treatment of schizophrenic psychoses. In a specially implemented psychiatric treatment unit (PTU) we administered a high‐dose depot neuroleptic combination therapy initially consisting of both substances to seriously ill schizophrenic prisoners who exhibited highly aggressive behaviour (N = 20). We initially used both antipsychotics at the same time as a simple regimen in order to restore the prisoners’ health to enable them to return to their home prisons. A single coercive intervention was performed in 14 out of 20 prisoners which was followed by a second one in two cases according to Article 101 of the German Code of Criminal Procedure. On average, prisoners needed a treatment course of 30.4 days. Within this time PANSS global scores were reduced by approximately 40%. Side effects occurring as a consequence of neuroleptic treatment were negligible and could be dealt with.

There were 89,708 prisoners in Indonesia in April 2006. The majority were charged for narcotics related crimes. Prisons are working at over‐capacity and with miniscule healthcare budgets. There has been an increase of deaths due to AIDS, particularly among people who inject drugs. Official data shows that HIV prevalence averages 22% in prisons. In late 2002, the Ministry of Justice (MOJ) decided to promote HIV/AIDS prevention and care activities for prisoners to prevent the spread of HIV within prisons, and from there to the community as a whole. In 2005, MOJ launched the Indonesian National Strategy for HIV/AIDS Prevention, Care and Support for Prisoners. The Indonesian HIV/AIDS Prevention and Care Project has been actively involved in the design of these programs and supported their implementation in several prisons, together with other organizations. The Indonesian National Strategy is the first of its kind in Asia, and one of only a few dedicated national strategies for HIV/AIDS prevention and care for prisoners. It has enabled education, as well as the provision of condoms, bleach, methadone and antiretroviral therapy for prisoners. This paper describes the National Strategy for HIV/AIDS Prevention, Care and Support for Prisoners, which will help control the HIVepidemic among people who inject drugs and ultimately be beneficial for the community as a whole.

The social care needs of older prisoners is a neglected area. Social care policy and guidance does not exclude them but rarely mentions them explicitly; consequently their needs may be unmet. At the same time, more people are being sentenced and prisoners aged over 60 are the fastest growing group. Equally, older prisoners are rarely subject to the same safeguarding processes that take place in the community. This paper considers both issues and suggests some ways forward.

About 4% of all prisoners can be diagnosed with a psychotic disorder, but it is largely unknown how these prisoners function during imprisonment. The present study aimed to describe symptoms of psychotic prisoners during imprisonment and incidents caused by them as well as care provided to these prisoners. A total of 61 prisoners were observed for a maximum of 12 weeks. Results show that poverty of speech and blunted affect significantly decreased over time. The largest group of psychotic prisoners either did not suffer from positive psychotic symptoms or the encountered positive psychotic symptoms exhibited a steady or decreasing pattern during their imprisonment. Reasons for these findings still remain unclear.

The purpose of this paper is to understand prisoner perceptions on being trained and having received take-home naloxone (THN) kits once released from prison back into the community, in order to prevent an opiate-related overdose.

A survey was run of all prisoners receiving THN training across ten prisons in one English region. In total, 142 prisoners were surveyed out of 206 (69 per cent) being trained in THN across the ten prisons. Five focus groups (n=26) with prisoners were conducted across four remand and one open prison that included discussions on THN within a range of topics. Discussions were recorded using short-hand and the data were subsequently thematically interpreted using visual mapping techniques.

The survey highlighted a high degree of exposure amongst prisoners to overdose either directly (54 per cent) or having witnessed another person’s overdose (73 per cent). For prisoners who had overdosed, only a minority (38 per cent) were taken to hospital by an ambulance. In total, 81 per cent of prisoners surveyed also expressed little or no knowledge about THN prior to training. Prisoners were resistant to THN as an intervention resulting from this lack of prior knowledge. Focus group interviews suggested that there was a confused and mixed message in providing a harm reduction initiative within the context of recovery-orientated treatment. Prisoners also exhibited name confusion with other drugs (naltrexone) and there was some degree of resistance to being trained based on perceived side-effects brought on by its administration. Prisoners were also acutely aware of official agency perceptions (e.g. police) if seen to be in possession of THN kits.

The distribution of THN within a custodial setting requires consideration of wider marketing approaches to address levels of confusion and misapprehension amongst prisoners.

The study is one of the few focused on THN based on a UK prison environment.

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

Penal institutions affect their inmates’ mental as well as physical health. Prisoners have higher rates of physical health conditions than the public. While it is known that psychosocial factors determine patients’ quality of life, little research has focused on factors related to prisoners’ psychophysical quality of life (PQoL). The purpose of this study is to analyze the determinants of prisoners’ PQoL.

The sample consisted of 390 prisoners recruited from correctional facilities administered by the Warsaw District Inspectorate of Prisons. This study hypothesized that social support, coherence and self-efficacy would be positive determinants of PQoL and that depression, anxiety and anger would be its negative determinants. The collected data were analyzed by means of structural equation modeling.

The positive determinants of PQoL in prisoners are coherence, self-efficacy and social support. The negative determinant of PQoL is trait depression.

This study has revealed a list of factors significant for improving prisoners’ PQoL. Factors have also indicated which of the predictors measured are the most significant. The identified set of significant factors should be taken into account in social rehabilitation programs for prisoners as contributing to the preservation of life and health.

Despite the volumes that have been written on America's correctional crisis – the peerless incarceration rate, disproportionate confinement of minority group members and democratically untenable policies of disenfranchisement of people with felony convictions – criminal justice policy has changed little within the past decade or more. An important voice has been left out of these correctional policy formulations – that of prisoners. This paper proposes convict labor unions as one way to address this issue. It utilizes the United States Supreme Court majority's arguments in Jones v. North Carolina to assess the feasibility of inmate labor unions in light of current federal, state and local institutional operations; and provides a very tentative outline of how a prisoners’ labor union could be structured and function – exploring the potential democratic ramifications of such unions for corrections and in broader social policy.

Following the military coup that toppled the government in September 1980, Turkish prisons, like the rest of the country, came under military control. Abhorrent levels of violence inflicted under military discipline became the source of horror stories. However, by early 1990s, official authorities had almost completely lost control of prisons to political prisoner organizations. This chapter analyzes how such a drastic change took place within a decade. Focusing on the ongoing struggles between political prisoner organizations and official actors over control of daily life, I argue that the resistance strategies developed by the political prisoners against the military disciplinary project in 1980s became the source of a prisoner-imposed disciplinary project in 1990s.