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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

This paper aims to explain the phenomenon of low incidence of COVID-19 in Polish prisons. This paper addresses three questions: was the Polish prison system ready to respond to the threats posed by COVID-19; what action has it taken in this regard; and with what effect?

An analysis of the current condition of the Polish prison system was undertaken focusing on items that were the focus of prisoners’ complaints, the interventions of the Ombudsman and the bulletins of the Central Board of the Prison Service. This analysis has been juxtaposed with the opinions of experts in epidemiology and medicine and changes introduced in the law relating to prisoners.

During the COVID-19 epidemic – despite serious chronic problems in the Polish penitentiary system – the statistics indicated that 24 individuals were infected and no deaths occurred. When compared to the statistics of non-prison cases, this result is extremely low.

Given the newness of the problem, the conflicts of different interests, the “double” isolation of prisons (penal and epidemiological) and the reluctance of the prison administration to provide information about what is happening behind prison walls, researchers must rely on statistics and subjective contacts with prisoners, for example, by investigating their complaints.

As a result of the research, the author believes that the transparency of institutions such as prisons should be ensured, primarily expressed in the provision of information to both prisoners and the public relating to methods adopted to prevent epidemics in the context of prison and prisoners.

The value of this paper is to show how prisons have managed in a new, exceptional situation to balance the right to health and personal safety of prisoners and warders, with the right to contact with the outside world and humane living conditions in a closed and doubly isolated space. The findings presented will add value to the knowledge and effectiveness of the prison administration’s reaction and response to an emergency such as an epidemic.

There is an increased focus on making prison cultures more rehabilitative, with clear evidence that certain environmental characteristics contribute towards rehabilitation. To date, limited research has explored the rehabilitative culture in a high security prison. This study aims to measure staff and prisoner ratings of social climate and their levels of hope in such an establishment.

The research adopted a quantitative approach, using the EssenCES and State Hope Scale. Data was analysed using parametric and non-parametric tests to explore correlations/relationships between variables.

Findings indicated that higher ratings of social climate were associated with higher levels of hope. Staff rated the social climate more favourably than prisoners, and Category B prisoners had higher levels of hope than Category A prisoners. No significant correlation was found between length of time in service or custody and ratings of social climate or hope.

This paper highlights the importance of developing a positive social climate and hope, supporting the rehabilitative culture initiatives.

This paper contributes to the limited literature on social climate and hope within UK forensic settings. Furthermore, reliability testing indicates the State Hope Scale is appropriate for use with a UK forensic population, extending its application.

This study aims to examine sociodemographic characteristics, levels and patterns of mortality experiences amongst Indian prisoners over the past two decades (1998–2018).

This study used prison statistics in India to analyze occupancy rate, percentage distribution, annual/decadal change, male–to–female ratios, prison mortality rate and causes of natural/unnatural deaths.

During 1998–2018, prisons in India grew by 18% and prisoners by 69%, leading to overcrowded jails. Males outnumbered female prisoners. Seventy percent of prisoners had an educational attainment level lower than 10th grade. In 2018, over 14 per 1,000 prisoners suffered from a mental illness and 384 per 100,000 died. Unnatural deaths accounted for 8%–11% of all prisoner deaths; 84% were by suicide. Illness accounted for 95% of all natural deaths in 2018; one–quarter was due to heart diseases.

The study did not establish an association between sociodemographic characteristics with mental illness and mortality due to the non-availability of data.

The pattern of a deteriorating living environment, rise in mental illnesses and mortality among Indian prisoners calls for immediate action from the authorities to protect them. Almost all unnatural deaths were by suicide (mostly by hanging). This detailed study would help authorities to take corrective measures for prisoner safety and well-being. There is also a need to develop a scientific database for this population.

To the best of the authors’ knowledge, this is the first study to examine morbidity and mortality experiences of the prisoner population using national statistics.