Prison and it’s Impact on Health 

Feeling trapped and alone in a prison cell is how many prisoners feel. Imagine if one of your friends or family members were in this position?

Being in this situation can take a toll on your health, especially being separated from your family for long periods of time. Imagine entering prison with a history of drug or alcohol addiction without knowing whether or not assistance will be provided. In prisons, mental health is a big problem. (Durcan, 2021) From 45% suffering with depression and 8% being diagnosed with acute psychosis, many inmates are struggling.

In this blog, I will discuss health issues within prison, how they deal with it and if the prison offers them help.   

Healthcare in prisons

(His Majesty’s Prison and Probation Service, 2014) The NHS has been responsible for ordering all prisoner healthcare services in England from April 2013. This covers assistance with drugs and alcohol. In England, there is a national partnership agreement that brings together many departments, including the MoJ and the department of health and social care, to help coordinate and support services provided to prisoners. Prisoners have access to the same healthcare as individuals outside of prisons, and treatment is provided without charge—but only after receiving the doctor’s permission. The healthcare staff in prisons handle the majority of issues, but if there is something they are unable to handle, they can either arrange for outside treatment or have a specialist visit the facility.

Prior to entering prisons, some individuals have had mental health issues, some linking to substance misuse. For prisoners, specialised assistance is provided. It’s possible for prisoners to enter prison with addictions and behavioural issues; specialised support is available in prisons for individuals with disabilities, HIV/AIDS, drug and alcohol use disorders, and other conditions such as bipolar and schizophrenia.

Health Care Prison staff can discuss and make choices on behalf of a prisoner who is unable to make decisions due to a mental health problem. For instance: they will guide the prisoner on which medication would be beneficial for their health and advise them on ways to cope with their mental health.

(Chandler, Fletcher and Volkow, 2009) Reoffending can be decreased by supporting addicts and offenders in their recovery. Courts have the power to order drug, alcohol, or mental health treatment as part of a community sentence. This makes it possible for criminals to access community-based treatment, which is thought to be more successful than a brief prison term in reducing crime. 

Mental health in prisons

(National Audit Office (NAO), 2017) In 2016, there were 40,161 incidents of self-harm in prisons and 120 self-inflicted deaths. (Ministry of Justice, 2022) In 2021, there were 52,726 self-harm incidents and has increased by 5% in female establishments and a further 371 deaths in prison. Evidently, the system that is trying to improve mental health in prisons is not working, as these statistics have been on the rise. People are more likely to develop or increase mental health issues in prison compared to outside the prisons. 

We can only ask why? 

When COVID hit in 2019, many restrictions were introduced into prisons. For example: ‘isolation’, in which prisoners were not able to have visitors come and see them. Of course, this took a big toll on the prisoners’ health, especially mental health. Many inmates died from COVID, especially as a place like a prison is a high-risk environment for infectious diseases to break out. Not just inmates were impacted, but also prison staff too. To try and control the outbreak, prisoners would have to stay in their cells for 23 hours per day during lockdown. (www.qub.ac.uk, 2021) Depression and anxiety increased tremendously with one out of three prisoners scoring at the level of severe anxiety disorder. Additionally, two thirds of survey respondents have stated that access to mental health support had worsened, instead of improving, during the lockdown. Many prisoners used self-harming as a coping mechanism during this difficult time. Boredom didn’t help their problem of feeling alone, which resulted in them into overthinking- increasing anxiety and paranoia levels.

Case study

(Campbell, 2018) “Poor healthcare in jails is killing inmates”, is the title of this article. It details how the poor quality of healthcare provided to inmates in English prisons is having a negative impact on their health. Because of the lack of healthcare in prisons, many prisoners die. One of the causes of this issue is thought to be inadequate personnel and staff training. Prisoner mental health has been negatively impacted by overcrowding, particularly when two inmates share a small cell, according to Peter Clarke, England’s chief prison inspector.

Summary

In summary, healthcare is offered in prisons to help all inmates from every background. From those that have had health issues to those that are coming from a drug or alcohol addiction, prisoners get healthcare like those outside of the prisoners. However, even with all the help offered, there still seems to be a big gap between the health of the prison compared to those outside of the prisons. Prisoners are more likely to have mental health issues, to self-harm and commit suicide. Health in prisons is slowly getting worse rather than getting better according to statistics. We can only question the system and ask why?

Do you know anyone that has had their health impacted due to being in prison?

https://www.gov.uk/guidance/healthcare-for-offenders 

https://www.theguardian.com/society/2018/oct/27/prisoners-dying-poor-care-services-prisons-mental-health-care-quality-commission-report 

https://www.nao.org.uk/reports/mental-health-in-prisons/

https://www.gov.uk/government/statistics/safety-in-custody-quarterly-update-to-september-2021/safety-in-custody-statistics-england-and-wales-deaths-in-prison-custody-to-december-2021-assaults-and-self-harm-to-september-2021 

https://www.qub.ac.uk/News/Allnews/featured-research/landmark-study-covid-19-measures-mental-health-crisis-prisons.html#:~:text=More%20than%20one%20out%20of,levels%20of%20post%2Dtraumatic%20stress.&text=Two%20thirds%20of%20survey%20respondents,of%20improving%2C%20during%20the%20lockdown

Chandler, R.K., Fletcher, B.W. and Volkow, N.D. (2009). Treating Drug Abuse and Addiction in the Criminal Justice System. JAMA, 301(2), p.183. doi:https://doi.org/10.1001/jama.2008.976.

https://www.centreformentalhealth.org.uk/publications/future-prison-mental-health-care-england