Counterintuitive findings from a qualitative study of mental health in English women’s prisons

This is an accepted manuscript of an article published by Emerald Group Publishing Limited in International Journal of Prisoner Health on 01/12/2016, available online: https://doi.org/10.1108/IJPH-05-2016-0013 The accepted version of the publication may differ from the final published version.Purpose Large numbers of women in prison report significant emotional and mental health problems, and there is evidence to suggest that the prison environment may exacerbate the incidence and severity of these issues (Armour, 2012). However, there has been limited exploration of the extent to which women’s mental health problems exist prior to incarceration, whether symptoms first occur in incarceration, and how incarceration affects this. The paper aims to discuss these issues. Design/methodology/approach In-depth interviews were conducted with 43 women incarcerated in three English prisons and a thematic analysis of the data was conducted. Review of official prison records provided a form of data triangulation. Findings Analysis of the data revealed that while many women who experienced mental health issues in prison had experienced these issues in the past, a number of women reported first experiencing mental health and emotional problems only after entering prison. Although these problems often recede, this demonstrates the significant impact that entering prison can have upon the mental health of women. Unusually, the data highlighted many positive experiences of support within prison. However, there was some lack of consistency in the treatment and support offered to women. Originality/value The data presented here are in many ways more positive than previous research and – as opposed to much of the existing literature that simply states the prevalence women’s issues in prison – provides insight into the lived experiences of women in prison. This paper documents how prison can present an opportunity for women to engage with treatment, but there is a need for a clearer understanding of women’s needs and consistent and appropriate support

The prisoner's right to vote and civic responsibility: Reaffirming the social contract?

Copyright © 2009 NAPOThis article considers the issue of the prisoner’s right to vote in the light of recent developments in law and policy. It critically reviews the purported justifications for disenfranchisement and argues that re-enfranchisement should be pursued on the grounds of both principle and policy

Palliative care in UK prisons: practical and emotional challenges for staff and fellow prisoners

Despite falling crime rates in England and Wales over the past 20 years, the number of prisoners has doubled. People over the age of 50 constitute the fastest growing section of the prison population, and increasing numbers of older prisoners are dying in custody. This article discusses some of the issues raised by these changing demographics and draws on preliminary findings from a study underway in North West England. It describes the context behind the rise in the numbers of older prisoners; explores the particular needs of this growing population; and discusses some of the practical and emotional challenges for prison officers, health care staff, and fellow prisoners who are involved in caring for dying prisoners in a custodial environment

Foreign national prisoners in the UK: explanations and implications

This article examines the rapid expansion of the foreign national prison population in the UK against a backdrop of public and political anxiety about immigration and crime. It explores official data considering some of the possible explanations for the growth in the number of foreign national prisoners and the implications this has for penal management. Whilst increases in both the number of foreign nationals entering the UK and the number of foreign nationals in UK prisons has strengthened the association between immigration and crime in the public imagination, there is little empirical evidence to suggest that foreign nationals are more dangerous than British nationals. Instead, the growth of the foreign national prison population appears to stem from a number of sources that may operate alone or in tandem

Transfers from prison to hospital under Sections 47 and 48 of the Mental Health Act between 2011 and 2014

In England and Wales, prisoners with mental disorder of such severity as to warrant inpatient treatment may be transferred to hospital under the Mental Health Act. UK Government guidance recommends that this process should be completed within 14 days; however, evidence suggests that in many cases it can take much longer. This retrospective service evaluation of 64 male prisoners, who were transferred under Section 47 or Section 48, aimed to evaluate transfer durations. The mean time from referral to admission was 76 days. Prisoners with a psychotic disorder were admitted more quickly. Remand prisoners were admitted more quickly than sentenced prisoners. Findings suggest that, in the UK the transfer time of prisoners under Sections 47 and 48 of the Mental Health Act continues to far exceed the 14-day target which raises concern about equivalence of care for prisoners. Our findings support arguments for fundamental amendments to the admissions process

Transforming Women’s Rehabilitation? An Early Assessment of Gender-Specific Provision in Three Community Rehabilitation Companies

Following the implementation of the Offender Rehabilitation Act 2014, the Transforming Rehabilitation (TR) reforms expanded the offender management market to include several private providers, known as Community Rehabilitation Companies (CRCs). The TR reforms have been the subject of intense debate since the outset. Political, academic and campaign-group commentary has critiqued the rapid implementation of the new agenda and examined its likely impact on existing services (particularly those run by the charitable sector). A growing body of research has also questioned the likely impact of the legislation on community provision for women, a field already beset with precarious funding streams. Lamenting the ‘lack of strategic focus’ on women, a recent review by Her Majesty’s Inspectorate of Probation (HMIP) revealed that ‘dedicated funding for women’s community services has virtually disappeared, and provision is mixed and uncertain’ (2016a: 4). Drawing on 36 interviews conducted with probation officers and practitioners (keyworkers) working for women’s services, this paper validates such concerns. While the supposed subjects of an established government strategy, it is particularly regretful to report such findings in the tenth anniversary year of Baroness Corston’s seminal report

Exploring concepts of health with male prisoners in three category-C English prisons

Lay understandings of health and illness have a well established track record and a plethora of research now exists which has examined these issues. However, there is a dearth of research which has examined the perspectives of those who are imprisoned. This paper attempts to address this research gap. The paper is timely given that calls have been made to examine lay perspectives in different geographical locations and a need to re-examine health promotion approaches in prison settings. Qualitative data from thirty-six male sentenced prisoners from three prisons in England were collected. The data was analysed in accordance with Attride-Stirling's (2001) thematic network approach. Although the men's perceptions of health were broadly similar to the general population, some interesting findings emerged which were directly related to prison life and its associated structures. These included access to the outdoors and time out of their prison cell, as well as maintaining relationships with family members through visits. The paper proposes that prisoners' lay views should be given higher priority given that prison health has traditionally been associated with medical treatment and the bio-medical paradigm more generally. It also suggests that in order to fulfil the World Health Organization's (WHO) vision of viewing prisons as health promoting settings, lay views should be recognised to shape future health promotion policy and practice

‘We Call it Jail Craft’: The Erosion of the Protective Discourses Drawn on by Prison Officers Dealing with Ageing and Dying Prisoners in the Neoliberal, Carceral System

The UK prison population has doubled in the last decade, with the greatest increases among prisoners over the age of 60 years, many of whom are sex offenders imprisoned late in life for ‘historical’ offences. Occurring in a context of ‘austerity’ and the wider neoliberal project, an under-researched consequence of this increase has been the rising numbers of ‘anticipated’ prison deaths; that is, deaths that are foreseeable and that require end of life care. We focus here on ‘jail craft’; a nostalgic, multi-layered, narrative or discourse, and set of tacit practices which are drawn on by officers to manage the affective and practical challenges of working with the demands of this changed prison environment. Utilising findings from an empirical study of end of life care in prisons, we propose that the erosion of jail craft depletes protective resources and sharpens the practical consequences of neoliberal penal policies

Moving prison health promotion along: Towards an integrative framework for action to develop health promotion and tackle the social determinants of health

The majority of prisoners are drawn from deprived circumstances with a range of health and social needs. The current focus within ‘prison health’ does not, and cannot, given its predominant medical model, adequately address the current health and well-being needs of offenders. Adopting a social model of health is more likely to address the wide range of health issues faced by offenders and thus lead to better rehabilitation outcomes. At the same time, broader action at governmental level is required to address the social determinants of health (poverty, unemployment and educational attainment) that marginalise populations and increase the likelihood of criminal activities. Within prison, there is more that can be done to promote prisoners’ health if a move away from a solely curative, medical model is facilitated, towards a preventive perspective designed to promote positive health. Here, we use the Ottawa Charter for health promotion to frame public health and health promotion within prisons and to set out a challenging agenda that would make health a priority for everyone, not just ‘health’ staff, within the prison setting. A series of outcomes under each of the five action areas of the Charter offers a plan of action, showing how each can improve health. We also go further than the Ottawa Charter, to comment on how the values of emancipatory health promotion need to permeate prison health discourse, along with the concept of salutogenesis