Healthcare needs of young people transitioning back to the community after a custodial sentence

Abstract

Abstract Background People in prison have poorer health outcomes than the general population, added by the long-term impact of incarceration on mortality. Young people in custody face extra challenges associated with the stage of development. There is a lack of a tailored approach and policy to young people when transitioning back to the community. This paper draws from a PhD research that looked at the challenges to access healthcare during the transition back to the community. The specific question is: What are young people's healthcare needs when released from custodial sentences? Methods An ethnographic study conducted in Scotland in partnership with a community-based organisation. The participants were eight young people and ten practitioners that work in health and social care. Participatory observation and in-depth interviews were used to collect data during July 2019 and March 2020. Data analysis was conducted with Reflexive thematic analysis. NVivo supported data management. Results The identified needs were individualised issues, structural factors, mental health, substance use and geographical disposition of services. There is a need for mental support and continuity of care associated with substance use. The demand for local services is vital for healthcare provision. Healthcare needs go beyond the necessity of services and health issues. They are associated with stigma in the interaction with practitioners. Institutional practices and practitioners' attitudes reinforce non-explicit forms of discrimination and health inequalities. Conclusions Practitioners and policymakers need to focus on the person-centred approach. They need to listen to young people. Data showed a need for specific services, like mental health and drug use. Moreover, practitioners need to avoid stigmatisation and discrimination by a caring practice. Public health and social care policies need to address stigma and access to services for young people after a custodial sentence. Key messages It is necessary to avoid stigmatisation and improve access to services for young people transitioning back to the community after a custodial sentence. Public Health and social care policies need to address this marginalised group by offering person-centred approaches, continuity of care and support during re-entry.