Norwegian Prison Research Articles

Thinking about prisons: A response to O’Flaherty, Sethi, and Murphy

I provide a response to the commentaries on my book The Idea of Prison Abolition (2022) by Brendan O’Flaherty and Rajiv Sethi and by Colleen Murphy. With respect to the first commentary, I briefly discuss the comparison of US prisons to Norwegian prisons; the deterrent effect of well-crafted sentences; and the prospects of a world without prisons. In response to the second commentary, I argue that the methods of the scholar-activist and those of the analytic political philosopher are not incompatible with meaningful engagement and disagreement on the abolition-versus-reform question despite these methodological differences.

How to Change Practice and Policy to Address the Unique Needs of Senior Inmates: Insights From the Norwegian Correctional System

This study explores challenges senior inmates face in a Norwegian prison and evaluates the “Come and Meet Each Other” (CAMEO) program's effects on their life, focusing on changes in policy and practice to transform inmates’ perceptions of their environment. Utilizing a mixed-methods approach, including survey and interviews, thematic analysis revealed that CAMEO enhances inmates’ daily lives, dignity, and community integration, promoting a more normal life. Despite positive outcomes, issues persist with drug rehabilitation cohabitation and prison structure. Recommendations include improving facility design, expanding activities, and enhancing staff training. The findings highlight broader issues in correctional settings and suggest areas for further research on recidivism and reintegration.

The Ideal Client: Selecting Candidates for Drug Treatment in Prison

Abstract Therapeutic interventions have been implemented in many prison systems around the world, in an attempt to address high rates of harmful substance use amongst people in prison. This article analyses the criteria for acceptance to drug recovery units in Norwegian prisons, based on an ethnographic study of four high-security prisons and 22 interviews with prison staff. The main criteria that were considered by staff during the assessment of potential candidates, were the timing and type of sentence applicants held; the type of offence applicants were convicted for; the types of medications they used and their perceived motivations for entering treatment.

Estimated effects of opioid agonist treatment in prison on all-cause mortality and overdose mortality in people released from prison in Norway: a prospective analysis of data from the Norwegian Prison Release Study (nPRIS)

Estimated effects of opioid agonist treatment in prison on all-cause mortality and overdose mortality in people released from prison in Norway: a prospective analysis of data from the Norwegian Prison Release Study (nPRIS)

Mortality in women with a history of incarceration in Norway: a 20-year national cohort study.

Women carry a substantial burden of psychiatric, somatic and lifestyle-related morbidity in the prison context. By describing causes of death and estimating the risk and burden of mortality compared with the general population, this study investigates how mortality operates in this highly marginalized and under-researched population. In this registry-based study of all women incarcerated in Norwegian prisons from 2000 to 2019 (N = 11 313), we calculated crude mortality rates, years of lost life and, by using mortality in age-matched women from the general population as a reference, age-standardized mortality ratios and years of lost life rates. Over a mean follow-up time of 10.7 years, at a median age of 50years, 9% of the population had died (n = 1005). Most deaths (80%) were premature deaths from an avoidable cause. Drug-induced causes and deaths from major non-communicable diseases (NCDs) were most frequent (both 32%). Compared with women in the general population, women with a history of incarceration were more likely to die from any cause. Trends in annual age-standardized years of lost life rates suggest that the mortality burden associated with major NCDs has gradually replaced drug-induced causes. Women with a history of incarceration die at a greater rate than their peers and largely from avoidable causes. The profile of causes contributing to the substantial burden of mortality placed on this population has changed over time and has important implications for future efforts to reduce morbidity and the risk of premature death following release from prison.

All-cause and cause-specific mortality among individuals imprisoned for driving under the influence of alcohol and drugs in Norway (2000–2016): a retrospective cohort study

AimsTo describe all-cause and cause-specific mortality and to investigate factors associated with mortality among individuals imprisoned for driving under the influence (DUI) of alcohol and psychoactive drugs in the Norwegian...

A Comparison of Open and Closed Prison Systems: Can These Systems be Implemented in Australia?

This article examines the Norwegian prison system, which focuses on the rehabilitation of inmates and their reintegration into society, and whether this system can be implemented in Australia. It focuses on the individual experiences of inmates within open and closed Norwegian prison systems and highlights the differences and challenges they face. Open prisons aim to mimic community living by affording inmates greater freedoms. However, open prisons also introduce complexities such as confusion, anxiety, ambiguity, relative deprivation, and individual responsibility. Closed prisons, like the renowned Halden Prison, present different challenges which are similar to those in classic styles of prisons. Inmates within these two systems express mixed views about the rehabilitative effects they perceive the prison to have. The article also explores the social perceptions of punishment and how they influence the implementation of similar prison models in other countries. This analysis aims to contribute to the ongoing discourse on the effectiveness of various prison systems in reducing recidivism and promoting inmate rehabilitation across different societies.

Exploring mental health comorbidities and opioid agonist treatment coverage among people in prison: A national cohort study 2010–2019

IntroductionDespite a high prevalence of opioid use disorder (OUD) among people in prison, there is little knowledge of how many receive the recommended opioid agonist treatment (OAT) and what characterizes those who receive OAT and those who do not when it comes to mental health comorbidities. We aimed to describe people with OUD in Norwegian prisons over a ten-year period and their OAT status, and to investigate comorbidity of mental health disorders stratified by gender. MethodsData from the PriSUD study, including all people (≥19 years old) imprisoned in Norway between 2010 and 2019, linked to national patient registry data, including ICD-10 codes. We calculated the prevalence (1-year and 10-year) of OUD and OAT, and mental health comorbidity stratified on OAT-status and gender. ResultsAmong the cohort (n=51,148), 7 282 (14.2%) were diagnosed with OUD during the period of observation. Of those, 4 689 (64.4%) received OAT. People with OUD had high levels of comorbidity, including other drug use disorders (92.4% OAT, 90.3% non-OAT), alcohol use disorder (32.1% OAT, 44.4% non-OAT) and any other mental health disorders (61.6% OAT, 68.2% non-OAT). The proportion receiving OAT among people with OUD increased markedly during the ten years of observation; from 35.7% in 2010–70.9% in 2019. ConclusionPeople with OUD, both receiving OAT and not, had substantially more mental health comorbidities than the non-OUD population. Understanding how the prison population changes over time especially in terms of mental health needs related to OUD, is important for correctional health service planning.

Psychiatric morbidity among women in Norwegian prisons, 2010–2019: a register-based study

PurposeResearch suggests that women in prison have more mental health problems than men and are prone to suffer from more severe psychiatric disorders. This study utilizes national registry data to describe demographic and psychiatric gender differences in Norwegian prisons, and to investigate comorbid psychiatric disorders and time trends in psychiatric morbidity among women.MethodsLongitudinal data from the Norwegian Prison Release Study linked with the Norwegian Patient Registry and data from Statistics Norway provided information on health care utilization, socioeconomic status, and history of psychiatric disorders among all individuals (nwomen = 5,429; nmen = 45,432) who were incarcerated in a Norwegian prison between 2010 and 2019.ResultsWomen were more likely than men to have a history of any psychiatric disorder (75% vs. 59%). Substance use disorders and dual disorders were highly prevalent in both genders, yet highest among women (56 and 38% respectively, versus 43 and 24% among men). From 2010 to 2019, we found a considerable increase in the 12-month prevalence of most diagnostic categories among women entering prison.ConclusionPsychiatric and dual disorders are highly prevalent in Norwegian prisons, and especially among women. The proportion of women entering prison with a recent history of mental health problems has increased rapidly over the last decade. Women’s prison institutions need to adjust health and social services, and awareness about substance use and other psychiatric disorders in order to meet the increasing proportion of women facing these challenges.

Incarceration Conditions of the French Prisoners of War in the British Prison in Chatham in 1803-1814: Regression Analysis of the Duration of Captivity and Mortality

The relevance of this article is studying of the problem of “Man at war” includes examining a fate of prisoners of war. Detention conditions of Frenchmen in England during the Napoleonic wars remain a subject of discussions in the foreign historiography. Besides this, it has also never been studied earlier in the national historiography. In the article they are considered by means of regression analysis of captivity duration and mortality. Their dependence from such factors as age, height, rank, type of vessel, year of capturing etc. is considered. This method reveals if there was any discrimination in releasing and if food supply and other conditions were satisfying for survival in detention. The results are compared with the data of the Danish and Norwegian prisoners who were kept in the same prison. The aim is to examine detention conditions of the French captives on English prison hulks. The result of the study is reveal of the duration of captivity depending from the period of seizing: the first arrivals spent the longest time in a prison that indicates the halting of captives’ exchange as early as 1803. It also depended from way of leaving the prison: if the prisoner was exchanged, dyed or escaped. Persons aged less than 12 and over 50 were released earlier. Children, the elderly, officers could be released only on parole. Military seamen were kept longer than the rest. At the same time, death in captivity appears to be occasional. It indicates that food of the French prisoners in England was sufficient for survival. But other conditions led to a high mortality: 8-14 % of the French captives died in custody.

The association between drug use and mortality in a norwegian prison cohort: a prospective cohort study

BackgroundElevated mortality rates are found among people who have experienced incarceration, even long after release from prison. The mechanisms related to this excess mortality are complex products of both individual and situational factors. The aim of this study was to describe all-cause and cause-specific mortality among people with a history of imprisonment, and to examine both individual and situational factors associated with mortality.MethodsIn this prospective cohort study we used baseline survey data from the Norwegian Offender Mental Health and Addiction (NorMA) study (N = 733) linked with data from the Norwegian Cause of Death Registry during eight years of follow-up (2013–2021).ResultsAt end of follow-up, 56 persons (8%) of the cohort were deceased; 55% (n = 31) due to external causes such as overdoses or suicides, and 29% (n = 16) to internal causes such as cancer or lung disease. Having a score > 24 on the Drug Use Disorders Identification Test (DUDIT), indicating likely drug dependence was highly associated with external causes of death (OR 3.31, 95% CI 1.34–8.16), while having a job before baseline imprisonment had a protective effect on all-cause mortality (OR 0.51, ,95% CI 0.28–0.95).ConclusionsHigh DUDIT score at baseline were highly associated with external causes of death, even years after the DUDIT screening was done. Screening incarcerated people using validated clinical tools, such as the DUDIT, together with initiation of appropriate treatment, may contribute to reduced mortality in this marginalized population.

Singing Towards Freedom: An Exploration of Music Therapy Practices in Norwegian Prison Contexts

This narrative review explores the impacts of music therapy in Norwegian prisons as a powerful model for international mental health efforts for incarcerated populations. Exploring international prisoner mental health trends, Norway’s successful prison model, and challenges to Nordic prison contexts, significant background information explores the complex context around prisoner mental health and why Norway provides the best existent context for studying and implementing music therapy as a novel intervention. Looking at both qualitative and quantitative studies, this paper explores the effects of music therapy in Norwegian prisons. Though music therapy is difficult to study by its long-term nature, recent research speaks to music therapy as a viable treatment option that is effectively implementable in prison contexts and provide much needed help to incarcerated individuals. Many qualitative studies speak to this, focusing on how case studies and experiences with small cohorts create a personal experience for those receiving music therapy. In all of the qualitative studies explored, music therapy helped incarcerated Norwegian patients reach mental health goals in ways that other interventions had not been successful. Quantitative studies feature more ambiguous results, but all suggest successes for music therapy and suggest future experiments that have adequate ability to cover patients over longer timespans in more consistent incarceration contexts. Further exploration of all studies present inspire hope that music therapy can be successfully implemented further in Norwegian and international contexts.

Drug use and re-imprisonment: A prospective study of the Norwegian Offender Mental Health and Addiction (NorMA) cohort

BackgroundRe-imprisonments are common among people in prison who use drugs. This study aims to describe sociodemographic factors, mental health and level of pre-prison substance use in a cohort of people in prison, and to investigate re-imprisonment during follow-up according to their level of pre-prison drug use. MethodsThis was a prospective study using baseline data from the Norwegian Offender Mental Health and Addiction (NorMA) cohort (n = 733) recruited in 2013–2014 linked to data from the Norwegian Prison Registry and the Norwegian Cause of Death Registry. Self-reported drug use before imprisonment was measured at baseline using the Drug Use Disorder Identification Test (DUDIT). The outcome of interest was re-imprisonment examined using Cox regression. We excluded 32 persons because they were not released before the study ended. The study sample included 701 persons, with a total time-at-risk of 2479 person-years. ResultsAlmost half of the study sample reported high-risk drug use before imprisonment (DUDIT score >24). During the study period, 43% (n = 267) were re-imprisoned. People with high-risk use had a hazard ratio (HR) of 4.20 (95% CI: 2.95–5.97) of re-imprisonment compared with people with low-risk use (DUDIT score <6). Older age and more education than primary school were associated with a reduced risk of re-imprisonment. ConclusionCompared with low-risk use, high-risk drug use is highly prevalent among people in prison and is associated with higher rates of re-imprisonment. This highlights the need for screening and treatment of drug use disorders among people in prisons.

Barriers and opportunities to accessing social support in the transition from community to prison: a qualitative interview study with incarcerated individuals in Northern Norway

BackgroundIncarcerated individuals have poor mental health compared to the general population. Social support has a beneficial effect on mental health. The buffering model proposes that social support facilitates coping under stressful conditions, while the main effects model suggests that belonging to social networks and having positive social interactions are beneficial for mental health. Prisons are a highly interesting context for studying social support, as imprisonment is perceived as stressful and disrupts social relationships and the availability of support. This study aims to explore incarcerated individuals' perceptions of social support from various sources in the transition from community to prison, its perceived significance for mental health, and the opportunities and barriers to accessing social support in a Norwegian prison context.MethodsThe experiences of eight incarcerated individuals from a prison in Northern Norway were gathered through conducting individual in-depth interviews. The data analysis was inspired by Charmaz’s version of Grounded Theory.ResultsSocial support from peers was perceived to be important for the well-being and preserving of mental health in prison. Support from informal sources outside prison and prison officers were not granted the same significance by the participants. Although prison life was perceived as stressful, social support in the form of companionship, the feeling of belonging, shared activities, and everyday conversations were more important for the participants than support focusing on coping with the stress of incarceration.ConclusionsPeers are perceived to be the most important source of social support, and vital for well-being and mental health in prison. Barriers to support from family, friends and prison officers may amplify the significance of support from peers.

The association of prison security level with mortality after release from prison: a retrospective national cohort study (2000–16)

Incarceration might contribute to increased mortality in an already marginalised population. A better understanding of the prison-related factors that are associated with mortality is important for preventing the negative health consequences of incarceration. We aimed to investigate all-cause and cause-specific mortality following release from high-security and low-security prisons. In this retrospective national cohort study, we used data from the Norwegian Prison Release study (nPRIS), which includes complete national register data for 96 859 individuals from the Norwegian Prison Register linked to the Norwegian Cause of Death Register from Jan 1, 2000, to Dec 31, 2016. The study cohort included all people in Norway released from a high-security or low-security prison unit. Cause of death was categorised into internal causes (infectious, cancerous, endocrine, circulatory, respiratory, digestive, nervous system diseases, and mental health disorders) and external causes (accidents, suicides, and homicides) according to the 10th revision of the International Classification of Diseases. We calculated crude mortality rates (CMR) and estimated Cox proportional-hazards models. There were 151 790 releases in the study period (68·4% from low-security and 31·6% from high-security prisons) from 91 963 individuals. The overall CMR was 854·4 [95% CI 834·7-874·2] per 100 000 person-years (436·2 [422·1-450·3] per 100 000 person-years for internal causes and 358·3 [345·5-371·1] per 100 000 person-years for external causes). The overall post-release mortality rate was higher in those released from high-security prisons (1142·5 [95% CI 1102·6-1182·5] per 100 000 person-years) than in those released from low-security prisons (714·6 [692·6-736·6] per 100 000 person-years). Our results suggest an association between release from high-security prisons and elevated mortality due to both external causes (adjusted hazard ratio [aHR] 1·75 [95% CI 1·60-1·91]) and internal causes (1·45 [1·33-1·59]), compared to release from low-security prisons. Imprisonment and the post-release period can be an important point for public health interventions. Particular attention to health is warranted for individuals incarcerated in and released from high-security prisons. The potential impact of both individual-level characteristics of people incarcerated in high-security facilities, and of the prison environment itself, on mortality outcomes, should be investigated further. The South-Eastern Norway Regional Health Authority and The Norwegian Research Council.

Monitoring Prisons in Europe: Understanding Perspectives of People in Prison and Prison Staff

Prison monitoring has been promoted by international human rights bodies as a way to support the prevention of torture and ill-treatment in prison. However, there has been very limited examination of the operation of prison-monitoring bodies, especially from the perspective of those most affected by their recommendations: those who live and work in prisons. This article draws on interviews conducted with people living and working in a Scottish and a Norwegian prison to explore how they perceive a long-standing prison-monitoring body, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT). The article provides an examination of the benefit and utility of CPT recommendations from the point of view of people in prison and prison staff. The study further reveals that the effectiveness of CPT monitoring in prisons may be considered in terms aside from state implementation of recommendations and should include how people in prison see its work, its impact, its power to persuade, and its connection to the outside world. Through taking a prison-centered approach, the article contributes to wider discussions on whether and how human rights frameworks can alter experiences of punishment.

Musical life stories: Coherence through musicking in the prison setting

Despite the strong relationships evidenced between music and identity little research exists into the significance of music in prisoners’ shifting sense of identity. This article explores musicking as part of the ongoing identity work of prisoners in light of theory on musical performance, narrative and desistance and discusses implications for penal practice and research. Through the presentation of an ethnographic study of music therapy in a low security Norwegian prison we show how participation in music activities afforded congruence between the past, the present and the projected future for participants by way of their unfolding musical life stories. Complementing existing conceptualisations of music as an agent for change, our study suggests that musicking afforded the maintenance of a coherent sense of self for participating prison inmates, whilst offering opportunities for noncoercive personal development. We argue that research into musicking in prison offers fruitful ways of tracing how the complexities inherent in processes of change are enacted in everyday prison life, and that it can advance our knowledge of relationships between culture, penal practice and desistance.

A Mixed-Method Evaluation of a Prison Anti-doping Intervention: The Hercules Prison Program

The Norwegian Offender Mental Health and Addiction study denotes the need for physical activity and anti-doping interventions in Norwegian prisons. We developed and evaluated the efficacy of such intervention—the Hercules prison program. The program combines theoretical anti-doping lessons with practical strength training. The study adopts a mixed-methods approach (pretest-posttest design) comprising a longitudinal survey, observation, informal conversations, and in-depth interviews. Survey respondents were 104 male prisoners aged 18–56 (M = 34.81, SD = 9.34) years from seven Norwegian prisons. Of these, 52 provided both baseline and posttest responses. Participants completed questionnaires including demographic, doping use, and psychophysical items/measures. At the end of the intervention, in-depth interviews were conducted with 11 of the survey respondents. The survey data were analyzed using descriptive statistics, as well as independent and paired samples t-tests. The qualitative data were analyzed using Interpretative Phenomenological Analysis. A total of 7.5% and 33.3% of participants were current and former AAS users respectively, whereas 86.1% personally knew at least one current or former AAS user. Consistent with our expectation, there were increases in self-rated physical strength (t = −4.1, p < 0.001, d = 0.46) and strength training self-efficacy (t = −8.33, p < 0.001, d = 1.36), and a decrease in moral disengagement in doping (t = −4.05, p < 0.001, d = 0.52) from baseline to posttest. These findings are supported by the qualitative data. Notable success factors are relationship-building, instructors' expertise and acceptability, and gatekeepers' navigation and co-creation. The program provides valuable evidence of the potential benefits of combining anti-doping education with practical strength training in doping prevention in correctional settings.

Exploring Norwegian prison frontline workers' perceptions of inter professional collaboration - a pilot study.

Interprofessional collaboration is necessary for handling the complex psychosocial needs of prisoners. This collaboration must be addressed to avoid high recidivism rates and the human and societal costs linked to them. Challenges are exacerbated by a linear approach to handling prisoners' problems, silo working between welfare agencies and professional boundaries between frontline workers. There are few adequate theoretical frameworks and tools to address these challenges in the prison context. The purpose of this study is to explore the perceptions that frontline staff working in Norwegian prison facilities have regarding interprofessional collaboration in providing mental health services for prisoners. This study had a non-experimental, cross-sectional design to explore perceptions of interprofessional collaboration in a prison context. Descriptive and multifactorial analyses (exploratory factor analysis and confirmatory factor analysis) were used to explore the data. The analysis showed that three factors, communication, organizational culture and domain, explained 95% of the variance. Results are discussed using relational coordination, as well as the conceptual PINCOM model, as a theoretical framework. Few studies explicitly explore collaboration between professionals in mental health and prison services despite its being a prerequisite to achieving sufficient services for prisoners. To our knowledge, this current study is one of the first in Norway to explore collaboration in a prison context by analysing quantitative data and focusing on frontline workers perception of the phenomenon.

A comparative perspective on officer wellness: american reflections from norwegian prisons

ABSTRACT Correctional officers in the United States experience severe work-related stressors and are generally physically unwell compared to similar public employees. An innovative and new approach to improving American corrections that is starting to gain momentum stems from looking at the workplace dynamic in alternative international models, such as in Scandinavian prison systems, for models of workplace reform. This study examines the perspectives of staff and leaders from the Pennsylvania Department of Corrections who traveled to Scandinavia as part of a correctional exchange. Each day of the trip, correctional staff recorded their qualitative reflections and completed a basic survey about their observations and experiences. This article examines both forms of data to explore correctional officer wellness from the perspective of American correctional officers. Five key themes are discussed: morale, stress, danger, dynamic security, and communication. Survey results corroborate this pattern, as US correctional officers reported somewhat lower stress and more positive interactions during their time in Norway. Key takeaways and implications for policy are discussed.