Prison Health Research Articles

Caries and periodontal health status of male inmates: a retrospective study conducted in a French prison

PurposeThe purpose of this study is to describe the oral health status of inmates. The secondary aims were to compare recidivists with first-time offenders and also study the impact of psychoactive drugs on the oral health status.Design/methodology/approachThis retrospective study included 120 male inmates from a French prison. Data from the medical and the dental questionnaires and examinations were collected and analyzed.FindingsThe results showed that overall, the inmates had a poor oral health despite their young age. This population was at high risk regarding caries and periodontal diseases due to sedentary behaviors, improper diet, drug, alcohol and tobacco consumption. In total, 93% of inmates had at least one decayed untreated tooth and 95% had periodontal disease. The use of psychoactive drugs seemed strongly related to oral health status degradation. However, the comparison between recidivists and first-time offenders showed few differences.Practical implicationsThe need for periodontal and dental care is considerable in this population and increased in this environment where risk factors such as addictive behaviors and poor eating habits are common. The impact of psychoactive drugs on oral health should also be taken into consideration.Social implicationsUnfortunately, even though strategies for the prevention and management of oral health in prisons have been put in place for some years, the results still seem insufficient.Originality/valueThere are still few studies that analyze the impact of this medication on oral health in prisons.

Prevalence of skin diseases among elderly prisoners in Taiwan: an examination of skin health in prison

BackgroundAlthough prisoner health is a topic of significant importance, it has received limited attention in epidemiological studies, likely due to challenges in obtaining data. Therefore, this study aimed to investigate the prevalence of skin diseases among elderly prisoners in Taiwan.MethodsWe examined the presence of skin diseases in 2215 elderly prisoners based on the International Classification of Diseases, 9th revision Clinical Modification (ICD-9-CM). Additionally, the most common types of skin diseases among elderly prisoners in Taiwan were identified.ResultsThe prevalence of skin diseases among prisoners was estimated to be 55.03%. Elderly men prisoners exhibited a higher prevalence of skin diseases than the women prisoners. The most common skin diseases observed were as follows: contact dermatitis and other forms of eczema; pruritus and related conditions; cellulitis and abscesses; and urticaria.ConclusionSkin diseases were identified in more than half of the elderly prisoners. The overall quality of life of elderly prisoners can be improved by addressing their skin health, which would contribute to the fulfilment of their basic human rights.Clinical trials numberNA.

Complexities of midwifery care delivered to perinatal women in prison: A qualitative study

PurposeTo provide insight into the challenges faced by imprisoned perinatal women in accessing appropriate information, support, and care and the importance of the midwife's role in this context. MethodThis paper draws on two studies conducted in one United Kingdom (UK) women's prison over two separate time points (2019, 2021). In both qualitative evaluative studies that were descriptive in nature, semi-structured interviews were conducted with perinatal women and professionals involved in their care. Participants17 women participated across the two qualitative studies, six were pregnant, nine were on the Mother and Baby Unit (MBU) and two had given birth in the last 12 months but were not on the MBU. 12 professionals participated across the two studies. ResultsThe studies highlight the specific challenges that perinatal women in prison face compared to their community counterparts in being able to access reliable information on pregnancy, birth, and parenting; having access to appropriate and reliable peer support and mental health support not only in terms of provision but also in terms of accessibility; and in being able to advocate for themselves or having people that can advocate for them. ConclusionThese challenges arguably heighten the importance of, as well as the pressure on the midwife in this context. The authors therefore highlight the need for consideration of three factors for midwifery in this context: (1) Resourcing (2) Information provision to, and information sharing between, midwives to increase awareness of challenges faced by this cohort, and (3) Strengthening the midwife's position to support and advocate for women's perinatal mental health in prison.

Prison and forensic mental health staff after suicides in their care. A narrative review of international and German national evidence

Prison and forensic mental health staff after suicides in their care. A narrative review of international and German national evidence

IMPLEMENTASI RESTORATIVE JUSTICE TINDAK PIDANA RINGAN SEBAGAI SOLUSI MENGURANGI OVERCROWDING LEMBAGA PEMASYARAKATAN DI JAWA TENGAH

This research aims to find out and analyze whether the application of restorative justice in relation to criminal acts of theft in society has been able to effectively reduce overcrowding in Central Java? The fact in correctional institutions is that there is overcrowding or it could be said that there are too many prisoners occupying one cell in a correctional institution. Problems like this can cause discomfort in correctional institutions for prisoners which can affect the mental and physical health of prisoners who live in cells that do not match capacity. which is there to be inhabited or what is known as overcrowding, then one way to reduce overcrowding is with restorative justice, namely so that minor crimes such as theft and others can be resolved amicably and not escalated in order to reduce the accumulation of prisoners which causes overcrowding in correctional institutions in the region. Central Java, By using empirical legal methodology, it is hoped that this research can find out whether the application of restorative justice in society for minor crimes can reduce overcrowding in correctional institutions in Central Java.

Promoting and Sustaining Sexual Health as a Health Resource in Prisons - A Scoping Review

Sexual health is a neglected topic in prisons, even though sexual health is a basic human need that includes physical, mental, social and spiritual aspects. There is limited knowledge concerning how to promote and sustain the sexual health of prisoners. The aim of this study was to increase knowledge of sexual health promotion as a health resource in prisons. By conducting a scoping review, we searched for sexual health-promoting activities, approaches or experiences from prisons globally. The findings included sexual health interventions covering conjugal visits and sexual health promotion through education and collaboration. There are connections between mental health and sexual health for prisoners, and sexual health also influences quality of life. In conclusion, it is evident that there is a significant imperative for further research, interventions and measures in this domain to ensure holistic rehabilitation for prisoners.

Editorial: a changing name and an expanding direction for The International Journal of Prison Health

Editorial: a changing name and an expanding direction for The International Journal of Prison Health

Presence of Inmates with Mental Health Problems in Detention and Correctional Centers in the Republic of Kosovo.

Conventions adopted by the United Nations and Council of Europe pay special importance to the treatment of prisoners with mental health problems. Their treatment is close-ly related to respect for human dignity, and the prohibition of torture, cruel and degrading treatment or punishment. The Eu-ropean Court of Human Rights, in many cases, has ruled that the detention of a mentally-ill person can raise issues under Ar-ticle 3 of the European Convention on Human Rights and that the lack of adequate medical care can result in treatment in con-travention of this article. The Republic of Kosovo is not a mem-ber of the United Nations and Council of Europe. However, it has incorporated in its Constitution a number of Conven-tions adopted by the United Nations and Council of Europe. Also, Kosovo has adopted a legal framework which prohibits torture, cruel and degrading treatment or punishment in ac-cordance with the international human rights standards. The Constitution also provides that human rights and fundamen-tal freedoms guaranteed by the Constitution shall be interpret-ed in accordance with the case law of the European Court of Human Rights. Review of Ombudsperson's, Committee for the Prevention of Torture, Prison Health Department of Kosovo Ministry of Health reports, as well as reports of the NGOs in Kosovo.

Condom provision in prison settings: misconceptions, stereotypes and recommendations to promote acceptance

Purpose This study aims to highlight prevalent misconceptions and stereotypes surrounding condom provision programs in prison settings and proposes solutions to enhance the availability, accessibility and quality of condom provision programs in prison settings. Design/methodology/approach Unprotected sex is a prevalent high-risk behavior and a major avenue for infection transmission in prison settings, worldwide. Despite this fact, many prison health policymakers exhibit hesitation in distributing condoms among people residing in prisons. Findings Common misconceptions and stereotypes surrounding condom provision programs in prison settings are presented and discussed in the text. Originality/value To the best of the authors’ knowledge, this study is the first of its kind presenting the prevalent misconceptions and stereotypes surrounding condom provision programs in prison settings and recommending solutions to address this issue.

Improving Oral Health in Prisons: A Randomized Controlled Trial Protocol (PriOH) (Preprint)

Improving Oral Health in Prisons: A Randomized Controlled Trial Protocol (PriOH) (Preprint)

A model of care for Aboriginal and Torres Strait Islander prisoner health and wellbeing in South Australia

PurposeAboriginal and Torres Strait Islander (Aboriginal) people are overrepresented in Australian prisons, where they experience complex health needs. A model of care was designed to respond to the broad needs of the Aboriginal prisoner population within the nine adult prisons across South Australia. The purpose of this paper is to describe the methods and findings of the Model of Care for Aboriginal and Torres Strait Islander Prisoner Health and Wellbeing for South Australia.Design/methodology/approachThe project used a qualitative mixed-method approach, including a rapid review of relevant literature, stakeholder consultations and key stakeholder workshop. The project was overseen by a Stakeholder Reference Group, which met monthly to ensure that the specific needs of project partners, stakeholders and Aboriginal communities were appropriately incorporated into the planning and management of the project and to facilitate access to relevant information and key informants.FindingsThe model of care for Aboriginal prisoner health and wellbeing is designed to be holistic, person-centred and underpinned by the provision of culturally appropriate care. It recognises that Aboriginal prisoners are members of communities both inside and outside of prison. It notes the unique needs of remanded and sentenced prisoners and differing needs by gender.Social implicationsSupporting the health and wellbeing of Indigenous prison populations can improve health outcomes, community health and reduce recidivism.Originality/valueOnly one other model of care for Aboriginal prisoner health exists in Australia, an Aboriginal Community Controlled Health Organisation-initiated in-reach model of care in one prison in one jurisdiction. The South Australian model of care presents principles that are applicable across all jurisdictions and provides a framework that could be adapted to support Indigenous peoples in diverse prison settings.

A systematic review of the effect of dietary and nutritional interventions on the behaviours and mental health of prisoners.

Prisoners experience a higher burden of poor health, aggressive behaviours and worsening mental health than the general population. This systematic review aimed to identify research that used nutrition-based interventions in prisons, focusing on outcomes of mental health and behaviours. The systematic review was registered with Prospective Register of Systematic Reviews on 26 January 2022: CRD42022293370. Inclusion criteria comprised of current prisoners with no limit on time, location, age, sex or ethnicity. Only quantitative research in the English language was included. PubMed/Medline, Web of Science, EMBASE, PsycINFO and CINAHL were searched, retrieving 933 results, with 11 included for qualitative synthesis. Studies were checked for quality using the revised tool to assess risk of bias in randomised trials or risk of bias in non-randomised studies of interventions tool. Of the included studies, seven used nutritional supplements, three included diet changes, and one used education. Of the seven supplement-based studies, six included rule violations as an outcome, and only three demonstrated significant improvements. One study included mental health as an outcome; however, results did not reach significance. Of the three diet change studies, two investigated cognitive function as an outcome, with both reaching significance. Anxiety was included in one diet change study, which found a significant improvement through consuming oily fish. One study using diet education did not find a significant improvement in overall mental resilience. Overall, results are mixed, with the included studies presenting several limitations and heterogeneity. Future research should aim to consider increased homogeneity in research design, allowing for a higher quality of evidence to assess the role nutrition can play in improving the health of prisoners.

Supporting Older, Frail, and Vulnerable Adult Prisoners Through Peer Care: Observations, Reflections, and Recommendations Based on a UK/U.S. Researcher Exchange Visit.

This article describes key findings from a UK/U.S. prison health researcher exchange in September 2023. The aims were to increase familiarity with the research context and to observe the roles of peer caregivers in U.S. prison settings. The researchers identified several differences and similarities in peer caregiving between UK and U.S. sites and detail six recommendations related to policy and practice concerning both sides of the Atlantic. It is believed that the adoption of such recommendations will contribute to improved care and, thereby, the health and well-being of vulnerable people incarcerated in prison.

Cancer incidence, treatment, and survival in the prison population compared with the general population in England: a population-based, matched cohort study

The growing and ageing prison population in England makes accurate cancer data of increasing importance for prison health policies. This study aimed to compare cancer incidence, treatment, and survival between patients diagnosed in prison and the general population. In this population-based, matched cohort study, we used cancer registration data from the National Cancer Registration and Analysis Service in England to identify primary invasive cancers and cervical cancers in situ diagnosed in adults (aged ≥18 years) in the prison and general populations between Jan 1, 1998, and Dec 31, 2017. Ministry of Justice and Office for National Statistics population data for England were used to calculate age-standardised incidence rates (ASIR) per year and age-standardised incidence rate ratios (ASIRR) for the 20-year period. Patients diagnosed with primary invasive cancers (ie, excluding cervical cancers in situ) in prison between Jan 1, 2012, and Dec 31, 2017 were matched to individuals from the general population and linked to hospital and treatment datasets. Matching was done in a 1:5 ratio according to 5-year age group, gender, diagnosis year, cancer site, and disease stage. Our primary objectives were to compare the incidence of cancer (1998-2017); the receipt of treatment with curative intent (2012-17 matched cohort), using logistic regression adjusted for matching variables (excluding cancer site) and route to diagnosis; and overall survival following cancer diagnosis (2012-17 matched cohort), using a Cox proportional hazards model adjusted for matching variables (excluding cancer site) and route to diagnosis, with stratification for the receipt of any treatment with curative intent. We identified 2015 incident cancers among 1964 adults (1556 [77·2%] men and 459 [22·8%] women) in English prisons in the 20-year period up to Dec 31, 2017. The ASIR for cancer for men in prison was initially lower than for men in the general population (in 1998, ASIR 119·33 per 100 000 person-years [95% CI 48·59-219·16] vs 746·97 per 100 000 person-years [742·31-751·66]), but increased to a similar level towards the end of the study period (in 2017, 856·85 per 100 000 person-years [675·12-1060·44] vs 788·59 per 100 000 person-years [784·62-792·57]). For women, the invasive cancer incidence rate was low and so ASIR was not reported for this group. Over the 20-year period, the incidence of invasive cancer for men in prison increased (incidence rate ratio per year, 1·05 [95% CI 1·04-1·06], during 1999-2017 compared with 1998). ASIRRs showed that over the 20-year period, overall cancer incidence was lower in men in prison than in men in the general population (ASIRR 0·76 [95% CI 0·73-0·80]). The difference was not statistically significant for women (ASIRR 0·83 [0·68-1·00]). Between Jan 1, 2012, and Dec 31, 2017, patients diagnosed in prison were less likely to undergo curative treatment than matched patients in the general population (274 [32·3%] of 847 patients vs 1728 [41·5%] of 4165; adjusted odds ratio (OR) 0·72 [95% CI 0·60-0·85]). Being diagnosed in prison was associated with a significantly increased risk of death on adjustment for matching variables (347 deaths during 2021·9 person-years in the prison cohort vs 1626 deaths during 10 944·2 person-years in the general population; adjusted HR 1·16 [95% CI 1·03-1·30]); this association was partly explained by stratification by curative treatment and further adjustment for diagnosis route (adjusted HR 1·05 [0·93-1·18]). Cancer incidence increased in people in prisons in England between 1998 and 2017, with patients in prison less likely to receive curative treatments and having lower overall survival than the general population. The association with survival was partly explained by accounting for differences in receipt of curative treatment and adjustment for diagnosis route. Improved routine cancer surveillance is needed to inform prison cancer policies and decrease inequalities for this under-researched population. UK National Institute for Health and Care Research, King's College London, and Strategic Priorities Fund 2019/20 of Research England via the University of Surrey.

Multi-sector stakeholder consensus on tackling the complex health and social needs of the growing population of people leaving prison in older age

BackgroundAs populations age globally, cooperation across multi-sector stakeholders is increasingly important to service older persons, particularly those with high and complex health and social needs. One such population is older people entering society after a period of incarceration in prison. The ‘ageing epidemic’ in prisons worldwide has caught the attention of researchers, governments and community organisations, who identify challenges in servicing this group as they re-enter the community. Challenges lie across multiple sectors, with inadequate support leading to dire consequences for public health, social welfare and recidivism. This is the first study to bring together multi-sector stakeholders from Australia to form recommendations for improving health and social outcomes for older people re-entering community after imprisonment.ResultsA modified nominal group technique was used to produce recommendations from N = 15 key stakeholders across prison health, corrections, research, advocacy, aged care, community services, via online workshops. The importance and priority of these recommendations was validated by a broader sample of N = 44 stakeholders, using an online survey. Thirty-six recommendations for improving outcomes for this population were strongly supported. The key issues underlying the recommendations included: improved multi-stakeholder systems and services, targeted release preparation and practices that ensure continuity of care, advocacy-focused initiatives in the community, and extended funding for effective programs.ConclusionsThere is consensus across stakeholders on ways forward, with intervention and policy updates required at the individual, systems and community levels. These recommendations entail two important findings about this population: (1) They are a high-needs, unique, and underserved group at risk of significant health and social inequity in the community, (2) Multi-sector stakeholder cooperation will be crucial to service this growing group.

Implementation of COVID-19 vaccination services in prison in six European countries: translating emergency intervention into routine life-course vaccination.

Evidence has shown that the risk of transmission of SARS-CoV-2 is much higher in prisons than in the community. The release of the COVID-19 vaccine and the recommendation by WHO to include prisons among priority settings have led to the inclusion of prisons in national COVID-19 vaccination strategies. Evidence on prison health and healthcare services provision is limited and often focuses on a single country or institution due to the multiple challenges of conducting research in prison settings. The present study was done in the framework of the EU-founded project RISE-Vac. It aimed to analyse the best practices and challenges applied in implementing COVID-19 universal vaccination services during the pandemic to support future expansion of routine life course vaccination services for people living in prison (PLP). Two online cross-sectional surveys were designed and piloted: survey1 on prison characteristics and (non-COVID-19) immunisation practices; survey2 on the implementation and coverage of COVID-19 vaccination with open-ended questions for thematic analysis. Each RISE-Vac project partner distributed the questionnaire to one or two prisons in their country. Answers were collected from eight European prisons' directors or medical directors between November 2021-May 2022. According to our findings, the implementation modalities of COVID-19 vaccination services in the surveyed prisons were effective in improving PLP vaccination coverage. Strategies for optimal management of the vaccination campaign included: periodic time slot for PLP vaccination; new staff recruitment and task shifting; distribution of informational material both to PLP and prison staff. Key challenges included continuity of care after release, immunisation information system, and vaccine hesitancy. To the best of our knowledge, this is the first study describing the implementation of COVID-19 vaccination services in European prisons, suggesting that the expansion of vaccination provision in prison is possible. There is no unique solution that will fit every country but commonalities likely to be important in the design and implementation of future vaccination campaigns targeting PLP emerged. Increased availability of vaccination services in prison is not only possible, but feasible and highly desirable, and can contribute to the reduction of health inequalities.

'The god of criminals is their belly': diet, prisoner health, and prison medical officers in mid-nineteenth-century English and Irish prisons.

Existing scholarship on prison diets has emphasised the role of food and its restriction as a key aspect of the deterrent system of prison discipline introduced in the 1860s. Here we suggest that a strong emphasis was placed on dietary regulation after the establishment of the reformist, but also 'testing', separate system of confinement in the mid-nineteenth century. While the impact of diet on the physical health of prisoners was a major concern, we argue that the psychological impact of food was also stressed, and some prison administrators and doctors argued that diet had an important protective function in preserving inmates' mental wellbeing. Drawing on a wide range of prison archives and official reports, this article explores the crucial role of prison medical officers in England and Ireland in implementing prison dietaries. It highlights the importance and high level of individual adaptations to dietary scales laid down centrally, as a means of utilising diet as a tool of discipline or as an intervention to improve prisoners' health. It examines the forays of some prison doctors into dietary experiments, as they investigated the impact of different dietaries or made more quotidian adjustments to food intake, based on local conditions and food supplies. The article concludes that, despite central policies geared to establishing uniformity and interest in new scientific discourses on nutrition, a wide range of practices were pursued in individual prisons, mostly shaped by practical rather than scientific factors, with many prison medical officers asserting their autonomy in making dietary adjustments.

IJCM_50A: Mortality trends in Indian prisons and its associated risk factors: a time trend analysis from 2017-2021

Background: The environmental health status of jail populations poses a significant public health threat for prisoners and the general population. The environment of jails provides a suitable foundation concerning morbidity and mortality of the general population due to the concentrated potential source of infectious diseases, difficult access to treatment for chronic health conditions, interruption in the continuity of care for serious behavioural health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. Prisoners should receive a healthcare provision equivalent to people living in the community. Those rights, if fulfilled, will contribute to the process of social rehabilitation and will facilitate further reintegration into society on release. Objective: To analyze the mortality trends in Indian prisons from 2017-2021 and determine associated risk factors. Methodology: The various mortality statistics and associated risk factors were retrieved from the Prison Statistics of India report published annually by the National Crime Records Bureau, Ministry of Home Affairs. A literature search was also done in electronic databases like -PubMed, Google Scholar, and other platforms using keywords- mortality in prisons, prison health, and death in Indian jails. Results: The obtained estimates identified an ascending trend in mortality in Indian prisons due to cardiovascular diseases, lung diseases, and suicide, accompanied by a rising trend in mental illnesses. Overcrowding, inadequate manpower for healthcare facilities, and poor budget allocation for prison health are some notable causes of rising mortality. Conclusion: The study’s findings revealed that prisoners, despite being a vulnerable section of the population, are deprived of adequate medical facilities due to restrictions imposed by law. Therefore, reducing overcrowding, recruiting adequate manpower for healthcare facilities and adequate budget allocation for prison health shall play an instrumental role in reducing the trend of mental illnesses and mortality in Indian prisons.

Mental and physical health morbidity among people in prisons: an umbrella review

People who experience incarceration are characterised by poor health profiles. Clarification of the disease burden in the prison population can inform service and policy development. We aimed to synthesise and assess the evidence regarding the epidemiology of mental and physical health conditions among people in prisons worldwide. In this umbrella review, five bibliographic databases (Web of Science, PubMed, PsycINFO, Embase, and Global Health) were systematically searched from inception to identify meta-analyses published up to Oct 31, 2023, which examined the prevalence or incidence of mental and physical health conditions in general prison populations. We excluded meta-analyses that examined health conditions in selected or clinical prison populations. Prevalence data were extracted from published reports and study authors were contacted for additional information. Estimates were synthesised and stratified by sex, age, and country income level. The robustness of the findings was assessed in terms of heterogeneity, excess significance bias, small-study effects, and review quality. The study protocol was pre-registered with PROSPERO, CRD42023404827. Our search of the literature yielded 1909 records eligible for screening. 1736 articles were excluded and 173 full-text reports were examined for eligibility. 144 articles were then excluded due to not meeting inclusion criteria, which resulted in 29 meta-analyses eligible for inclusion. 12 of these were further excluded because they examined the same health condition. We included data from 17 meta-analyses published between 2002 and 2023. In adult men and women combined, the 6-month prevalence was 11·4% (95% CI 9·9-12·8) for major depression, 9·8% (6·8-13·2) for post-traumatic stress disorder, and 3·7% (3·2-4·1) for psychotic illness. On arrival to prison, 23·8% (95% CI 21·0-26·7) of people met diagnostic criteria for alcohol use disorder and 38·9% (31·5-46·2) for drug use disorder. Half of those with major depression or psychotic illness had a comorbid substance use disorder. Infectious diseases were also common; 17·7% (95% CI 15·0-20·7) of people were antibody-positive for hepatitis C virus, with lower estimates (ranging between 2·6% and 5·2%) found for hepatitis B virus, HIV, and tuberculosis. Meta-regression analyses indicated significant differences in prevalence by sex and country income level, albeit not consistent across health conditions. The burden of non-communicable chronic diseases was only examined in adults aged 50 years and older. Overall, the quality of the evidence was limited by high heterogeneity and small-study effects. People in prisons have a specific pattern of morbidity that represents an opportunity for public health to address. In particular, integrating prison health within the national public health system, adequately resourcing primary care and mental health services, and improving linkage with post-release health services could affect public health and safety. Population-based longitudinal studies are needed to clarify the extent to which incarceration affects health. Research Foundation-Flanders, Wellcome Trust, National Institutes of Health.

The Role of Management Information Systems in the History of Mental Health Care for Prisoners in the USA

From the prehistorical to contemporary periods, prisoners’ mental health has been a burgeoning issue in the United States (USA). After a decade of incarceration and a misleading penal system, prisoners' mental health has become a discussed topic for scholars not only in the correctional system but also in other disciplines. Despite having diverse initiatives for the improvement of the penal system, few initiatives have been held to take into consideration of prisoner's mental health. To fill this gap, the main purpose of this paper is to provide a brief overview of the mental health of prisoners by analyzing previous research on the mental health of prisoners along with suggesting some probable ways from management information perspectives that can be helpful to reduce a great number of prisoners and bring some positive changes in the correctional system.