Scottish Prison Service Research Articles

Alcohol Brief Interventions (ABIs) for male remand prisoners: protocol for development of a complex intervention and feasibility study (PRISM-A)

IntroductionIn the UK, a significant proportion of male remand prisoners have alcohol problems. Alcohol Brief Interventions (ABIs) are an effective component of a population-level approach to harmful and hazardous drinking....

Project-based learning in Scottish prisons

The article describes the development of a project-based approach to learning in seven Scottish prisons. It argues that the project-based approach is ideally suited to prison education due to its flexibility and ability to enrich the relatively narrow prison curriculum and create meaningful links with wider society, reducing the isolation of prisoners. The approach also empowers staff and encourages interdisciplinary working. The project-based approach is well placed to support and reinforce desistance-based practice in education and fits well with both the new Scottish Prison Service strategy, Unlocking Potential, Transforming Lives and with Scottish Government's education policy, Curriculum for Excellence.

PWE-141 Continuity Of Care in Hepatitis C Patients Serving a Custodial Sentence in Scotland

IntroductionHepatitis C Virus (HCV) has been deemed by the Scottish Government to be ‘One of the most serious and significant public health risks of our generation’.1 Approximately 90% of those...

Protecting the health of offenders in prison and other places of detention

The care of prisoners (offenders) in England lies with the Department of Health (DH) and the ability of the PCTs to commission services. In other countries of the UK this differs; in Scotland the Scottish Prison Service manages the responsibility of offender health, with responsibility resting with local health boards in Wales and the South Eastern Health and Social Care Trust in Northern Ireland. This article provides the community nurse with an overview of health protection in England's prisons and places of detention along with a review of communicable disease, immunization and infection prevention and control. General advice on legal obligations is provided with infection control principles and a discussion concerning incident and outbreak management. The role of the community nurse in the prison setting is no different to the role being undertaken in any other situation or environment where people require health care. Offenders are entitled to the same standards of healthcare as the general public.

P2-101 Prisoner mortality in Scotland 1996–2007: retrospective cohort study

IntroductionMortality is substantially increased among those who have been imprisoned but there is little information about the extent to which excess mortality might be explained by deprivation. All cause mortality...

Smoking cessation programme in a young offenders institution

Abstract Focal points

Prison staff fear training cutbacks after transfer to NHS.

About 250 nurses being transferred from the Scottish Prison Service to the NHS in October fear the move could reduce training opportunities.

A comparison of accidental and intentional fatal drug overdoses within the drug death population in Scotland: a case of comortality?

This article considers the social and clinical life circumstances of individuals who succumbed to drug deaths in Scotland in 2003. Specifically, comparisons are made between those who died of accidental and intentional illicit drug overdoses. A cross-linkage process allowed for a comparison of patient notes obtained from general practice, drug treatment services, the Scottish Prison service, the Scottish Criminal Records Office, acute services, non-statutory services and the Procurator Fiscal. Individuals who intentionally overdosed were older, more likely to be females and in a relationship, more likely to be living in their own homes in areas of lower deprivation, to have children and to have sought medical treatment for a psychological condition. They were less likely to have a criminal record or a history of incarceration or substance misuse problems. These findings demonstrate the diversity of the drug death population and may have implications for future prevention policies aimed at individual sub-p...

PRISM: A Promising Paradigm for Assessing and Managing Institutional Violence: Findings from a Multiple Case Study Analysis of Five Scottish Prisons

PRISM: Promoting Risk Intervention by Situational Management (Johnstone & Cooke, 2008) provides a systematic process for evaluating a range of situational risk factors known to influence institutional violence in prisons and secure hospital settings. This paper reports on findings from the first multiple case-study evaluation using this protocol. We applied PRISM in the Scottish Prison Service (SPS). The SPS is a modern prison system. It respects prisoners’ human rights, maintains order and control via humane and dignified means, and works towards the rehabilitation of prisoners and reducing reoffending rates overall. The SPS comprises a national headquarters where relevant policies and protocols are derived but governors and senior management teams are based within the local prisons to ensure the effective running of the organisation. While the SPS can boast decreasing rates of serious violence, there are significant variations across sites. We used PRISM to explore the relevance of situational risk factors to understanding these variations. Results suggested that the protocol was a promising paradigm for assessing risk factors unique to each site as well as showing utility for exposing problems related to the national policies and practices. The risk assessment led to a range of risk management interventions being proposed. The implications of the findings are discussed.

Analysing communication in a complex service process: an application of social network analysis in the Scottish Prison Service

This article utilizes social network analysis (SNA) and associated statistical techniques to examine a complex process known as Sentence Management in a Scottish Prison Service facility. Findings indicate that communication did not always follow the formal hierarchical process defined by that organization, significant fragmentation existed between certain key roles, and four central actors controlled much of the process. This research demonstrates the applicability of the SNA as an operations management tool to analyse structural communication patterns. This case study further suggests that SNA may be particularly applicable to the public service sector, to better understand informal communication networks within operations that are largely dependent on human performance.

Analyzing Communication in a Complex Service Process: An Application of Triangulation in a Case Study of the Scottish Prison Service

This article highlights the role of statistical analysis in clarifying the flow of communication embedded in a complex service process within the Scottish Prison Service (SPS). Using triangulation techniques in a case study of a selected SPS site, it was found that parts of a critical process known as Sentence Management (a process facilitating long-term prisoners’ access to a range of services geared to addressing offending behavior) did not follow the formal hierarchical processes of the prison. To better understand the flow of these emergent communication patterns, standard statistical analysis methods were employed. Findings indicate significant fragmentation between key roles in the process, highlighting weaknesses in this integrated approach to Sentence Management that will have consequences for prisons and prisoners alike. The findings of this research support the need for managers to recognize and actively influence informal communication networks within formally defined service processes. This research demonstrates the utility of using triangulation of multiple methods of inquiry in this context, and this may be used by the SPS and wider public service to better understand and influence informal communication networks within key processes.

Recording of clinical information in a Scotland-wide drug deaths study

The aim of this study was to analyse the nature and extent of data extracted from case files of deceased individuals in contact with services 6 months prior to drug deaths in Scotland during 2003. A cross-sectional descriptive analysis of 317 case notes of 237 individuals who had drug-related deaths was undertaken, using a data linkage process. All contacts made with services in the 6 months prior to death were identified. Information on clinical and social circumstances obtained from social care, specialist drug treatment, mental health, non-statutory services, the Scottish Prison Service and Criminal Records Office was collated. More than 70% (n = 237) were seen 6 months prior to their drug death. Sociodemographic details were reported much more frequently than medical problems, for example, ethnicity (49%), living accommodation (66%), education and income (52%) and dependent children (73%). Medical and psychiatric history was recorded in only 12%, blood-borne viral status in 17% and life events in 26%. This paucity of information was a feature of treatment plans and progress recorded. The 237 drug deaths were not a population unknown to services. Highly relevant data were missing. Improved training to promote in-depth recording and effective monitoring may result in better understanding and reduction of drug deaths.

S05-03 Comorbidity and comortality

Aims:To analyse the nature and extent of data extracted from case files of deceased individuals in contact with health, social care and criminal justice services six months prior to their drug deaths in Scotland during 2003.Methods:A cross-sectional descriptive analysis of 317 case notes of 237 individuals who had drug related deaths, using a data linkage process, was undertaken. All contacts made with services in the six months prior to death were identified. Information on clinical and social circumstances obtained from case records of social care services, specialist drug treatment, mental health and non-statutory services and the Scottish Prison Service and Criminal Records Office were collated using the Centre for Addiction Research and Education Scotland (CARES) Clinical and Social Circumstances Data Collection Form.Findings:More than 50% (n=237) were seen six months prior to their drug death. Sociodemographic details were reported much more frequently than medical problems. While there was information available on ethnicity (49%), living accommodation (66%), education and income (52%), and dependent children (73%), medical and psychiatric history was recorded in only 12%, blood-borne viral status in 17%, and life events in 26%. This paucity of information was also a feature of the treatment plans and progress recorded for these individuals.Conclusions:The 237 drug deaths were not a population unknown to services. Highly relevant data about the six-month period prior to death were missing. Improved training to promote in-depth recording, and effective monitoring may result in better understanding and reduction of drug deaths.

Casting Light On Prison Violence in Scotland

Violence among prisoners and that between prisoners and staff is a perennial concern for all prison systems. That violent prisoners are only violent in certain circumstances suggests a need to develop ways to understand not only the origins of violence in prison but also the situational contexts in which violence occurs. The technology of risk assessment has evolved dramatically in the last decade; however, the focus on individual risk factors has been at the expense of a de-emphasizing of the role of situational factors. In this article, evidence for the importance of situational factors in relation to prison violence is considered. The authors describe the development of a new risk assessment procedure—promoting risk intervention by situational management (PRISM). Within the context of the Scottish Prison Service, they conclude that systematic attention to situational risk factors can help reduce prison violence.

Alcohol and prisons: report of a workshop held by WHO HIPP at the eurocare bridging the gap conference, Helsinki, November 2006

A major European Alcohol Policy Conference, Bridging the Gap, was held in Helsinki, Finland from 20th to 22nd of November 2006. The World Health Organisation Health in Prison Project (WHO HIPP)1 convened a workshop on the subject of Alcohol in Prisons. The workshop was led by Dr Alex Gatherer, WHO HIPP; Dr Andrew Fraser, Director of Health and Care, Scottish Prison Service; Dr Lesley Graham, Public Health Specialist, Scottish Prison Service and Dr Heikki Vartiainen, Medical Director, Prison Health Services, Helsinki, Finland. Major strategic objectives of WHO HIPP were outlined, namely, to harmonize and integrate public health with prison health and to promote international awareness and best practice. A recent development in global public health thinking is the underpinning of human rights, and therefore the right to health, as a driver for health development and health for all. The principle that prisoners have the right to health care at least equivalent to that being provided in the community and that prison health is part of public health was endorsed by WHO in the Moscow declaration of 2003.2 Prisons are disproportionately filled with some of the most vulnerable people of society and have multiple, complex health care needs. This provides an opportunity to deliver interventions to those who are often the hardest to reach and importantly, an opportunity to address health inequalities, another key principle of the new public health.3 The recent public health success in the arena of tobacco control, at times without political support, is leading to a new confidence in addressing other public health challenges in modern society such as violence. Alcohol problems are a major and growing public health problem in Europe and concerted attention is rightly now being focused …

Scottish Prison Service “locks in” management knowledge

Scottish Prison Service “locks in” management knowledge

Impact of a salmonella outbreak investigation in a maximum security Scottish prison

Following notification of a stool sample positive for Salmonella from an inmate of a maximum security prison a concerted multidisciplinary public health response was undertaken. Lanarkshire NHS Board Health Protection Team (HPT) held one Problem Assessment Group Meeting and two Outbreak Control Team Meetings. The outbreak period spanned three weeks during which there were three confirmed and six probable cases of Salmonella enteritidis PT4 in prison inmates. The source was not identified despite thorough investigation, however the outbreak control team (OCT) was able to identify key recommendations around general hygiene, shared toilet facilities and storage of cooked food in cells. The outbreak stimulated closer working arrangements between the prison medical services and the local HPT. Co-operation during the outbreak investigation and subsequent to the OCT report facilitated both operational changes at the prison and improvements to the management of infection control across the Scottish Prison Service.

Filling in the Blanks: Uncovering Confidential Information Regarding Scotland's Prisoner Escort

Abstract In November 2003 the Scottish Prison Service signed a contract with Reliance for the provision of prisoner escort and court custody services throughout Scotland. It soon came out that the performance targets and financial penalties in the contract were covered by confidentiality clauses. But Sheila Bird has carried out some statistical detective work to estimate the concealed financial penalties for a prisoner unlawfully at large and to show that Reliance has been in serious breach of a crucial monthly performance threshold.

Independently verified reductionism: Prison privatization in Scotland

The Scottish Parliament recently considered proposals, which, if implemented, would lead to a considerable expansion of prison privatization. Both the Scottish Prison Service and the Scottish Executive used what they claimed to be an independently verified cost saving of £700 million as the major justification for these proposals. The way this figure was constructed and used provides an example of the increasing tendency on the part of government to quantify what cannot be quantified, to ‘make the invisible visible’. This article uses several methods to interrogate this figure of £700 million, particularly the role played by ‘net present value’ in its construction. Its fuller significance emerges from an understanding of the contexts of the Private Finance Initiative and Public Private Partnership, the experience of prison privatization and the foreclosure of alternatives to privatization. This article is based upon an analysis of government documentation, interview evidence with key players and testimony given by them to a cross-party committee charged with investigating these proposals.

The future of mandatory drug testing in Scottish prisons: A review of policy

This article reviews the procedures for the management of drug misuse in Scottish prisons 10 years after the introduction of the legislative framework permitting the introduction of mandatory drug testing (MDT). In April 2005 the Scottish Prison Service announced its decision to discontinue mandatory random drug tests (MRDTs) in Scottish prisons. This decision was not without controversy and was met by criticisms in the media that the prison service had given up on the fight against controlling substance abuse among inmates within Scottish prisons. This research examines the reality of the problem and some of the issues that have arisen over the past 10 years. The current usage of mandatory drug testing and some possible future implications of its usage are researched through the realistic but forward‐looking approach currently utilised at Edinburgh prison.