Rehabilitation doxa and practitioner judgment. An analysis of symbolic violence on health care provision in the Scottish prison system

Abstract

Rehabilitation doxa and practitioner judgment. An analysis of symbolic violence on health care provision in the Scottish prison systemDoxa da rehabilitação e o julgamento professional. Uma análise da violência simbólica na provisão de cuidados em saúde no sistema prisional escocês Resumo Este artigo apresenta uma análise das condições simbólicas que governam a provisão de saúde nos sistemas prisional escocês. O artigo considera o contexto ampliado do sistema prisonal escocês, onde a provisão de saúde segue uma estrutura similar tanto nas unidades juvenis quanto nas de adultos. Nossa intenção é provocar um debate sobre a doxa (Bourdieu, 1977) que sustenta as tomadas de decisão sobre provisão de saúde nas prisões, onde o contexto político marcado pelo pragmatismo, aliado à 'patologização' das políticas sociais, de saúde e de justiça criminal, tem sido uma força hegemônica.Abstract This paper presents an analysis of the symbolic conditions which govern health care provision in the Scottish prison system. The paper considers the wider context of Scottish prisons, where health care provision follows a similar structure both in juvenile and adult prisons. Our intention is to provoke a debate about the doxa (Bourdieu, 1977), which underlies decision making in respect of health care in prison, in a political environment where pragmatism, allied to the 'pathologisation' of social policies, health and criminal justice has been a hegemonic force.

Developing health and wellbeing in prisons: an analysis of prison inspection reports in Scotland

“…It is clear that Scotland has been at the forefront of much of the attempts to embed a health promoting prison philosophy in their prison system [ 4 ]. They have adopted a progressive and forward-thinking ideology on health promotion which has been facilitated by a number of factors, including: the size of the SPS and the wider political position of the Scottish government [ 6 , 7 ]. Their original framework for promoting health in prison [ 13 ] “has been considered by those in the prison environment to have made a real difference” ([ 5 ], p.6).…”

“…Their approach has been synonymous with compassion and with an excellent understanding of health inequalities and how these are manifest in prison populations [ 5 ]. The reasons for progressive outlook are multifaceted, but may relate to: a political climate within Scotland that places emphasis on social justice as a core feature – current policy and practice in Scotland, suggests a political position in relation to incarceration, which is sustained by the belief that prison provides a window of opportunity; a focus on collaboration and continuity of care between the prison system and community; a less fragmented health care system; and SPS embracing a care-orientated approach in its philosophy [ 6 , 7 ]. Despite this, Scotland continue to be at a ‘cross-roads’ in relation to how they seek to address and deliver health interventions in the prison setting [ 6 ] with evidence lacking in informing policy and practice decisions [ 8 ] and calls for more carefully planned and evaluated health-promoting interventions in this environment [ 9 ].…”

Developing Health and Wellbeing in Prisons: an Analysis of Prison Inspection Reports in Scotland

“…It is clear that Scotland has been at the forefront of much of the attempts to embed a health promoting prison philosophy in their prison system [4]. They have adopted a progressive and forward-thinking ideology on health promotion which has been facilitated by a number of factors, including: the size of the SPS and the wider political position of the Scottish government [6,7]. Their original framework for promoting health in prison [13] "has been considered by those in the prison environment to have made a real difference" [5, p.6].…”

“…Their approach has been synonymous with compassion and with an excellent understanding of health inequalities and how these are manifest in prison populations [5]. The reasons for progressive outlook are multifaceted, but may relate to: a political climate within Scotland that places emphasis on social justice as a core feature -current policy and practice in Scotland, suggests a political position in relation to incarceration, which is sustained by the belief that prison provides a window of opportunity; a focus on collaboration and continuity of care between the prison system and community; a less fragmented health care system; and SPS embracing a care-orientated approach in its philosophy [6,7]. Despite this, Scotland continue to be at a 'cross-roads' in relation to how they seek to address and deliver health interventions in the prison setting [6] with evidence lacking in informing policy and practice decisions [8] and calls for more carefully planned and evaluated health-promoting interventions in this environment [9].…”

The repellent role of institutions

“…The professional judgment is defined from a set of parameters and categories, which, in general, are based on the references of the world, ways of living and acting, defined by the habitus. Consequently, the same process that 'naturalizes' behaviors and ways of acting in the world will be the reference from which this judgment is established (4) .…”