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

Abstract

Background The Scottish Prison Service (SPS) has been long regarded for its progressive policy approach to health promotion in prison. It is one of the few countries with a strategic plan for health promotion implementation. Given the paucity of understanding in relation to the concept of a health promoting prison, this study assessed routinely collected prison inspection data to understand and distil learning in regard the practical implementation of health-promoting prisons. Methods Her Majesty’s Chief Inspector of Prisons for Scotland (HMIPS) oversees the independent inspection of all prisons. This desk-based study analysed openly accessible inspection reports from a public repository. The sample was limited to inspection reports using the 2018 revised Standards to ensure comparability between reports. Eight unique inspection reports meeting this criterion were downloaded between January and October 2020. The prisons had their inspections undertaken between May 2018 and January 2020. Data from the reports which focused on ‘health and wellbeing’ were inductively coded using NVivo 12 to support thematic analysis. Results Results are presented against the values and principles outlined in the SPS’ own framework for promoting health in prison. All of the institution reports contained evidence of fairness and justice in their prison and understandings of health inequalities were recognised by staff. There were also examples of mutual (peer) support between people in prison; good relationships between staff and prisoners; and strong health promotion leadership. Conversely, some environmental conditions hindered the development of health promotion – this included staffing shortages and some practices fostering health inequity. Even where a prison was reported as having health promotion activities in place these were focused on a narrow range of individual risk factors such as smoking cessation or substance misuse. Far less attention was paid to wider health determinants. Conclusions Scotland has been at the forefront of attempts to embed a health promoting prison philosophy in their justice system. Inspection data focusing on ‘health and wellbeing’ were analysed, but the analysis suggests that more could be done to ensure a health promoting setting. The way prisons inspectors are assessing health and wellbeing in particular areas is very narrow, with the focus exclusively on healthcare without a wider appreciation of how other areas of prison life can impact.

Health promotion co-existing in a high-security prison context: a documentary analysis

“…This paper offers insight into how to potentially operationalise health promotion in a specific type of prison – the high-security estate. This contribution is potentially of importance, as the evidence base on effective interventions to improve health and well-being in prison is largely unknown (Woodall et al , 2019) and moreover, current views of health promotion in this context tends to assume a “one-size fits all” approach without the specificity of considering high-security contexts.…”

“…Current understanding as to what works in regard to promoting health and well-being is not fully understood – mainly because of challenges in developing the evidence base and conducting research in this context. Nonetheless, some have suggested that peer interventions; exercise and fitness; horticulture interventions; yoga, mindfulness and meditation; group psycho-education; creative arts for health; sexual health interventions and therapeutic communities are potentially beneficial (Woodall et al , 2019).…”

Pengalaman Komunikasi Kesehatan pada Anak Didik Pemasyarakatan di Lembaga Pembinaan Khusus Anak

“…Bentuk perhatian pada kesehatan di Lembaga Pemasyarakatan termasuk LPKA menjadi hal yang penting dari sisi kemanusiaan, kesehatan masyarakat dan ekonomi (Woodall & Freeman, 2021). Hal ini karena kesehatan tidak hanya ditentukan berdasarkan tindakan dan perubahan perilaku tetapi juga dengan upaya pembentukan kondisi dan lingkungan yang mendukung kesehatan itu sendiri.…”

“…LPKA sebagai lembaga di bawah Kementerian Hukum dan HAM memberikan pelayanan kesehatan termasuk promosi dan kegiatan kesehatan yang berbasis HAM. Hal ini juga sesuai dengan penelitian terdahulu (Woodall & Freeman, 2021) pada lembaga pemasyarakatan remaja di Skotlandia. Menurut Woodall & Freeman (2021), informasi dan pelaksaan kegiatan kesehatan sejatinya harus lebih berfokus pada isu penguranagan tindak kekerasan, mewujudkan lembaga pemasyarakat bebas asap rokok, peningkatan kesejahteraan dan pemulihan remaja terlebih pada mental.…”

Innate Health: A Novel Examination of What Explains Well-being, Prosocial Behavior, and Aggression among Men Living in a UK Prison

“…Changes in appraisal and meaning making are well-recognized processes for improving well-being outcomes such as emotional regulation and coping activities (Lazarus & Folkman, 1984). Unfortunately, marginalized groups (such as prisoners) receive few mental health programs that offer a health-promoting focus (Woodall & Freeman, 2021), for example positive psychology, inner strength development, and/or well-being interventions. Additionally, this realization capacity or innate health stance is rarely delivered directly, articulated clearly, operationalized, and/or empirically evidenced.…”