Should we use a direct regulation to implement the Healthy Prisons Agenda in England? A qualitative study among prison key policy makers

Ismail, Nasrul; Viggiani, N. De

doi:10.1093/pubmed/fdx116

Cited by 7 publications

(9 citation statements)

References 11 publications

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“…This, in turn, contributed to a 27% increase in the number of assaults per prisoner between 2015 and 2016 19. Although the full impact of austerity is not yet apparent,24 this finding clarifies the tension between aspirations to equivalence and the reality of institutional instability, which arises from scant resources.…”

Section: Discussionmentioning

confidence: 78%

How do policymakers interpret and implement the principle of equivalence with regard to prison health? A qualitative study among key policymakers in England

Ismail

Viggiani

2018

J Med Ethics

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Inconsistent interpretation of equivalence, the prevailing security drive, increasing numbers and health complexities of prisoners and fiscal austerity threaten the implementation of equivalence in English prisons. This research calls for new guidance on how to interpret and implement equivalence, along with measures to educate prison governors and staff on the prison rehabilitation value, ensure greater investment in prison health and consider alternatives to imprisonment to future-proof the principle of equivalence in the English prison system.

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Section: Discussionmentioning

confidence: 78%

How do policymakers interpret and implement the principle of equivalence with regard to prison health? A qualitative study among key policymakers in England

Ismail

Viggiani

2018

J Med Ethics

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“…Despite the nuances required by legislation in support of the Healthy Prisons Agenda, legislation should be further re-evaluated (14). Specifically, a multi-scalar implementation across 194 WHO member states will lay the foundation for meaningful transnational comparisons of the success of legislation in implementation of the Healthy Prisons Agenda across countries and continents, while simultaneously establishing a feedback loop from these countries back to the WHO as the custodian of the Agenda.…”

Section: Resultsmentioning

confidence: 99%

“…Despite this promise, overcrowding, which afflicts almost a fifth of prisons worldwide (2), may hinder the efficacy of prisons as health-promotion settings. To enhance the effectiveness of the Healthy Prisons Agenda, we propose that statutory instruments should be used to prioritise alternatives to imprisonment, such as community sentences or early release (14). Beyond overcrowding, implementation of the Healthy Prisons Agenda relies on prison governors and prison staff.…”

Section: Using Legislation To Strengthen the Status Of Prisons As Heamentioning

confidence: 99%

Using laws to further public health causes: the Healthy Prisons Agenda

2019

Self Cite

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In this commentary, we propose using laws in implementing the Healthy Prisons Agenda. We evaluate the efficacy of laws in tackling health inequalities in prisons, provide recommendations on how states can uphold their international commitments that safeguard prisoners’ right to healthcare, and frame prisons as health-promoting settings. We also assess the challenges that can thwart this proposal, such as the non-binding nature of international obligations, global prison overcrowding and the dependency on prison governors and staff for implementation of the Agenda. The commentary concludes by recommending further evaluation of our proposal and testing its potential generalisability to other health-promotion agendas.

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“…PSIs form part of the therapeutic delivery model but these interventions are often not delivered due to the difficulties of operationalising interventions in a correctional setting [ 28 ]. Contextually, [ 29 ] [ 30 ]) extend this argument to suggest that the prisons operate with a command-and-control, hierarchical management structure and an overarching suspicion of public health approaches will also further limit the ambition of delivering genuine equivalence of care in prison healthcare.…”

Section: Discussionmentioning

confidence: 99%

Estimating a treatment effect on recidivism for correctional multiple component treatment for people in prison with an alcohol use disorder in England

Sondhi

Leidi

Best

2020

Subst Abuse Treat Prev Policy

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Background There is an emerging literature on the impact of correctional substance abuse treatment (SAT) on reoffending for people in prison with substance misuse issues. This study estimates a pathway effect for people in prison receiving multiple component treatments for an alcohol use disorder (AUD) to reduce reoffending by applying treatment effect estimation techniques for observational studies. Treatment groups comprised pharmacological treatments, psychosocial interventions (PSIs) and interventions that incorporate Risk Need Responsivity (RNR) programming. RNR compliant treatment matches treatment dose to the risk of reoffending, targets criminogenic need and is tailored to a person’s learning style. Methods Multiple treatment effect estimators are provided for people in prison diagnosed with an AUD in England when compared to a derived control group for: Pharmacological treatment only; RNR compliant treatment and PSIs. Results The outcomes for RNR compliant treatment suggest a lower recidivism rate compared to the control group. Pharmacological only treatment results in a statistically significant higher level of reoffending relative to the control group. Conclusions The creation of a universal system of ‘equivalence of care’ framed within a public health context in English correctional SAT may have had an unintended consequence of diluting approaches that reduce recidivism. There is an opportunity to develop an integrated, cross-disciplinary model for correctional SAT that unites public health and RNR compliant approaches.

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Should we use a direct regulation to implement the Healthy Prisons Agenda in England? A qualitative study among prison key policy makers

Abstract: A direct regulation should not be used to operationalize the Healthy Prisons Agenda. Rather, self-regulation, along with proactive solutions for the identified barriers to implementing the Agenda, is the most appropriate path forward.

Cited by 7 publications

References 11 publications

How do policymakers interpret and implement the principle of equivalence with regard to prison health? A qualitative study among key policymakers in England

How do policymakers interpret and implement the principle of equivalence with regard to prison health? A qualitative study among key policymakers in England

Using laws to further public health causes: the Healthy Prisons Agenda

Estimating a treatment effect on recidivism for correctional multiple component treatment for people in prison with an alcohol use disorder in England

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