Salutogenesis in Prison

This chapter concludes Part VII, with a focus on salutogenesis in prisons. In this chapter, the authors present and debate how prison health rhetoric, policy and practice are influenced by a pathogenic view of prisoner “health.” The authors comment that there is a growing recognition of a salutogenic approach to prison health policy and practice, to help tackle the root causes of health, criminality and inequality. This chapter emphasises that while the health of prisoners is influenced by material and social factors beyond their control, a salutogenic approach offers an alternative way of delivering public health and health promotion in prisons. The chapter concludes noting that the application of salutogenesis in prisons is in its infancy. They call for research, policy and practice framed by a salutogenic orientation, leading to sustained and effective measures to improve the health of people in criminal justice settings, and reducing health inequalities in prisons.

All smoke and mirrors? The Taylor litigation and issues surrounding the smoking ban in New Zealand prisons

<p>A 2005 prisoner health survey found that almost three quarters of the New Zealand prison population identified as smokers. Tobacco was deeply engrained in prison culture and smoking was viewed as an aid for managing the stress and boredom associated with prison life. The Department of Corrections implemented a policy on 1 July 2011, banning smoking in all areas of all prisons in New Zealand. The policy aimed to improve the long-term health of prisoners, and create a healthier workplace environment. Arthur Taylor, a notorious and litigious criminal, successfully challenged the delegated legislation implementing the policy by way of judicial review. This paper argues that the judicial reasoning was flawed, as it was based on erroneous assumptions without a thorough assessment and interpretation of the legislative history. Despite Taylor’s successful claims, the smoking ban was then incorporated into primary legislation. This paper examines the method of implementation, finding issues with retrospective and privative clauses introduced by a late stage supplementary order paper. Prisoners are a group especially vulnerable to curtailment of rights and freedoms, and this paper concludes that removal of the freedom to smoke in prison cells and outside in prison yards was a step too far.</p>

All smoke and mirrors? The Taylor litigation and issues surrounding the smoking ban in New Zealand prisons

<p>A 2005 prisoner health survey found that almost three quarters of the New Zealand prison population identified as smokers. Tobacco was deeply engrained in prison culture and smoking was viewed as an aid for managing the stress and boredom associated with prison life. The Department of Corrections implemented a policy on 1 July 2011, banning smoking in all areas of all prisons in New Zealand. The policy aimed to improve the long-term health of prisoners, and create a healthier workplace environment. Arthur Taylor, a notorious and litigious criminal, successfully challenged the delegated legislation implementing the policy by way of judicial review. This paper argues that the judicial reasoning was flawed, as it was based on erroneous assumptions without a thorough assessment and interpretation of the legislative history. Despite Taylor’s successful claims, the smoking ban was then incorporated into primary legislation. This paper examines the method of implementation, finding issues with retrospective and privative clauses introduced by a late stage supplementary order paper. Prisoners are a group especially vulnerable to curtailment of rights and freedoms, and this paper concludes that removal of the freedom to smoke in prison cells and outside in prison yards was a step too far.</p>

The older prisoner health and social care assessment and plan (OHSCAP) versus treatment as usual: a randomised controlled trial

Background Older people are the fastest-growing demographic group among prisoners in England and Wales and they have complex health and social care needs. Their care is frequently ad hoc and uncoordinated. No previous research has explored how to identify and appropriately address the needs of older adults in prison. We hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs 3 months after prison entry, compared to treatment as usual (TAU). Methods The study was a parallel randomised controlled trial (RCT) recruiting male prisoners aged 50 and over from 10 prisons in northern England. Participants received the OHSCAP or TAU. A clinical trials unit used minimisation with a random element as the allocation procedure. Data analysis was conducted blind to allocation status. The intervention group had their needs assessed using the OHSCAP tool and care plans were devised; processes that lasted approximately 30 min in total per prisoner. TAU included the standard prison health assessment and care. The intention to treat principle was followed. The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30 November 2016. Results Data were collected between 28 January 2014 and 06 April 2016. Two hundred and forty nine older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. Two hundred and fifty three 3 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD = 2.07) and 2.06 (SD = 2.11) for the TAU group (mean difference = 0.088; 95% CI − 0.276 to 0.449, p = 0.621). No adverse events were reported. Conclusion The OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving the OHSCAP did not experience improved outcomes compared to those who received TAU. Trial registration Current Controlled Trials: ISRCTN11841493, 25/10/2012.

The Older Prisoner Health and Social Care Assessment and Plan (OHSCAP) versus Treatment as Usual: A Randomised Controlled Trial

Background Older adults are the fastest-growing subgroup among prisoners in England and Wales and have more health and social care needs than their younger counterparts and those the same age living in the community . We hypothesised that the Older prisoner Health and Social Care Assessment and Plan (OHSCAP) would significantly increase the proportion of met health and social care needs three months after prison entry, compared to treatment as usual (TAU).MethodsA parallel randomised controlled trial (RCT) was conducted at ten prisons in the North of England. Males aged 50 and over received the OHSCAP or TAU. The allocation procedure was minimisation with a random element. The OHSCAP process involved individuals having their needs assessed, care plans being created and reviewed. TAU encompassed the standard prison health assessment. The trial was registered with the UK Clinical Research Network Portfolio (ISRCTN ID: 11841493) and was closed on 30th November 2016.ResultsData were collected between 28th January 2014 and 06th April 2016. 249 older prisoners were assigned TAU of which 32 transferred prison; 12 were released; 2 withdrew and 1 was deemed unsafe to interview. 253 prisoners were assigned the OHSCAP of which 33 transferred prison; 11 were released; 6 withdrew and 1 was deemed unsafe to interview. Consequently, data from 202 participants were analysed in each of the two groups. There were no significant differences in the number of unmet needs as measured by the Camberwell Assessment of Needs – Forensic Short Version (CANFOR-S). The mean number of unmet needs for the OHSCAP group at follow-up was 2.03 (SD=2.07) and 2.06 (SD= 2.11) for the TAU group (RR = 0.088; 95% CI -0.276 to 0.449, p = 0.621). No adverse events were reported. Conclusion Those received the OHSCAP did not experience an improvement to the meeting of the needs in comparison to the TAU g. This was largely due to the OHSCAP not being implemented as planed due to a national prison crisis.The OHSCAP was fundamentally not implemented as planned, partly due to the national prison staffing crisis that ensued during the study period. Therefore, those receiving OHSCAP did not experience improved outcomes compared to those who received TAU. Trial RegistrationISRCTN11841493 25/10/2013Protocol available at: http://www.isrctn.com/ISRCTN11841493

Prisoner health status at three rural Haitian prisons

Purpose Little is known about the health status of prisoners in low-income countries. In Haiti, prisons typically lack adequate medical care, clean water and food, though some prisoners receive additional food from visitors. The purpose of this paper is to characterize the physical and mental health of Haitian prisoners in three select prisons and examine the effects of having visitors and length of detention on health status. The authors hypothesized that prisoners with more visitors and shorter detention times would have better overall health status. Design/methodology/approach The authors conducted a cross-sectional study of 290 male inmates in three regional prisons in Haiti. Data were collected on prisoners’ sociodemographic characteristics, number of visitors, length of detention, body mass index (BMI), self-reported physical and mental health status, and food insecurity. Findings Overall, prisoners at all three prisons had poor health outcomes. Prisoners with more visitors were significantly less likely to be underweight and more likely to have a higher BMI, better self-reported physical function and lower levels of food insecurity. The length of incarceration was negatively associated with physical function and self-rated health, but positively associated with BMI. These results suggest that prisoners who do not receive supplemental food from visitors are at increased risk for food insecurity and poor nutritional and physical health status. Originality/value These findings demonstrate the importance of supplemental food from visitors in stabilizing prisoner health in Haiti and emphasize the need for the provision of adequate nutrition to all prisoners. This study also suggests that policies that reduce incarceration times could improve health status among prisoners.