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Lennox C, Duncan-Zaleski M, Nasim S, Shirley O, Ross K, Chitsabesan P, Robinson L, Shaw J, Leonard S. The impact of the COVID-19 pandemic for children in custody: An analysis of inspection reports. PLoS One 2024; 19:e0304862. [PMID: 38900712 PMCID: PMC11189207 DOI: 10.1371/journal.pone.0304862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Children in custodial settings are a vulnerable group. Prior to the COVID-19 pandemic there were concerns about the safety of children in these settings. COVID-19 has had an impact on everyone but given the vulnerability of children in custody, there were concerns about the impact of COVID-19 restrictions. All custody settings for children are independently inspected and this research aimed to analyse data from inspection reports. Twenty-six inspection reports undertaken between March 2020 and October 2021 were analysed to understand the impact of COVID-19 on delivery of usual care/regime. RESULTS Data showed that across all site's children spent considerable amounts of time isolated and in some cases, this was deemed to amount to solitary confinement. There was evidence of some positive experiences, in the smaller sites, around COVID-19 slowing the pace of life allowing staff and children could foster relationships. However, in the larger sites, isolation was extreme and COVID-19 policies such as 'bubbles' appear to have created unintended consequences as sites have moved into recovery, leading to increased violence and stress. COVID-19 directly impacted staffing levels. This and the COVID-19 policies to reduce mixing also had an impact on how children's behaviour, welfare and safeguarding was managed. In some larger sites, being COVID-19 secure was prioritised over the needs of the children. CONCLUSIONS This research highlights the importance of multi-site longitudinal research to understand how children, staff and institution's function. The experiences of children in custody during COVID-19 differed by site type. The research suggests that the larger sites are struggling to keep children safe and there should be a shift towards smaller, more therapeutic environments. More research is needed to understand the longer-term unintended consequences of COVID-19 policy in custody, for these vulnerable children.
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Affiliation(s)
- Charlotte Lennox
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, School of Health Science, The University of Manchester, Manchester, United Kingdom
| | - Martha Duncan-Zaleski
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, School of Health Science, The University of Manchester, Manchester, United Kingdom
| | - Sahara Nasim
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, School of Health Science, The University of Manchester, Manchester, United Kingdom
| | - Olivia Shirley
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, School of Health Science, The University of Manchester, Manchester, United Kingdom
| | - Kenny Ross
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Prathiba Chitsabesan
- Pennine Care NHS Foundation Trust, Manchester, United Kingdom
- Manchester Metropolitan University, Manchester, United Kingdom
| | - Louise Robinson
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, School of Health Science, The University of Manchester, Manchester, United Kingdom
- Lancashire and South Cumbria NHS Foundation Trust, Preston, United Kingdom
| | - Jenny Shaw
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, School of Health Science, The University of Manchester, Manchester, United Kingdom
| | - Sarah Leonard
- Faculty of Biology, Medicine and Health, Division of Psychology and Mental Health, School of Health Science, The University of Manchester, Manchester, United Kingdom
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Sheard L, Bellass S, McLintock K, Foy R, Canvin K. Understanding the organisational influences on the quality of and access to primary care in English prisons: a qualitative interview study. Br J Gen Pract 2023; 73:e720-e727. [PMID: 37666512 PMCID: PMC10498379 DOI: 10.3399/bjgp.2023.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/05/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Primary care for routine healthcare conditions is delivered to thousands of people in the English prison estate every day but the prison environment presents unique challenges to the provision of high-quality health care. Little research has focused on the organisational factors that affect quality of and access to prison health care. AIM To understand key influences on the quality of primary care in prisons. DESIGN AND SETTING This was a qualitative interview study across the North of England from 2019 to 2021. METHOD Interviews were undertaken with 43 participants: 21 prison leavers and 22 prison healthcare professionals. Reflexive thematic analysis was undertaken. RESULTS The overarching organisational issue influencing quality and access was that of chronic understaffing coupled with a workforce in flux and dependence on locum staff. This applied across different prisons, roles, and grades of staff, and was vocally discussed by both patient and staff participants. Intricately related to understaffing (and fuelled by it) was the propensity for a reactive and sometimes crisis-led service to develop that was characterised by continual firefighting. A persistent problem exacerbated by the above issues was unreliable communication about healthcare matters within some prisons, creating frustration. Positive commentary focused on the characteristics and actions of individual healthcare professionals. CONCLUSION This study highlights understaffing and its consequences as the most significant threat to the quality of and access to prison primary care. Strategies to address health care affecting prison populations urgently need to consider staffing. This issue should receive high-profile and mainstream attention to address health inequalities.
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Affiliation(s)
| | - Sue Bellass
- Manchester Metropolitan University, Manchester, and University of Leeds, Leeds
| | | | | | - Krysia Canvin
- Keele University, Keele, and University of Leeds, Leeds
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Tesler R, Regev O, Birk R, Barak S, Shapiro Y, Weiss Y, Zigdon A, Ben Zvi K, Vaknin Y, Green G, Sohlberg I, Zwilling M, Goldstein L. Health promotion programs in prison: attendance and role in promoting physical activity and subjective health status. Front Public Health 2023; 11:1189728. [PMID: 37546299 PMCID: PMC10400886 DOI: 10.3389/fpubh.2023.1189728] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Maintaining an inmate's health can serve as a challenge due to unhealthy background, risky behavior, and long imprisonment. This study aimed to analyze the prevalence of participation in health promotion activities among Israeli inmates and its association with their physical activity levels and subjective health status. Methods A cross-sectional study was designed to examine 522 inmates (429 males, 93 females). The data were collected by trained face-to-face interviewers and self-report questionnaires. Results Most of the participants (82.37%) did not meet the recommended physical activity level. Half of the participants reported that their physical activity levels decreased since they were in prison compared with 29.50% who reported that their physical activity levels increased. Physical activity and subjective health status were significantly higher among younger male inmates. Furthermore, participation in health-promoting activities was associated with higher levels of physical activity and subjective health status. Discussion Health promotion activities may play an important role in addressing the challenges of maintaining inmate health. Implications of the findings are further discussed.
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Affiliation(s)
- Riki Tesler
- Department of Health System Management, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Health System Management, Health Promotion and Wellbeing Research Center, School of Health Sciences, Ariel, Israel
| | - Ofer Regev
- Department of Health System Management, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Health System Management, Health Promotion and Wellbeing Research Center, School of Health Sciences, Ariel, Israel
| | - Ruth Birk
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel, Israel
| | - Sharon Barak
- Department of Health System Management, Health Promotion and Wellbeing Research Center, School of Health Sciences, Ariel, Israel
- Department of Nursing, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Pediatric Rehabilitation, The Chai Sheba Medical Center, The Edmond and Lily Safra Children’s Hospital, Ramat-Gan, Israel
| | - Yair Shapiro
- Department of Health System Management, School of Health Sciences, Ariel University, Ariel, Israel
| | - Yossi Weiss
- Department of Health System Management, School of Health Sciences, Ariel University, Ariel, Israel
| | - Avi Zigdon
- Department of Health System Management, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Health System Management, Health Promotion and Wellbeing Research Center, School of Health Sciences, Ariel, Israel
| | - Kathrin Ben Zvi
- Department of Pediatric Rehabilitation, The Chai Sheba Medical Center, The Edmond and Lily Safra Children’s Hospital, Ramat-Gan, Israel
| | | | - Gizell Green
- Department of Health System Management, Health Promotion and Wellbeing Research Center, School of Health Sciences, Ariel, Israel
- Department of Nursing, School of Health Sciences, Ariel University, Ariel, Israel
| | - Idit Sohlberg
- Department of Business Administration, Ariel University, Ariel, Israel
| | - Moti Zwilling
- Department of Business Administration, Ariel University, Ariel, Israel
| | - Liav Goldstein
- Israel Prison Service, Medical Officer Office, Ramla, Israel
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Gilling McIntosh L, Rees C, Kelly C, Howitt S, Thomson LDG. Understanding the mental health needs of Scotland's prison population: a health needs assessment. Front Psychiatry 2023; 14:1119228. [PMID: 37265556 PMCID: PMC10229789 DOI: 10.3389/fpsyt.2023.1119228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/27/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction This study reports on an assessment of mental health needs among Scotland's prison population which aimed to describe the scale and nature of need as well as identify opportunities to improve upon the services available. The project was commissioned by the Scottish Government to ensure that future changes to the services available to support the mental health and wellbeing of people in prison would be evidence-based and person-centered. Methods A standardized approach to health needs assessments was employed. The study was comprised of four phases. In phase I a rapid literature review was undertaken to gather evidence on the prevalence of mental health needs experienced by people in prison in the UK. In Phase II a multi-method and multi-informant national mapping exercise involving providers to all Scottish prisons was undertaken to describe the mental health services available, and any gaps in these services, for people in and leaving prison. In Phase III prevalence estimates of several mental health needs were derived for Scotland's current prison population, modeled from a national survey dataset of Scotland's community population using logistic regression. Finally in Phase IV, professional stakeholders and individuals with lived experience were interviewed to understand their experiences and insights on challenges to supporting the mental health and wellbeing of people in prison, and ideas on how these challenges could be overcome. Results Evidence across the four phases of this needs assessment converged indicating that existing provision to support the mental health of people in prison in Scotland was considered inadequate to meet these needs. Barriers to effective partnership working for justice, health, social work and third sector providers appear to have led to inadequate and fragmented care, leaving prisoners without the support they need during and immediately following imprisonment. Conclusions Joint and coordinated action from justice, health and social care, and third sector providers is needed to overcome enduring and structural challenges to supporting the mental health of people in prison. Eighteen evidence-based recommendations were proposed to the Scottish Government relating to the high-level and operational-level changes required to adequately meet the prison population's mental health needs.
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Affiliation(s)
- Lindsey Gilling McIntosh
- Centre for Clinical Brain Sciences, Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Cheryl Rees
- Centre for Clinical Brain Sciences, Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Caroline Kelly
- Forensic Mental Health Services Managed Care Network, Carstairs, United Kingdom
| | - Sheila Howitt
- Department of Forensic Psychiatry, The State Hospitals Board for Scotland, Carstairs, United Kingdom
| | - Lindsay D. G. Thomson
- Centre for Clinical Brain Sciences, Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
- Forensic Mental Health Services Managed Care Network, Carstairs, United Kingdom
- Department of Forensic Psychiatry, The State Hospitals Board for Scotland, Carstairs, United Kingdom
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Aharon SB, Regev O, Tesler R, Barak S, Shapira Y, Weiss Y, Shtainmetz N, Vaknin Y, Goldstein L, Ben-Zvi K, Birk R. Assessment of Nutritional Status and Health Perception among Male Inmates in Israeli Prisons. Nutrients 2023; 15:nu15102255. [PMID: 37242137 DOI: 10.3390/nu15102255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/27/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
The nutritional and health perceptions of inmates are crucial to their overall well-being. However, limited research has been conducted on this topic. This study aimed to assess the nutritional and health perception state of male inmates in eleven prisons in Israel. A cross-sectional study was conducted between February and September 2019 with 176 voluntary participants. Structured questionnaires were used to collect data on socio-demographic characteristics, healthy habits, subjective health status, and prison situation variables. The study found that the prevalence of overweight (40%) and obesity (18.1%) among 18-34-year-old inmates was significantly higher than in the reference Israeli population. Short detention periods (up to one year) predicted less weight gain, while older age predicted poorer health status. Better emotional status significantly predicted better subjective health status among male inmates. There is a need for nutrition interventions to improve the health of inmates. The significant weight gain during incarceration and the associated lower health index and stress highlights the importance of increasing knowledge and promoting a healthier lifestyle in incarceration as early as possible and continuing over time.
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Affiliation(s)
| | - Ofer Regev
- Health Management Department, Ariel University, Ariel 40700, Israel
| | - Riki Tesler
- Health Management Department, Ariel University, Ariel 40700, Israel
| | - Sharon Barak
- Nursing Department, Ariel University, Ariel 40700, Israel
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Ramat-Gan 52621, Israel
| | - Yair Shapira
- Health Management Department, Ariel University, Ariel 40700, Israel
| | - Yossi Weiss
- Health Management Department, Ariel University, Ariel 40700, Israel
| | - Noa Shtainmetz
- Health Management Department, Ariel University, Ariel 40700, Israel
| | | | - Liav Goldstein
- Chief Medical Officer Office, Israel Prison Service, P.O. Box 81, Ramla 72100, Israel
| | | | - Ruth Birk
- Nutrition Department, Ariel University, Ariel 40700, Israel
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Woodall J, Freeman C, Warwick-Booth L. Health-promoting prisons in the female estate: an analysis of prison inspection data. BMC Public Health 2021; 21:1582. [PMID: 34418998 PMCID: PMC8380381 DOI: 10.1186/s12889-021-11621-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women in prison have comparatively greater health needs than men, often compounded by structures and policies within the prison system. The notion of a 'health-promoting' prison is a concept which has been put forward to address health inequalities and health deterioration in prisons. It has, however, not been fully discussed in relation to women in prison. The paper aims to distil the learning and evidence in relation to health promotion in female prisons using prison inspection reports of women's prisons in England and Wales. METHODS Prison inspection reports are one way of ascertaining the contemporary situation in prisons. Prison inspections are often unannounced and use a myriad of methods to draw conclusions around various aspects of prison life. Thirteen prison inspection reports were analysed thematically focusing on health promotion within the institutions. Two analysts conducted the work using NVivo 12. RESULTS Five core thematic areas were identified during the analysis of the reports. Saliently, a joined-up approach to health promotion was not a common feature in the prisons and indeed the focus tended to be on screening and 'lifestyle issues' rather than a concern for the underlying determinants of health. There was often an absence of a strategic approach to health promotion. There were some good examples of the democratic inclusion of women in prison in shaping services, but this was not widespread and often tokenistic. There were some examples of inequity and the inspection reports from a small number of institutions, illustrated that the health needs of some women remained unmet. CONCLUSIONS The paper suggests that there is potentially some work before conditions in women's prisons could be described as 'health-promoting', although there are some examples of individual prisons demonstrating good practice. The health promoting prison movement has, implicitly at least, focused on the needs of men in prison and this has been to the exclusion of the female prison population. This does lead to several challenges and the potential for exacerbating health challenges faced by an already marginalised and vulnerable group. Greater focus on the health promotion needs of women in prison is required.
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Affiliation(s)
- James Woodall
- School of Health and Community Studies, Leeds Metropolitan University, Leeds, England.
| | - Charlotte Freeman
- School of Health and Community Studies, Leeds Metropolitan University, Leeds, England
| | - Louise Warwick-Booth
- School of Health and Community Studies, Leeds Metropolitan University, Leeds, England
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