This book outlines important suggestions by international experts to improve the health of those in prison and to reduce both the health risks and risks to society of imprisonment. In particular, it aims to facilitate better prison health practices in the fields of: (i) human rights and medical ethics, (ii) communicable diseases, (iii) noncommunicable diseases, (iv) oral health, (v) risk factors, (vi) vulnerable groups and (vii) prison health management. It is aimed at professional staff at all levels of responsibility for the health and well-being of detainees and at people with political responsibility. The term “prison” covers all institutions where a state holds people deprived of their liberty.
About the authors
Human rights and medical ethics
1. The essentials about prisons and health. Key points Background. The duty of care. Why prison health is important. Difficulties with isolation of services. Essential components of a prison health service. Good governance for prison health. References
2. Standards in prison health: the prisoner as a patient. Key points. Basic principles. Relationship between the prisoner and health care staff. Organization of prison health care. European Prison Rules. References.
3. Prison-specific ethical and clinical problems. Key points . Introduction. Health care staff in prisons. Disciplinary measures. Physical restraint. . Intimate body searches. Prisoners who stop eating or go on hunger strikes. Torture and inhumane or degrading treatment. References.
4. Violence, sexual abuse and torture in prisons. Key points . Introduction. Definitions of violence in prison. Violence in prisons. Sexual violence in prisons. Torture and ill-treatment. Prevention of violence in prisons. Prisons and health The role of the prison health services. References
5. Solitary confinement as a prison health issue. Key points. Introduction. What is solitary confinement? How does solitary confinement affect health and well-being. Particularly vulnerable groups. Long-term effects. When and why is solitary confinement used in contemporary penal systems? How do international law and human rights bodies view solitary confinement? Conclusion. References
6. Health in pre-trial detention. Key points. Introduction. Defining pre-trial detention. Guidelines. Challenges of pre-trial detention. Improving health conditions at the pre-trial stage. References
7. HIV and other bloodborne viruses in prisons. Key points . Introduction. Bloodborne viruses. The issues or challenges within the prison environment. A comprehensive approach. The evidence. Interventions. Nutrition support and diet. Continuity of treatment. Palliative care/compassionate release. Quality assurance and monitoring of, and interventions for, HIV and hepatitis C and D. References
8. TB prevention and control care in prisons. Key points. Introduction. Transmission. finding. Contents Screening strategies. Clinical features of TB. Treatment. MDR-TB. TB/HIV co-infection. TB infection control. Advocacy, communication and social mobilization. Continuum of care for released prisoners. References.
9. Infectious diseases in prison. Key points . Introduction. Influenza. Measles, mumps and rubella. Viral hepatitis. Tetanus. Diphtheria. Sexually transmitted infections. Ectoparasites. Vaccination, quarantine and personal hygiene. References
10. Noncommunicable diseases and prisoners. Key points . Introduction. Burden of disease and risk factors for NCDs in prisoners. Challenges in providing appropriate prevention and care to prisoners. References
11. Mental health in prison. Key points . Introduction. Human and prisoners’ rights and basic needs. Equivalence. Prevalence of poor mental health. Complexity and multiple needs. Illness and social focus. The impact of prison on mental health and well-being. Prisoners’ views of their needs. Prisoners’ views on what constitutes a good mental health service. Mental health awareness in the prison system. Prisons and health Prisoners and their families. Diagnosis and assessment. Screening and assessment. Treatment in prison. Personality disorders. Continuity of care. Meeting the needs of different groups in the prison population. The recovery approach. The roles of peers and mentors. Diversion and liaison. References
12. Dental health in prisons . Key points . Introduction. Oral health. General impact of general health on oral health. Utilization of the prison dental service . Provision of prison dental services. Accessibility of dental services. Good clinical practice. Oral health promotion. The dental team. Commissioning prison dental services. References
13. Drug use and related consequences among prison populations in European countries . Key points . Introduction. Drug use among the prison population. The social characteristics of drug treatment clients in prison . Health problems. Methodological limitations. References
14. Drug treatment and harm reduction in prisons . Key points . Introduction. Prevention, treatment, harm reduction and aftercare . What works?. Contents Psychosocial drug treatment and pharmacological approaches as complementary measures in a comprehensive package of drug services. Opioid substitution treatment in custodial settings. Harm reduction programmes. References
15. Alcohol and prisons . Key points . Introduction. Alcohol in Europe . Alcohol and crime. Alcohol problems in prisoners. Effective detection. Effective interventions. Integrated care. Issues and challenges with alcohol problems in prisons. References
16. Tobacco use in prison settings: a need for policy implementation . Key points . Introduction. Main issues: prevalence and exposure to SHS in prison settings. WHO Framework Convention on Tobacco Control (WHO FCTC). Reasons for the high prevalence of tobacco use in prisons. 139 Significance of tobacco use in prison . Tobacco use by prison staff. Addressing the smoking issue in prisons. Outline of a tobacco control policy in German prisons . References
17. Prisoners with special needs. Key points . International standards . General principles of care . Treatment in prisons . A suitable prison or place of detention . A proper manner of detention . Some important messages . Prisoners with physical disabilities . Ethnic minorities and indigenous peoples . Foreign prisoners. Prisons and health Lesbian, gay, bisexual and transgender prisoners . Older prisoners. References
18. Women’s health and the prison setting . Key points . Introduction. Violence and abuse. Substance use. Mental health issues. Infectious diseases. Dental health. Children of women in prison. Organization of health care for women in prison. References
19. The older prisoner and complex chronic medical care. Key points . Introduction. Accelerated ageing: who is old in prison? Geriatric medicine and the multimorbidity model of care. Polypharmacy. Geriatric syndromes. Functional status and environmental mismatch. Mental health issues . End of life care and death . Ageing and re-entry into the community . References
Prison health management
20. Primary health care in prisons. Key points . Introduction. The purpose of health care. The experience of prison. The components of primary care. The primary care journey. Prison health care resources. Common problems encountered in primary care practice in prisons. Building blocks for primary care in prison. Measuring performance in health care. Competencies of and support for prison clinical staff. References
21. Promoting health in prisons: a settings approach. Key points . Introduction. Challenges and opportunities . The health promotion needs of prisoners. A whole-prison approach: a vision for creating a health-promoting prison. References.
22. Staff health and well-being in prisons: leadership and training . Key points . Introduction. Health and the prison. The stressful workplace. Risk factors and stress among prison employees. Health risk factors for prison staff . Health promotion programmes to support employees. Health awareness. Prison staff training in health. Managers, leaders and decision-making. Health care professionals. Maintaining professional standards. Clinical governance and performance monitoring. Conclusion. References
World Health Organisation (WHO)
Enggist, S., Møller, L., Galea, G. & Udesen, C. (eds.) (2014). Prisons and Health. World Health Organisation. Prisons and Health (who.int)