Editorial

Citation

MacDonald, M. and Kane, R.G.a.D. (2014), "Editorial", International Journal of Prisoner Health, Vol. 10 No. 1. https://doi.org/10.1108/IJPH-12-2013-0054

Editorial

Article Type: Editorial From: International Journal of Prisoner Health, Volume 10, Issue 1

Welcome to the first issue of 2014. We are pleased to present five papers that examine a range of topics including the development of mental health care for prisoners in the USA, health promotion policy in Norway, access to health care for probationers in the UK, the development of e-module training for prison officers in South Wales UK and the challenges that an ageing prison population poses to the criminal justice system in the USA.

In our first paper, Henry Dlugacz examines the development of mental health care for prisoners in the USA against a backdrop of growth in both the criminal justice system and the corrections population and a decrease in civil and community based mental health care. Dlugacz notes that prisoners with mental illness have come to represent a highly disproportional segment of the corrections population, which in turn has led to developments in correctional mental health care, particularly policy designed to treat mental illness, reduce its destructive outcomes and streamline re-entry into the community in attempts to reduce recidivism and improve clinical outcomes. The author describes how this combination of circumstances has started to change the mission of correctional health services from crises intervention and suicide prevention to include preparation for the prisoner's almost inevitable return to the community. The paper discusses five domains that have been affected by this transformation in correctional mental health care: public health, public safety, legal obligations, fiscal responsibility and ethical standards, as well examining critical issues including administrative segregation, suicide prevention and re-entry planning. Dlugacz concludes that correctional mental health in the USA is entering a critical stage and notes that services must be provided in accordance with evidence-based practices, meeting ethical and professional standards, as well as being cognisant of the potential public health and public safety benefits of adequate correctional mental health.

In our second paper Lidia Santora, Geir Arild Espnes and Monica Lillefjell use a case study of Norwegian health promotion policies in prison settings to examine the contribution of the modern correctional service to health promotion. The authors conducted a literature review of Norwegian policy documents relevant to prison settings followed by a general review of the literature on the principles of humane service delivery in offender rehabilitation to address two questions: first, how do Norwegian health policies assist the correctional population in achieving “good health” and “well-being” and second, besides the goals of crime prevention and crime reduction, how does criminological research and practice enable correctional settings to be health promoting? The reviews indicate that there is an obvious involvement in health promotion through authentic health promoting actions applied in correctional settings, which have a basis in the overarching goals of equity and the reduction of social inequalities in population health particularly for the disadvantaged who make up the majority of the prison population. The authors conclude that there are several implications resulting from their analysis including recognition among health promotion policy makers of the role that the principles of modern correctional practice plays, increased public awareness about the role correctional settings play in enabling health and third, the individual and community health and well-being benefits that accrue from the creation of supportive environments. The authors also note that further research is necessary to specifically investigate the correlation between health promotion and crime outcomes.

Continuing the theme of health and well-being, Emma Plugge, Anees Ahmed Abdul Pari, Janet Maxwell and Sarah Holland explore issues around health and access to health services for individuals on probation in the UK. Drawing on a series of focus groups conducted with staff and probationers, the authors identify key issues, which include substance use and mental health problems. The most important issue for probationers, however, was dealing with the stress of probation that was generally not acknowledged by professionals. All participants recognised the impact of issues including housing, finances and employment on the well-being of probationers and were concerned about the lack of access to health services, in particular mental health and alcohol services. The authors conclude that Identifying and effectively addressing probationers’ health needs is likely to have a major impact on decreasing their burden of illness, particularly mental health problems and alcohol-related problems, while also reducing re-offending. Additionally, one of the major challenges facing local health service commissioners and providers and the probation service is finding a way of working together, at a time of organisational change in the National Health Service and the Probation Service, to provide appropriate and accessible services for probationers.

In our fourth paper Stephanie E. Perrett, Mark Erricker and Marion Lyons report on an initiative in South Wales, UK to provide education on blood borne viral hepatitis (hepatitis B and hepatitis C) BBVs to prison staff via the development and implementation of an e-module. The e-module was finalised and rolled-out at one category B (medium secure) convicted closed male prison, holding around 1,200 male convicted prisoners. The roll-out of the e-module was fully supported by the prison Governor who also sent notices to staff asking that they complete the e-module as mandatory training. 76 per cent (530/697) of eligible staff completed the e-module. Evaluation of results, which included analysis of pre and post-test assessments, indicates that the e-module provides an educational tool to enhance understanding of BBV transmission risks and care of prisoners who may be at risk of or living with a BBV. Scores for the post module assessment were significantly higher for all questions than in the pre module assessment indicating that the content and method of the e-module was successful in enhancing understanding. The authors acknowledge the limitations of the study including presenting results from one intervention alone and an element of bias as a result of participants guessing answers. However, the results indicate an increase in understanding of BBV transmission, which is vitally important not only for protecting the officers themselves within a high-risk workplace but also in supporting those in their care who may be infected or have fear of infection.

In our final paper Tina Maschi, Deborah Viola, Mary T. Harrison, William Harrison, Lindsay Koskinen and Stephanie A. Bellusa examine the challenge facing the criminal justice system arising from the issue of an ageing prison population. Drawing on data collected from a sample of 677 older adult prisoners aged 50 and older (40 per cent response rate) housed in the New Jersey Department of Corrections in September 2010, complemented by a case study of the True Grit Program, a rehabilitation programme for older adults in the Nevada state prison system, the authors note that the biggest challenge for interdisciplinary professionals and programmes to foster health and well-being among incarcerated older adults is the development of competencies in working at the practice intersection of ageing, health/mental health, and criminal justice sectors of care. The authors conclude that the provision of required resources that match their complexity of needs, such as obtaining social security benefits or housing, early enough in the process might make a significant difference towards successful reintegration.

Morag MacDonald, Robert Greifinger and David Kane