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.
Acknowledgements.
About the authors
Abbreviations
Foreword.
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
Communicable diseases
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
Noncommunicable diseases
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
Oral health
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
Risk factors
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
Vulnerable groups
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
Contents
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)
