Social and Health Needs of UK Prisoners - Essay Example

?Social and Health Needs of UK Prisoners Her Majesty’s Prison Service provides service to the public by keeping in custody the law breakers committedby the courts. Its main duty is to help them change into law abiding citizens and care for them with humanity. It helps them to lead useful lives while in custody and even after release. The main objectives of the service are to hold the prisoners securely, reduce the risk of prisoners re-offending and to provide well ordered establishments where prisoners are treated decently, humanely and lawfully. However as the population of prisoners increase by day, the conditions surrounding the imprisoned in the country have deteriorated. There is a need for better health care in prisons and for an improvement in the prisoners’ general life inside bars. The National Health Service for example has recently got the mandate to look into matters of health care for prisoners taking over this duty from the prison service (Williamson 2006). This is a good call since there is admittedly a need to look into social and health issues of the prisoners. This paper will discuss the social and health needs of the prisoners in the United Kingdom and the reasons as to why the needs are relevant to the wider community. There is a wide spread concern that the rules and regimes of the prison environment could have detrimental impacts on the mental health of the prisoners and especially those with mental illnesses already. It is also well documented that the incidences of psychiatric morbidity and substance abuse is higher among the prisoners than the general public. Thus with the growing population, there are now more people with mental illnesses in the prisons than ever before (Harris, Hek and Condon 2007). The overcrowding, separation from family and friends, loss of autonomy and boredom are potentially detrimental to the mental stability of the prisoners. There is therefore a need to improve the state of mental healthcare so as to get to the main of objectives of the prisons to be anti-therapeutic environments. There is a need to really care for the prisoners from reception through to discharge mentally so as to improve their perceptions in the quality of their lives. The staff administering mental healthcare inside the prisons should have extra training to identify the prisoners who need extra support, those with history of mental illness and those who will be on remand for a long time (Brooker 2009). The population of the prisons in England and Wales has doubled in the last 20 years thus making the prisons to overcrowd. Overcrowding is the state where a prison contains more prisoners than the establishment’s CNA (Certified Normal Accommodation). THE United Kingdom has the highest percentage of overcrowding in Europe. The overcrowding leads to enormous burdens on the staff making it difficult to offer adequate resources to the offenders. This exacerbates tension and frustration levels by prisoners leading to higher risks of violence. This leaves prisoners under the danger of being hurt or killed. It also deteriorates the living conditions where inmates eat, sleep and even defecate in the cell, like in the case of Bedford, a condition which leaves them to the danger of infections. The overcrowding also denies some prisoners the access to education, training and work. This is because there is a high demand due to the high population. Overcrowding also brings difficulties in mental, drug and alcohol abuse treatment services. It is also expensive and increases the risk of a prisoner to committing crimes after release due to the above inconveniences (Singleton et al 1998). Some of the prisoners are fathers and mothers. This means that they are forced to combine serving their sentences and parenting. Their families therefore need support from the society and the administration. Their kids are especially at risks of experiencing poverty, mental illnesses, poor housing and more negative incomes. Most children with parents in prison will most likely go on to offend. There are also the unenthusiastic school life experiences like persistent truanting, bullying and failure to achieve academically. There should be frequent family and children visit days to help maintain the bond between prisoners and their families. This will decrease prisoners’ chances of getting depressed and make them optimistic about a better life. The prisons in the UK are characterised by national, ethnic and religious diversity. There is a great need for protection to the minor groups who suffer bullying from the larger groups. Race relations within prisons has spread too much that it has even called for political scrutiny due to racist murders in prison. These groups despite the fact that they are dangerous to smaller groups generally help the prisoners to cope with the prison life and improve their social lives. Race discrimination however, should have its initiatives extended to cover all prison contexts from discipline, transfer, categorisation and segregation. This will protect the minorities from being victimised by the other inmates and prison staffs, serial racist treatment and discrimination in decision making processes. Demographically, the prisons also contain prisoners that cut across all ages, places and gender. These prisoners according to studies conducted have social and health needs and challenges with which they contend. The older prisoners for instance are increasing due to the sentences becoming harsher and longer. Their numbers will continue to rise unless the sentencing trends are dealt with accordingly. The old prisoners are much prone to the mental illnesses due to the depression caused by the imprisonment. Their physical health status is ten years older than their outside contemporaries. The old should receive special social care also in the long term legislation should be introduced to clarify legal responsibilities for social care provision. Risk assessments should also take account of their social care and health needs. The minimum pay rate for the older prisoners should also be increased to the level of the working ones even though they can not work. Allegations of them being bullied should also be responded effectively and quickly. This is because they are very susceptible to attacks while in prison, in terms of physical and sexual abuse. This also applies much to the prisoners with disabilities. To fully comply with the Disability Discrimination Act, the disabled records should be on their own sections for better scrutiny and the prisoners with mobility problems should be located on the ground floors. These groups also need their personal hygiene, safety and privacy concerns attended to. Improved bathrooms and laundry facilities with appropriate aids and also adequate time and resources allocated to the disability liaison officers for them to accomplish their statutory duties to endorse disability equality. Accommodation that is provided on release should also take into account the aged, the disabled and their social needs. The prisoners also deal with drugs and alcohol intake. Ramsey, Bullock and Niven (2005), in their article, point out that many prisoners were heavy drinkers prior to imprisonment. Male offenders especially were found to be drug addicts and, with most being abusers of cannabis and some reported to have used heroin and cocaine, and tranquilizers without getting a prescription. It is worth noting that the use of drugs pre-prison did not vary across the lengths of sentences that the inmates were serving. The authors also point out that the risk of a relapse is higher for those serving short-term sentences should they be released back into the real world before they are free of the problem. This, they deduced from the fact that repeat offenders serving short sentences in most instances returned to prison with a drug problem. According to Stewart (2008), there is a direct correlation between high-risk tendencies and drug and substance abuse. This is such that, prisoners in the UK found to abuse drugs were more exposed to HIV and Hepatitis than those found to not abuse drugs. The prisoners therefore found that apart from the need for help with their drug problems, there were diseases brought on due to their drug abuse that needed medical attention. There is also a need to block the drugs entering into the prisons where clean prisoners could be forced to be abusers by circumstances or peer pressure. Drug abusers should also be helped through counselling and rehabilitations so as to release them as better citizens of the United Kingdom. The minority groups are the most disadvantaged groups and needs a lot of health and social care. These groups which include the old and disabled cited above also include the immigrants, the gay and the lesbians in the prisons. The immigrants are treated as they are mostly treated even on the outside like they do not belong there. This also happens to the gay and the lesbians who suffer a lot of victimisation in the prisons and therefore need special kind of care to escape depressions and physical injuries. There is a big connection between the social and health needs as demonstrated above. This is because the health needs of the prisoners stem up directly from their unmet social needs. Her Majesty’s Prison Service should therefore deal with these categories of needs simultaneously. Public health is basically the science and art of protecting and improving the health of the community through education, health lifestyle promotions and research for diseases and injury prevention. It is population based, emphasizes collective responsibility for health and emphasizes partnership with the contributors to health. It is generally concerned with ensuring that people stay healthy, through treatment and prevention. It is an initiative by government towards ensuring the aforementioned, while encouraging its citizens to make choices that will enhance their well-being in order to abate the risk and effects brought on by illnesses (Wilson & Mabhala 2009). The government engages in public health activities in order to discourage high-risk behaviour, for example smoking, drug abuse and irresponsible drinking and instead encourages healthy behaviour like eating a balanced diet. Public health consists of three strands. They are health improvement, health protection and health services. Health improvement has to do with the development of new ways through which the prisoners’ needs can be addressed. Within this strand, emphasis is placed on formulating effective and more efficient methods of providing health services in prisons (Carr et al. 2007). It deals with inequalities, education, housing, family, lifestyles and monitoring specific diseases and risk factors. Issues of immunization and education fall under health prevention and protection. This is whereby the government incorporates the efforts of the individuals in trying to protect them from future occurrences of diseases. Health protection against infectious diseases, chemical and poisons, radiation, emergency responses and environmental health hazards fall under this strand. Under this strand also, we also find measures such as provision of counselling and education on healthy nutrition lessons against drug abuse (Wilson and Mabhala 2009). Under the last strand, health services, all issues of services offered to the community are covered, whether it is in checkups or diagnosis and treatment. Clinical effectives, efficiency, service planning, clinical governance, equity, audit and evaluation all fall under this strand. A public health practice should be empowering, effective, evidence based, equitable, fair and inclusive. The main areas that public health takes into account other than the three strands are health and social service quality, academic public health, public health intelligence, policy and strategy development and implementation and the surveillance and assessment of the population’s health and wellbeing. Public health in prison, in summary, therefore, entails measures taken by UK government to improve on the health and lives of prisoners in its jurisdiction. Prisons are primarily organised by age and sex of the inmates. There are male prisoners’ prisons, female prisons and separate institutions that serve the needs of young offenders and adults. They are further divided into high security prisons, training prisons and local prisons. The local prisons serve as both remand centres for those remanded by court and to hold prisoners when they are first sentenced. Short term prisoners may spend their full sentences in the local prisons (Hemenway 2004). There are always high numbers of remand prisoners and prisoners with short sentences and therefore the local prisons are always overcrowded. There are also high numbers of prisoners who are still adjusting in their recent incarceration or recent sentencing. They are basically the reception of the other prisons and so they contain a throughput of prisoners. Therefore, these prisons should have in-patient facilities and a 24 cover for heath care. To promote health in the prisons, there must be an investment in sustainable policies,infructure and actions to adress the determinants of health. A capacity for leadership shopuld be built in prisons,health promotion practices, knowledge transfer and health and research literacy. Regulations and legistlation to ensure high level of protection from harm and enable enable equal opportunity for wellbeing and health of the prisoners shoul also be taken into account. Alliances and partnerships should also be established so as to create sustainable actions. To get successful outcomes for interventions, developing a settings approach to the whole prison is very vital. There should be set policies in the prisons that promote health such as no smoking policies, environments that actively support health, health education, prevention and other health promotion initiatives adressing assessed health needs. The training prisons are the normal prisons where most prisoners spend their time except may be the short term prisoners. Social and health needs here should be more organised since the seriously ill prisoners are already detected in the initial prisons or the local prison. Psychiatric disorders here are less because the prisoners are used to the prison life and are mostly not in confusion like the local prisons. Physical disorders may however rise due to physical bouts in the cells and fields. High security prisons are for the category A prisoners and those serving long term imprisonments.These prisons tend to have comprehensive health care services since there are older prisoners and present for longer. Mental health care is however very vital in these prisons due to the high number of reported depressions and pessimistic lives of the prisoners (Marmot 2010). Since most of them have committed major crimes and are also serving long lives, they are most likely to suffer from mental illnesses due to regrets and thoughts of retaliations. There are sixteen women prisons in the UK. They are also categorised into young offenders’ institutes, adult local prisons and adult training prisons (open and closed). When some are entirely women prisons, some are in wings of male prisons with separate living and sleeping areas. Women could be imprisoned far from their local areas due to the location of their prisons. Their specific health needs include maternity care, gynaecology, care of babies in the prison together with lots of health education for services such as family planning. Their admission rates to the establishments’ health care services are quite high compared to the other prisons or even normal people outside the prisons. This means that a lot of medical staff is needed in these prisons for mental, physical or emotional purposes. There are also social amenities like the sanitary pads that the government must also offer to the offenders always. The young offenders’ prisons are for ages between 15 and 21 and are run under the Young Offenders Institution Rules. They are further categorised into those whose inmates are predominantly juveniles and those who are 18 to 21. Young offenders institutes are either used as remand centres for those remanded by the courts or training prisons which could also be closed or open. These prisons do not call for excessive healthcare except for psychological guidance to the young minds. This is because many young offenders have emotional, temperamental and behavioural problems which could manifest suicidal or self harm behaviours (Acheson 1998). The needs of the prisoners are relevant to the wider community in many forms. When the prisoners are taken care medically, it is a great prevention to the community at large since otherwise the prisoners would be reservoirs of infections and chronic diseases. As we found out earlier, the prison is a highly populated and therefore diseases are most likely to erupt and if not treated inside the prisons the offenders would carry many diseases after release. The health disparity caused by physical and psychiatric disorders if not treated inside the prison could bring negative behavioural and socioeconomic conditions when the prisoner leaves the prison. The prisoners also learn to live drug free lives and also improve on their hygiene (Larkin 2009). This is an initial step in eradicating the spread of drug consumption within the community (Baggot, 2011). Ex- prisoners’ general knowledge on nutrition and hygiene translates to better health for his family and community. They are also more knowledgeable and would know how to deal with emergencies such as contagious diseases. With the mental illnesses it would be hard to co exist with the people out of prison but having addressed these issues before allowing the prisoner to interact with the community saves society unnecessary violence. In conclusion, when the prisoners are educated on vocational and life skills for purposes of self sufficiency, it not only improves their quality in life but also that of the community around them. There are fewer registered crimes in the community and country at large. Therefore, the benefits arising from catering to the social and health needs of prisoners are endless to the recipients and to their community. References Acheson Report 1998, Independent enquiry into inequalities in health, London, HMSO. Baggott, R 2011, Public health policy and politics, Palgrave, Macmillan. Brooker, C, Fox, C & Callinan, C 2009, Health Needs Assessment of Short Sentence Prisoners, Lincoln, University of Lincoln. Carr, S, Unwin, N & Pless-Mulloli, T 2007, An intoduction to public health and health policy, Buckingham, Open University Press. Harris, F, Hek, G & Condon, L 2007, “Health needs of prisoners in England and Wales: the implications for prison healthcare of gender, age, and ethnicity”, Health Soc Care Community, vol. 15 no. 1, pp. 56-66. Hemenway, D 2004, Private guns, public health, Ann Arbor, University of Michigan Press. Larkin, M 2009, Vulnerable groups in health and social care, London, Sage. Marmot review 2010, Fair society, helthy lives, strategic review of health inequalities in England. [Accessed 19 May 2013] . Ramsay, M, Bullock, T & Niven, S 2005, “The Prison Service Drug Strategy: The Extent to which Prisoners Need and Receive Treatment”, The Howard Journal of Criminal Justice, Vol. 44 no. 3, pp. 269-285. 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