Health In Prisons - World Health Organization
Health in prisonsA WHO guide to the essentials in prison health
Health in prisonsA WHO guide to the essentials in prison healthEdited by: Lars Møller, Heino Stöver,Ralf Jürgens, Alex Gatherer and Haik Nikogosian
Promoting health in prisonsThe essentialsAbstractBased on the experience of many countries in Europe and the advice of experts, thisguide outlines some of the steps prison systems should take to reduce the publichealth risks from compulsory detention in often unhealthy situations, to care forprisoners in need and to promote the health of prisoners and staff. This especiallyrequires that everyone working in prisons understand well how imprisonment affectshealth and the health needs of prisoners and that evidence-based prison healthservices can be provided for everyone needing treatment, care and prevention inprison. Other essential elements are being aware of and accepting internationallyrecommended standards for prison health; providing professional care with the sameadherence to professional ethics as in other health services; and, while seeing individual needs as the central feature of the care provided, promoting a whole-prisonapproach to the care and promoting the health and well-being of those in custody.KeywordsHEALTH PROMOTION – organization and administrationHEALTH SERVICES – standardsPRIMARY HEALTH CARE – standardsPRISONSPRISONERSQUALITY OF HEALTH CAREHEALTH PLANNING GUIDELINESEUROPEEUR/07/5063925ISBN 978 92 890 78209Address requests about publications of the WHO Regional Office for Europe to:PublicationsWHO Regional Office for EuropeScherfigsvej 8DK-2100 Copenhagen Ø, DenmarkAlternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site(http://www.euro.who.int/pubrequest). World Health Organization 2007All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission toreproduce or translate its publications, in part or in full.The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or areaor of its authorities, or concerning the delimitation of its frontiers or boundaries. Where the designation “country or area”appears in the headings of tables, it covers countries, territories, cities, or areas. Dotted lines on maps represent approximateborder lines for which there may not yet be full agreement.The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors andomissions excepted, the names of proprietary products are distinguished by initial capital letters.The World Health Organization does not warrant that the information contained in this publication is complete and correctand shall not be liable for any damages incurred as a result of its use. The views expressed by authors or editors do not necessarily represent the decisions or the stated policy of the World Health Organization.
Promoting health in prisonsThe essentialsContentsForeword viiPreface viiiContributors xDefinitions xvi1.Introduction 1Who this guide is for 1How to use this guide 1The essentials and important first steps 1Political leadership 2Management leadership 3Leadership by each member of the staff 4The special leadership role of health personnel 4Partnerships for health: (1) the role of prisoners 5Partnerships for health: (2) community support 5References 52.Standards in prison health: the prisoner as a patient - Andrew Coyle 7The basic principles 7The relationship between the prisoner and health care staff 8The organization of prison health care 9European Prison Rules 11Conclusion 12References 12Further reading 133.Protecting and promoting health in prisons: a settings approach - Paul Hayton 15Introduction 15Major problems that need to be addressed 15The whole-prison or settings approach and a vision for a health-promoting prison 17References 20Further reading 204.Primary health care in prisons - Andrew Fraser 21Introduction 21The components of primary care 24The journey of primary care 24Prison health care resources 25Common problems encountered in primary care practice in prisons 26Building blocks for primary care in prison 26Measuring performance in health care 27Conclusion 30References 31Further reading 315.Prison-specific ethical and clinical problems - Jean-Pierre Restellini 33Introduction 33Health care staff in prison 34Disciplinary measures 35Physical restraint 36Intimate body searches 36iii
Promoting health in prisonsThe essentialsPrisoners who stop eating or go on hunger strikes 37Torture and inhumane or degrading treatment 40Conclusions 41Reference 41Further reading 416.Communicable diseases - Dumitru Laticevschi 43Introduction 43Bloodborne diseases 45Tuberculosis 47Sexually transmitted infections 50Skin conditions 56Infectious diseases of the digestive tract 57Reference 58Further reading 597.HIV infection and human rights in prisons - Rick Lines 61Setting the context: HIV-related stigma and discrimination in prisons 61Confidentiality in prison 62HIV testing and pretest and post-test counselling 64 Coercive approaches are counterproductive 65Addressing concerns about trust and confidentiality: working with nongovernmental organizations,people living with HIV, peers and professionals outside the prison system 68Compassionate or early release 69Conclusion 69References 70Further reading 708.Tuberculosis control in prisons - Jaap Veen 73Introduction 73What is tuberculosis? 74What can be done to reduce the risk of transmission of tuberculosis? 76How to manage tuberculosis cases 79Treatment 79How should tuberculosis services in the penitentiary system be organized? 80Conclusion 82References 82Further reading 839.Drug use and drug services in prisons - Heino Stöver and Caren Weilandt 85Drug use and the consequences for prisoners, prisons and prison health care 85Definition of a drug user 87Nature and prevalence of drug use and related risks in prisons 88Prevention, treatment, harm reduction and aftercare 90Organization and practice of health care, treatment and assistance 91Assessment of drug problems and related infectious diseases 94Preventing drug use 95Detoxification 95Drug-free units 97Contract treatment units and drug-free units 97Abstinence-oriented treatment and therapeutic communities in prison 98Substitution treatment 99Counselling and peer support 100Harm reduction programmes 101Involvement of community services 105Vocational training 109References 109Further reading 11110.Substitution treatment in prisons - Andrej Kastelic 113Introduction 113What is substitution treatment? 114The main goals of substitution treatment 115Evidence of the benefits of substitution treatment 116Effective treatment 120iv
Promoting health in prisonsThe essentialsCriteria for treatment and treatment plan 121Risks and limitations 122Substitution agents 122Some basic information about treatment 126The link with treatment for HIV infection 128Special considerations for women 128Future perspectives 129References 129Further reading 13011. Mental health in prisons - Eric Blaauw and Hjalmar J.C. van Marle 133Mental health and mental illness in prisons 133Mental harm reduction and mental health promotion 134Levels of care 135Basic circumstances 137Staff training 139Conclusion 141Mental health promotion in prisons: a checklist 141References 14412. Dental health in prisons - Amit Bose and Tony Jenner 147Introduction 147Dental health needs in prisons 148Challenges in providing dental care to prisoners 148Oral health promotion 149Organization of prison dental services 150Models of good practice 151Conclusion 155Further reading 15513. Special health requirements for female prisoners - Jan Palmer 157Introduction 157Mental health problems 158Suicidal behaviour in prisons 159Substance use 161Pregnancy 164Children 165Sexually transmitted infections 166Bloodborne viruses 166Violence 166General health issues 167References 169Further reading 16914. Promoting health and managing stress among prison employees - Heiner Bögemann 171Introduction 171Research on the health of prison employees 172Risk factors and stress among prison employees 172Frequent psychosocial risk factors in prisons 173Promoting and developing employees with health in mind 174Practical approaches to health promotion: best practices 174Comprehensive health promotion for prison employees 175Example of a health in prison project with important milestones 175Essentials for active health management in prisons 176Health promotion self-help networks in prisons 177Continuing education 178Results and prospects 178References 179
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Promoting health in prisonsThe essentialsForewordA continuing challenge in public health is to get services to the people who needthem the most, especially those who are hardest to reach. Yet it is a sad reality of lifethat, at any one time, a high proportion of those with multiple health problems areincarcerated in the prisons of each country. They are certainly reachable, for acertain period at least.For more than a decade, WHO has had a network of countries of the Europeanregion (with more than 30 countries now involved) supported by senior representatives approved at the ministerial level that gather to exchange experiences andevidence on how best to make prisons healthier places for staff as well as prisoners. The detection of serious communicable diseases such as HIV infection andtuberculosis, accompanied by adequate treatment and the introduction of harmreduction measures as necessary, contributes significantly to the health status ofthe communities from which the prisoners come and to which they return. In addition, it is now known that substance dependence can satisfactorily be treated inprisons. The many imprisoned people who have mental health problems can alsobe helped.More recent developments include the real possibility that the time in custody canbe used to promote healthier lifestyles, with better control over smoking and alcohol and perhaps over the use of violence in interpersonal relationships. An information database has been developed to obtain a measure of progress throughout theEuropean region.I commend this guide as a worthwhile way of reducing the risks to public healthfrom inadequate services and as a way of promoting health and welfare amongsome highly disadvantaged people. This can contribute to reducing inequity inhealth.It is increasingly being recognized that good prison health is good public health.Dr Nata MenabdeDeputy Regional DirectorWHO Regional Office for Europevii
Promoting health in prisonsThe essentialsPrefaceOne of the strongest lessons from the end of the last century is that public healthcan no longer afford to ignore prison health. The rise and rapid spread of HIV infection and AIDS, the resurgence of other serious communicable diseases such astuberculosis and hepatitis and the increasing recognition that prisons are inappropriate receptacles for people with dependence and mental health problems havethrust prison health high on the public health agenda. As all societies try to copewith these serious health problems, it has become clear that any national strategyfor controlling them requires developing and including prison policies, as prisonscontain, at any one time, a disproportionate number of those requiring healthassistance.Good prison health creates considerable benefits. It prevents the spread of diseasesand promotes health through awareness of what everyone can do to help maintaintheir own health and well-being and that of others. In addition, however, it can helpto improve the health status of communities, thus contributing to health for all.This guide gives practical information and advice on how to achieve good health inprisons. Its advice is based on evidence of what works best, and the advice comesfrom selected experts with considerable knowledge of and experience in the specialneeds of prisons and places of compulsory detention. It outlines what is knownnow, but care will be taken to get regular feedback from those who wrote it andthose who are using it, so that the guide can be updated regularly.All prisons are different, but they share common challenges. Countries vary considerably in the resources available for improving prison services. The current positionof prison health services varies substantially in prisons throughout the world. Somecountries with basic or rudimentary services will need support to introduce theapproaches indicated in this publication. Others are in more favourable positions.But we believe that all countries will find some areas of their prison health servicesthat could be improved and will gain from careful consideration of this guide.To address prison health in Europe in a multidisciplinary fashion, we approached16 authors with expertise in both prison and public health and asked them to drafta chapter that covered the most important areas of prison health, the close connection with public health and looking ahead. We are very pleased that all the authorsresponded so effectively to our request.viii
Promoting health in prisonsThe essentialsThe Editorial Board comprised: Jonathan Beynon, International Committee of the Red Cross, Switzerland; Alex Gatherer, Health in Prisons Project, WHO Regional Office for Europe; Paul Hayton, Prison Health, Department of Health, United Kingdom; Haik Nikogosian, Division of Health Programmes, WHO Regional Office forEurope; Eva Koprolin, Pompidou Group, Council of Europe, France; Marzena Ksel, Prison Health Services, Poland; Lucia Mihailescu, General Directorate of Penitentiaries,
The relationship between the prisoner and health care staff 8 The organization of prison health care 9 European Prison Rules 11 Conclusion 12 References 12 Further reading 13 3. Protecting and promoting health in prisons: a settings approach - Paul Hayton 15 Introduction 15 Major problems that need to be addressed 15 The whole-prison or settings approach and a vision for a health-promoting .
Findings paper Life in prison: Living conditions 3 Introduction Some people may feel a sense of déjà vu or world-weariness when they hear repeated accounts of poor conditions in our prisons. Many reports from HM Inspectorate of Prisons (HMI Prisons) have pointed out that, all too often, prisoners are held in conditions that fall short of what most members of the public would consider as .
TUBERCULOSIS IN PRISONS: A PEOPLE'S INTRODUCTION TO THE LAW 4 INTRODUCTION T his is the issue: Tuberculosis (TB) in prisons is a crisis all around the world and right now those of us who fight for justice and human rights are not winning. But prisons systems must change; we have to win because lives depend on it.
Although private prisons do compete with public prisons, the extent to which private firms compete with each other for prison contracts is fairly minimal because there are few firms in the business.
CHAPTER 19 THE FEDERAL BUREAU OF PRISONS By Todd Bussert1 19.01 INTRODUCTION The Federal Bureau of Prisons (Bureau or BOP) is the country’s largest correctional system. As of 2016, approximately 196,000 prisoners are under the agen
U.S. Department of Justice Federal Bureau of Prisons P R O G R A M S T A T E M E N T OPI: OGC/ELE NUMBER: 3420.11 DATE: 12/6/2013 Standards of Employee Conduct /s/ Approved: Charles E. Samuels, Jr. Director, Federal Bureau of Prisons 1. PURPOSE AND SCOPE To provide policies and proc
DOL - Department of Labor VT - Vocational Training FEDERAL BUREAU OF PRISONS Friday, March 31, 2017 03:23:12 PM Page 2 of 312 . Horticulture 6 0 / 43 Location: Camp Farming, Fishing, and Forestry - Agricultural Workers . Electrician Tech FEDERAL BUREAU OF PRISONS Friday, March 31, 2017 03:23:12 PM Page 7 of 312 .
Investigating Performing Arts in Prisons Performing arts have become a growing worldwide presence in prisons over the past 30 years. Increasing numbers of theatre, music, dance, performance poetry, opera and film programs are being facilitated with both male and female prison inmates in diverse secure settings. They
of death—the land of the dead is associated with graves and prisons. Opposition to prisons is a proclamation of the resurrection, that life has overcome death. Prison abolition isn't just a "nice progressive cause" for Christians to take up because it's morally right. (Although our prisons are deeply cruel and immoral
