Put health at the heart of prison life academics advise

The paper, which has been published in a special edition of the journal, Criminal Justice Studies, was led by Dr James Woodall, Co-Director of the Centre for Health Promotion Research at Leeds Metropolitan University, and suggests that the current system of treating only immediate health needs is not sufficient for prisoners to begin leading healthier lives.

Dr Woodall said: "The majority of prisoners spend a very short time in prison, around six months, and then return to the community. The vast majority of prisoners in HMP Leeds, for example, are from West Yorkshire; so by thinking in terms of supporting and enabling prisoners to take control of their lives whilst in prison this can have a positive knock-on effect on public health in our region."

Prisoners generally have very poor health, with mental and physical health problems, substance misuse and social exclusion being widespread. Furthermore, a third of the prison population are homeless and more than two-thirds are unemployed prior to their imprisonment. Dr Woodall argues that just treating disease in prison is not enough: "We need to think more holistically about prison and offender health and move away from a solely disease-based focus to one which focuses on supporting all areas of health and wellbeing."

The research team, which included Dr Nick de Viggiani at the University of the West of England as well as Leeds Metropolitan University's Professor Rachael Dixey and Professor Jane South, argue that health should be at the heart of a prison's culture, including considering architecture, policies, ethos, social structures and prisoner-staff relationships. They also recommend that action needs to be taken to work more collaboratively with agencies in the community to address the deprived environments that the majority of prisoners were brought up in and will return to.

Examples seen in England and Wales such as prison councils and formal peer intervention schemes allow prisoners to discuss issues and be listened to, leading to improvements in prison culture and making prisoners feel supported and empowered, reducing the hostile and bullying culture which is detrimental to health and wellbeing. Other examples of developing personal skills cited in the study are practical life and social skills training, including parenting courses and learning about the prevention of sexually transmitted diseases.

Dr Woodall added: "People in prison can be viewed in two ways - as 'citizens in prison' or as prisoners. A contemporary prison system should embrace the former rather than the latter and equip individuals with the necessary skills to reintegrate successfully back into society."