People in prison's health needs: easy read version

A report about the health needs of people in prison - Easy Read

The Scottish Government asked 4 organisations to find out about people's health needs in prisons.

It wanted to find out about people in prisons and the support they need with:

• body health
• mental health
• social care
• substance use

In this document substance use means things like taking:

• alcohol
• drugs
• tobacco

The organisations wrote 4 reports.

The 4 reports were collected together and made into 1 main report.

This is the Easy Read copy of the main report. A link to the full report "Understanding the Needs of Scotland's Prison Population" can be found here Understanding the Needs of Scotland's Prison Population.

What we found out

1. Choice of services across all prisons

Not everyone in a prison can get the support they need.

Especially people who need more than 1 type of support.

It is difficult for services to work together to help people in prisons.

Often support is only offered when there has been a crisis.

These things should happen

• the NHS and the Scottish Prison Service should have the same idea of what good care looks like

• organisations who make decisions and give health care and support should work well together - this is called a partnership

• funds for health and care services should be right for each prison's size

2. Sharing Information

It was difficult for all 4 organisations to get information about the health of people in prisons.

This was because there were many different kinds of computer programmes holding information.

Not enough information is being shared between:

• courts and justice
• health care
• social work
• organisations like charities

Sometimes information is being shared well between:

• health care teams in prisons
• health care teams outside of prisons

Information is harder to share where:

• someone is moving from 1 prison to another prison
• someone is leaving prison
• the prison is in a different area to where they usually live

This means that people moving to a prison sometimes don't get their medicines quickly enough.

These things should happen

• make a new system which joins together all the health information about each person in prison

• make sure that different organisations supporting a person in prison follow the same clear way of working

• make sure that health records are passed to the next place when someone moves from a prison

3. Getting the services needed

Many people in Scotland's prisons have more than one health condition.

This makes health conditions and difficulties harder to deal with.

When someone comes to prison they will be very stressed.

They might not feel able to answer health questions at this time.

It would be better to wait a few days and take a closer look at each person's needs.

There is not enough transport and staff to get people in prison to their specialist care appointments.

Specialist care means getting support from staff who:

• work with people who have a health condition
• know a lot about that health condition

Something which has really helped people get specialist care is having online meetings by video.

More video meetings happened because of the COVID-19 pandemic.

It is easier because there is no need to take someone in or out of prison.

Some groups of people in prison have more health needs than others.

There are more mental health conditions in:

• younger people
• women

There are more physical health conditions in:

• white people
• women
• people older than 50

There are groups that miss out on services and support like:

• people who are waiting for their court hearing to happen
• older people

These things should happen

• do a review of how people in prison are taken to clinics for health care appointments

A review means a close look at something to see what is working well and what needs to change.

• use more technology to offer more online video meetings

• have a second assessment a few days after someone comes to a prison to have a closer look at their health needs

4. Staff

Lots of different staff work to support people in prisons.

These are people like:

• nurses
• doctors
• pharmacists
• mental health specialists
• office staff
• consultants
• prison officers
• social workers
• charity workers
• dentists
• opticians

There needs to be enough staff so that people in prisons can get the support they need.

COVID-19 made things extra hard because many staff members had to stay at home at different times.

Some staff leave because:

• they are being asked to do too much work
• they don't feel valued

Things that might help are:

• make it clear how working in health care in prisons can be a good and long career
• support staff with their own health and wellbeing

There is good staff training.

But it's not always possible for staff to take part in training if there are too few staff working.

Some types of health care don't have enough training courses.

This leaves gaps in care for some prisons.

Everyone who is new to working in prisons should have to do training in:

• which groups in prison need more health care support
• mental health
• trauma
• the different services
• how to get these services

Trauma is when something happens in your life that is frightening and it affects your mental health.

These things should happen

• make changes so that more staff want to stay working in prisons

• make sure there is training for all new staff working in prisons

5. Facilities

In this document facilities mean spaces, rooms and equipment.

Some prisons don't have enough rooms for health care work.

This was even harder during COVID-19 when people had to stay further apart.

Many prison buildings are old.

They are not accessible for people who use wheelchairs or find it hard to move about.

Now lots of people in prison are older and find it hard to move about.

Putting in accessible things – like hoists, ramps and medical equipment – is expensive.

People with lived experience of prisons say having these things is important:

• seeing daylight
• exercise that is different from using the gym
• a good place to stay after leaving prison

These things should happen

• give more money to prisons so that more space can be made for health care

• spend money on making prisons more accessible

• a review to make sure that prison buildings are right for:
  • disabled people
  • people who can't move easily
  • people who are close to the end of their life

• support people in prisons to find a good home before they leave prison

This is the end of the Easy Read report.

Copyright images © Photosymbols. Produced for the Scottish Government by Disability Equality Scotland.