Prison population: mental health needs

Appendix E. Qualitative methodology

Qualitative semi-structured interviews were conducted to address the corporate element of the health needs assessment through representation of the views of a range of professional stakeholders, and individuals with experience of prison and mental health needs and their carers.

The perspective of stakeholders with remits which afforded scope for implementation of recommendations or were concerned with shaping or monitoring HMP services were sought. Representatives from SPS with strategic, health, justice, and governance remits were interviewed alongside representatives providing third sector, legislative, and welfare oversight. Six executive and senior level stakeholders were interviewed.

The operational perspective was sought from among SPS and NHS staff based within prisons and who had caring roles and responsibilities. Representation was obtained from establishments across the four prison monitoring regions, including sites that housed, female, older offenders, and remanded individuals. Nine operational staff (7 NHS and 2 SPS) were interviewed.

Interviews were originally planned with five community-based individuals with experience of prison and mental health needs and their carers. Contributions from a group of individuals transferred from prison to the high secure State Hospital for treatment was also planned. The needs assessment's Research Advisory Group requested that 10 additional interviews be conducted with remanded and sentenced individuals resident within prisons. The continuing COVID-19 pandemic greatly affected both access to and engagement with community and prison-based individuals. Six interviews and a 'peer listening' exercise (group of three individuals) were conducted with people with lived experience of prison and mental health needs and their carers.

The topic guides were informed by issues highlighted by published reports concerning mental health within prisons and developed with input from the Research Advisory Group and Lived Experience Panel. The broadest topic guide for stakeholders explored; population needs and the extent to which they were being met; the reception process; medication and its delivery; the remand environment; attitudes towards the seeking of mental health support; service integration; lessons learned from the response to COVID-19; drug culture and mental health needs; how specific groups are supported; liberation; barriers to implementing recommendations; and observed service improvements.

In light of the pandemic all interviews were conducted and recorded using Microsoft Teams. Following transcription, the researcher added any additional notes and imported the document to NVivo 12 Pro for thematic analysis as outlined by Braun and Clarke (2006).