Meeting the Health Needs of Offenders

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Meeting the Health Needs of Offenders Dave
Spurgeon Research Development Manager, Nacro
Transforming Rehabilitation Dave Spurgeon,
Research DVE
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Background

• Offenders are one of the least healthy most
  socially excluded groups in society.
• Many have complex or multiple needs.
• While many of these needs may be sub-threshold
  to access individual services/provision taken
  together they present a picture of considerable
  need and risk of harm to self or others.
•  
• Addressing the health inequalities can have a
  positive impact of reducing offending and
  re-offending and reducing social exclusion.
•  
• Most of what is known about the health needs of
  offenders relates mainly to studies and
  prevalence data collected in prison.
• However, 2 studies on offenders on probation
  caseloads show health inequalities significantly
  worse than the general population the health of
  female offenders is both significantly worse than
  their male counterparts and the general
  population

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Higher Mortality Rates

• Data on all cause mortality among current and or
  ex-prisoners is difficult to identify and
  collect
• However, in jurisdictions where such collections
  are possible, dramatic differences are evident
  between current or former prisoners and general
  population in relation to all cause mortality as
  well as accidental death and suicide.
• Data from the UK is shown as example.

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Substance Misuse
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Drug Related Deaths
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Mortality rates suicide

• Suicide rates are higher in prison populations
  than among peers in the community.
• WHO data shows a suicide rate which ranges from 0
  (0.0) to almost 300 (0.3) per 100,000
  prisoners, with an average of about 60 (0.06)
  per 100,000 in the 47 WHO European Member States
  that belong to the Council of Europe.
• Data from the UK is shown as an example.

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High Prevalence of disease mental health
Prisoners often have higher prevalence of mental
health problems and behaviours, including
personality disorder, depression and psychosis.
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Learning Disability
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Smoking prevalence
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Physical health needs
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Infectious diseasesBBV/HIV infection

• Many prison populations have high prevalence of
  infection with blood-borne viruses (BBVs)
  (Hepatitis B C) and HIV due to large numbers of
  injecting drug users (IDUs) among incarcerated
  populations
• Some evidence of onward transmission of infection
  in some European states due to injecting of
  drugs, tattooing and unprotected sexual activity-
  although definitive data is difficult to find.

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Barriers to engagement

• Not registered with a GP practice
• Not engaged with services and/or services
  disengaged with the person
•  
• Multiple needs doesnt reach threshold for
  individual services treated in silos and not
  holistically
•  
• Complications of funding and/or commissioning
•  
• Health and care not integrated
•  
• Offender label denies access to services and/or
  increases risk
•  
• No accommodation, no health provision
•  
• Difficulties re continuity of care through the
  gate and post-release

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• Dave Spurgeon
• Research Development Manager
• Nacro, Park Place, 10 12 Lawn Lane
• London SW8 1UD
• Dave.spurgeon_at_nacro.org.uk
• davespurgeon_at_blueyonder.co.uk
• Tel [phone]