Awareness of the health needs of prisoners

This study reports on a small scale survey among discipline officers in three prisons in Wales to try to estimate the extent of their knowledge about health problems among prisoners; how they glean information, and how they communicate with prison healthcare staff. The results indicate that these officers are concerned for inmates' welfare, are knowledgeable about, and are competent to identify and handle, problems of physical health. By contrast, they find mental health problems unpredictable and mystifying, and are not confident that in the prison context professionals can solve those problems. Discipline officers are well placed to act as front-line health surveillance staff and feel that they communicate well with healthcare staff. However, they feel that information does not flow freely in the opposite direction, and are concerned about the problems that arise from healthcare staff adhering to the 'medical in confidence' principle by which information on a prisoner's condition should not be shared outside strictly professional health-care groups, thus excluding discipline groups. In trying to elaborate on our results by looking at two recent review papers on mental health in prisons, we discovered that it is not clear exactly how prevalent such problems are: there is no evidence to contradict the views of the discipline officers, yet some to support them.