Challenges in Prison Health Post-COVID: Insights from User Voice

Through extensive consultations with over 11,000 residents, including 1,000 in prisons with health councils, user voice highlights issues in mental healthcare, access to medication, and substance misuse services post-COVID. A significant portion of residents face challenges in obtaining mental health support, accessing necessary medications, and dealing with substance misuse problems. Residents express feeling isolated, stressed, and neglected, emphasizing the need for enhanced support services and consistent access to essential healthcare resources in the prison system.

• Prison health
• Mental healthcare
• Medication access
• Substance misuse
• User voice

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1. PRISON HEALTH COMING OUT OF COVID SOLUTIONS FROM THE USER VOICE #ComingOutOfCovid

2. We spoke to over 11,000 residents, 1,000 specifically in prisons with health councils, since the pandemic began in March 2020 0800 number Face-to-face Virtual meetings Email

3. Mental Healthcare THE ISSUES Substance Misuse Services Access to Medication

4. 1 IN 4 WHO CONTACTED USER VOICE COULDN T GET THE MENTAL HEALTH SUPPORT THEY NEEDED RESIDENTS FELT MORE ISOLATED AND STRESSED DURING COVID-19 more isolated more frustrated I tried to hang myself and no one has bothered to come and see me We need more free call lines for prayers, mental health, domestic violence, general counselling 24/7 not just use of inhouse mental health team for only high risk residents We asked residents how they felt in comparison to before the lockdown 87% 83% Suffer from mental health and nobody believes me not seen anyone from MH since lockdown and the staff don t understand I need my medication reviewing more stressed more worried Still not heard from mental health feeling suicidal cannot take it no more feel hopeless 63% 80%

5. DIDNT DO AN APPOINTMENT JUST STOPPED THEM They re stopping my meds by healthcare, they didn t do an appointment just stopped them like that been 6 weeks I ve been putting apps in to see doctor for 6 weeks MEDICATIONS 16% felt that medication was the biggest issue in prisons I AM NOT GETTING THE CORRECT MEDS I am not getting the correct meds for my clots on my lungs, the doctor said he d sort it months ago. please help me I HAD TO SIT AND WITHDRAW FOR 14 DAYS I have come into the prison on 400mg of pre gablin and valium and they have just taken me off everything its just not a I had to sit and withdraw for 14 days without any support NOBODY WILL LISTEN I have schizophrenia and my medication has been halved and some stopped so now my behaviour has changed and nobody will listen MEDICATION ALWAYS RUNNING OUT AND TAKES AGES TO COME

6. SUBSTANCE MISUSE Cycle of debt, violence, bullying and self harm there are people who have debt or unfinished business that s on hold for now but it could get pretty nasty. 57% I think there may be an increase in violence when debts are called in, POs need to be aware stated they had received no substance misuse support during the lockdown. Some have been unable to access drugs during this time, while others have turned to them to cope with the negative effects of spending most of their day locked in their cell. Considered a missed opportunity by some, many of whom were also struggling with their mental health where support had been reduced. I think it s a missed opportunities; I think Christ someone like me right now I'm ideal, I'm there, I m a prime target for it but there's nothing there. See User Voice Report Banged Up: Out of Sight but Not Out of Mind (2020) for more information

7. PRISON HEALTH COMING OUT OF COVID SOLUTIONS FROM THE USER VOICE #ComingOutOfCovid

9. Peer training and education PUT POWER IN THE HANDS OF THE PEOPLE THAT NEED IT Intensive training IF PEER LED INITIATIVES WERE INVESTED IN, SERVICES WOULDN T HAVE STOPPED DURING COVID Space to do training/ education Supported by prisons Invest Recognised qualification

10. Peer led self-help groups/one-to- one support Peer led Coming Out Of Covid Campaign 68% of residents stated that they never found any messaging from harm reduction materials helpful. Needs to be a priority Prison s need to facilitate and support it Provide safe spaces where it can take place Certified and effective training from qualified individuals Train the trainer allows prisoners to train others Lived experience leaflets stories of prisoners Word of mouth Wayout TV, Prison Radio See User Voice Report Banged Up: Out of Sight but Not Out of Mind (2020) for more information

11. PRIORITISE PRISONER WELLBEING & BUILD ACCOUNTABILITY Clear leadership over wellbeing of prisoners Campaign in prison culture and staff culture about wellbeing Robust focus on wellbeing

12. Policy PARTNERSHIP AT ALL LEVELS OF THE CRIMINAL JUSTICE SYSTEM Procurement Service design Service evaluation