Transcript Meeting the Health Needs of Offenders Dave Spurgeon Research

Meeting the Health Needs of
Offenders
Dave Spurgeon
Research & Development Manager,
Nacro
Transforming Rehabilitation
Dave Spurgeon, Research & DVE
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.
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Most of what is known about the health needs of offenders relates mainly to studies and prevalence
data collected in prison.
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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
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.
Substance Misuse
Drug Related Deaths
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.
High Prevalence of
disease: mental health
Prisoners often have higher prevalence of
mental health problems and behaviours,
including personality disorder, depression and
psychosis.
Learning Disability
Smoking prevalence
Physical health needs
Infectious diseases:
BBV/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.
Barriers to engagement
 Not registered with a GP practice
 Not engaged with services and/or services disengaged with the person
 Multiple needs – doesn’t 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
Dave Spurgeon
Research & Development Manager
Nacro, Park Place, 10 – 12 Lawn Lane
London SW8 1UD
[email protected]
[email protected]
Tel: 07856 740679