HMP – Healthy Male Prisoners?

Paul and Liam Leyhill

Mengage has recently been involved in delivering a male health course to prisoners at HMP Leyhill. Prison and health are two words that are not commonly associated with each other unless you happen to work in a prison healthcare setting, yet prisoners are adversely affected by health concerns in comparison to the rest of the population.  We believe that work that prevents illness and promotes wellbeing should be part of a healthy prisons landscape. Here we take a brief look at some of the concerns and the approach we took providing prisoners with an understanding of male health issues.

The statistics

A few statistics  provide evidence of the burden of health issues among the prison populace:

  •  As of the week ending April 29th, 2016, the UK prison population stands at 85,540 people, 81,729 of whom are male (1).
  •  According to the Men’s Health Forum, figures for 2014 indicate 72% of male prisoners suffer from two or more mental disorders (2)
  •  One third of deaths in custody (35%) are due to cardio-vascular causes  – the biggest cause of male death in the general population (3).
  • Approximately 80% of all prisoners smoke compared with 24% of the general population (3).
  • Blood-borne viruses affect a larger proportion of people in prison than the wider population; rates of illegal drug use amongst prisoners are higher than that of the general population (3).
  • Higher rates of sexually transmitted infections have been reported among prisoners compared to the general population (3).
  • Statistics also demonstrate that prisoners possess poor literacy and maths skills in comparison to the general population – education being a social determinant of health (4).

What can be done?

In comparison with the general population, male prisoners can be described as being at a disadvantage in terms of their health status, particularly their mental health – yet to use an old quote  “a loss of freedom should not constitute a loss of health”. So, what can be done? Providing prisoners with adequate primary healthcare is of course an  important part of health provision within HMPs, however preventative health work – informing prisoners about their own health, what influences and impacts upon their health, and importantly practical steps they can take to improve their own health in an accessible and easy to understand manner is also as important, both during their time in jurisdiction and in preparing for when they leave prison. Reinforcing the need for work that prevents ill-health and promotes well-being, Public Health England has stated that prison health services should work alongside other prison departments and include preventative health programmes addressing specific aspects of health (3).

For the past few weeks Mengage has been delivering a bespoke version of our Award in Male Health to a group of male prisoners at HMP Leyhill; the course – originally designed with a purpose of providing health professionals and others who work with men in a health capacity ( eg sports coaches) with an awareness of how to work on health issues with boys and men, was tweaked to include relevant information for prisoners and delivered with relevant activities to make it accessible to the group of men undertaking the course.

Too often men’s health discourses, particularly in the popular media, are limited by simplistic notions that men’s health is just about prostate and testicular cancers or mechanistic perspectives that consider male health to revolve around physical keep fit regimes and the cult of the six pack. All you need to do is to grow a moustache. Job done? Of course, good exercise and awareness of male-specific reproductive illness is part of male health work, but there’s more. How about talking about the positive things that can be done to improve health – talking about the value of education, improving life chances – and  lifelong learning? Or just having an interest – car maintenance , woodworking – something that keeps you active? How about the value of making and maintaining friendships and good social connections? How about advocating for male friendly services? How about the value of secure employment – and  employment that is safe and conscious of health? How about being a good role model to your children and peers? And what about things you can do to help to maintain your own mental health and enabling men to flourish? What about discussing how culture impacts upon our health? And of course the things we can do to maintain physical health – not smoking, staying within recommended alcohol limits, eating a good diet. All of these and more were covered in the Mengage course delivered at HMP Leyhill. If you want to find out more about this course please contact us.

And, whilst we’re advocating the value of a focus on preventative work, we were very impressed by the practical work of the Recoop project at the prison, working with older offenders;  comparisons could be made with men’s sheds in terms of activities generating supportive social connections and ongoing  support for men seeking rehabilitation. We need to see more health improvement work that supports prisoners and assists them in their rehabilitation into wider society – not only providing awareness of concerns such as smoking, diet, and other aspects of physical health, but also awareness of the associated social and economic factors that impact on their lives – and the things that they can do to overcome these.  Improving prisoners health and addressing these factors is beneficial, not only for prisoners, but also for their families, their communities and wider society. More please.

References

(1) The Howard League. Weekly Prison Watch.

(2) Men’s Health Forum. Statistics on mental health and men.

(3) Public Health England. Health and Justice Health Needs Assessment Template: Adult Prisons.

(4) Prisoners Education Trust.