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Welcome to the EuroPris Knowledge Management System. The table below shows questions and responses from European National Agencies. Select a question for more information or use the filters on the left to narrow down questions based on Agency or Category.
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Introduction: The MenACE project aims to increase the response to mental health disorders within prisons and the quality of palliative and end of life care services by enhancing the competences of management and frontline staff. One objective is to gather approaches, lessons learned and practices in the field of mental healthcare, palliative care, and geriatrics in European prison services. We now kindly ask you to contribute to this collection of practices by answering the questions below. For more information about the project, see www.menace-project.org.
Doctors psychiatrists work at healthcare units at 8 (out of 10) prisons. The Central prison hospital provides in-patient psychiatric services. Inmates with physical disabilities or special needs (i.e. who need assistance at home, who can’t wash up or eat on their own or need active medical care) are accommodated at the Social care unit of Alytus Correction House. Inmates accommodated at the unit are more often visited by medical staff, if necessary each inmate in need has an assistant. In cases palliative care or rehabilitation is necessary, inmates are transferred to the Nursing and supportive care unit of the Central prison hospital.
Based on current practices you are aware of in other prison agencies, which would you highlight as best practice in the mentioned fields?n/a
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According to what is called The principle of normality, there is no obligation for the PPS to provide health care. Our inmates has the same right to health care from the general health care systems as all other inhabitants in Sweden. Due to practical and security reasons we provide some open health care. That means that all prisons and remand prison has access to at least one nurse and a general practitioner. Almost every remand prison and about two thirds of the prisons also have access to psychiatrists. This implicates that mental health problems that doesn´t need observation by mental health staff for 24 hours, needing for coercive treatment or by other reasons need the staffing and resources of a hospital can be handled in PPS. Palliative care or problems with aging can be handled by the same principles. In certain prisons there are arrangements for wheelchairs, beds with lift, assistance by personal hygiene, assistance by feeding that carries out our problems for the day. But there are not resources for intravenous supplies of nutrition, treatment with intravenous or intramuscular pharmaceuticals outside daytime working. When in need for that the patient is referred to the general health care systems.
Based on current practices you are aware of in other prison agencies, which would you highlight as best practice in the mentioned fields?I think that ion England the department of Health provide economic support to the Department of Justice to buy health care for the inmates. In New Zeeland there is a system where PPS could boy places in psychiatric clinics to guarantee the inmates the mental health care their needs require. In Sweden we often disagree with the general healthcare systems how our inmates needs best should be fulfilled.
As an example of good practice – the fact that psychiatric care in prisons is organized in two stages. The first stage includes prison psychiatrists who provide counselling, treatment, supervision, support treatment or send prisoners, if necessary and in more difficult cases, for further diagnosis, counselling and treatment to the Latvian Prison Hospital. The second stage - the psychiatric department of the Latvian Prison Hospital takes care of acute cases and makes further diagnosis and inpatient treatment. Following the discharge from the hospital, recommendations are provided to prison psychiatrists on supervision and support therapy. From the point of view of a medical doctor (internist) working in the Latvian Prison Hospital, one issue regarding older prisoners and prisoners with terminal illness and prisoners serving long-term and life sentences – life in prison can challenge anyone, but particularly old ones who suffer from chronic illnesses, are extremely ill, and need very cost effective treatment from wheelchair to walkers to special transport in case they need to be transferred to specialized hospitals; so taking that in consideration, the team in the Hospital is working on gaining and granting early conditional release to elderly and critically ill prisoners who pose little risk to public safety.
Based on current practices you are aware of in other prison agencies, which would you highlight as best practice in the mentioned fields?In Estonian prison and prison hospital, they provide more compassionate and palliative care practices in prison helping to cope and adjust to prison life, for example in addition to medical treatment, the prisoners have a chance to work or do some jobs in the prison, have a chance to get an individual space to live to maintain family contact by using the family visiting program.
According to the Law on the Enforcement of the Prison Sentence inmates shall be granted medical treatment and regular care for their physical and mental health. Each prison/penitentiary and penitentiary has medical ward to provide general healthcare for prisoners while more complexed medical examinations and interventions are provided in prison hospital or in civil hospitals (outside the Prison System). Elderly prisoners who request palliative care as well as prisoners with chronic illnesses who need additional care are allocated to the prison hospital where they are treated in line with medical indications. In line with security assessment elderly prisoners who don’t need specific healthcare are as a rule allocated to regular prisons and penitentiaries (closed, semi-open and open) but on wards which are more adjusted to their needs. Criminal Law provides that offenders with reduced criminal responsibility (limited mental incapacitation) can be punished by imprisonment together with security measure of compulsory psychiatric treatment which is carried out in the prison system (stationary in the prison hospital and outpatient in prison/penitentiary). This security measure can’t last longer than the sentence itself and it is subjected to a court review once a year. Other mental health issues, including substance addiction and/or behavioral addictions are treated in prisons/penitentiaries or in prison hospital (depending on severity of mental problem) by teams of specialists lead by psychiatrist. All prisoners who request stationary medical treatment are allocated to prison hospital
Based on current practices you are aware of in other prison agencies, which would you highlight as best practice in the mentioned fields?We are not familiar with practices of other jurisdictions in the field of prisoners’ mental healthcare, palliative care, and geriatrics.
Healthcare Services within prisons in Northern Ireland are provided through the South Eastern Health and Social Care Trust. This includes physical and mental health care and palliative care. We have a specific landing in one prison which has been enhanced to provide more suitable accommodation for older prisoners, together with a range of activities that are designed for older prisoners. This landing also has a limited facility to support those who require end of life services in prison.
Based on current practices you are aware of in other prison agencies, which would you highlight as best practice in the mentioned fields?HMP Whatton which is a prison within the UK’s Her Majesty’s Prison and Probation Service caters specifically for sex offenders and house a high number of older prisoners. It has an excellent palliative care facility in-house.
Norway has organized some of the services in prison different from most other European countries. Health services (both mental health and somatic) are “imported” services from the health service in the municipality or from the specialized health service. This means the provider of a service in the community also provides the service in prison. But – there is a close cooperation between the Correctional Service and the Health Service, which for instance has resulted in specialized units in some prisons – where health personnel and the prison officers are working together with drug addicted inmates. When inmates in Norway are in need of palliative care or geriatric services, they will usually be transferred to a hospital/institution giving palliative or geriatric services. According to the Norwegian Execution of Sentences Act there are – if some conditions are fulfilled - possible to transfer prisoners to hospitals/institutions and the rest of the sentence will be served there.
Based on current practices you are aware of in other prison agencies, which would you highlight as best practice in the mentioned fields?-
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Geriatrics (Older People): PHE Guide to Undertaking a health and social care needs assessment of Older People in prison – there also some example of good practice in this guide https://www.gov.uk/government/publications/health-and-social-care-needs-assessment-of-older-people-in-prison
Based on current practices you are aware of in other prison agencies, which would you highlight as best practice in the mentioned fields?PHE have published Women in prison: standards to improve health and wellbeing - these standards provide an approach for improving the health and wellbeing of women in prison and a have a detailed section on improving mental health and reducing suicides and self-harm. https://www.gov.uk/government/publications/women-in-prison-standards-to-improve-health-and-wellbeing PHE has published a guide to support Better care for people with co-occurring mental health and alcohol/drug use conditions - A guide for commissioners and service providers in community and criminal justice settings https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/625809/Co-occurring_mental_health_and_alcohol_drug_use_conditions.pdf