Women’s health in prison

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Presentation transcript:

Women’s health in prison By Ingrid Lycke Ellingsen Spec. psychiatry

Women – a neglected minority in the prison context? 2-10 % of the total prison population. Women seek medical attention more often than men. Women have, in addition to common ailments, different gender-specific problems/disorders.

Why are female detainees seeking the medical service more often than male? Has the prison environment a greater negative impact on women than men?

Overcrowding Malnutrition Lack of hygiene General weakness Insufficient water Drinking Washing Toilets Flies and mosquitos Infections Contagious diseases Risk of epidemics Risk of mortality

4 main groups Somatic diseases Mental health problems/diseases Women-specific health-related problems/diseases Others

Somatic diseases Chronic (e.g. heart/lung, diabetes, epilepsy, cancer) Musculoskeletal Neurological Transmissible diseases (e.g. TB, HIV/Aids, hepatitis…) Dependency (drugs, alcohol, tobacco, legal/illegal medicines) Dental And many more

Mental health Depressive reactions, anxiety, stress Sleep disturbances Personality disorders Self harm Suicide attempt/suicide Psychosis Drug related disorders ADHD PTSD

Women-specific health related problems/disorders Amenorrhea, irregular bleedings Infections (e.g. HIV, Chlamydia, Gonorrhea) Sequele after sexual abuse/violence Abort, pregnancy, birth

Other vulnerable groups Ill-functioning women Physically or mentally disabled Brain damaged Victims of exploitation, bullying, trafficking

By reception – 3 questions to ask Is the person dangerous to herself? (Is she seriously ill? Has she withdrawal symptoms? Is there a risk for self harm/suicide?) Is the person dangerous to others? (Has she a transmissible disease? Is she in mental unbalance which can result in violence?) What measures shall be taken by the health care service?

Prevention – treatment - rehabilitation Easy access to doctors/nurses (initial screening, regular consultations, emergency treatment) Equivalence of care Staff (adequate numbers, competence, and professional independence) Suitable equipped infirmary/hospital ward Adequate supply of medicines Facilities for physiotherapy Consent and confidentiality Specific protection of the most vulnerable (children, youth, mentally diseased, chronically ill, terminally ill)