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

2. 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.

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

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

5. 4 main groups Somatic diseases Mental health problems/diseases
Women-specific health-related problems/diseases
Others

6. 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

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

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

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

10. 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?

11. 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)