1. Improving Health Outcomes for Prisoners “Better Health, Better Lives for prisoners “ Sharon Hardie Health Promotion Manager - East

2. Overview of Prisoner Health Needs What we know.... People in prison suffer significant health inequalities; Much higher morbidity and mortality across a wide range of physical and mental health issues; Such health inequalities are evident not only when in prison but also continue to have an affect beyond the prison walls; People in prison often belong to wider social groups and networks who contribute disproportionately to wider health and social inequalities.

3. Overview of Prisoner Health Needs What we know.... Prisons impact positively on health care needs of people but this effect is often reliant on being in prison; A return to the community often results in ‘flipping’ previous health gains including access to health services especially preventive health services like screening, immunisation and chronic care.

4. Health Status Prevalence on admission to PrisonPrevalence in the Community Alcohol Problems73%13% male/ 7% female Illegal Drug Use56%8% Smoking Rates76%26% all Hepatitis C20%1% Asthma12%5.4% Epilepsy2.1%0.7% Chlamydia12%0.8% Severe Dental Decay29% male/ 42% female10% male/ 3% female Schizophrenia9% male/ 36% female0.5% Depression25%5% (approx.) Personality Disorders66% (approx.)5% (approx.) ‘Prison Health in Scotland 2007’

5. Seize the opportunity...... The Health Promoting Prison 2002 Better Health, Better Lives for Prisoners 1,2 & 3 (2012) Healthier People, Safer Communities: (2013)

6. Seize the opportunity...... Transfer of prison health care services to NHS; Appointment of an NHS Director for Health & Justice; Health & Justice Collaboration – Health Improvement; Ministerial Group on Offender Reintegration – Going forward. SPS Unlocking Potential- Transforming Lives/Purposeful Activity strategy

7. Multi Agency Health Promoting Prison Group Active for 7 years 3 Year Action Plan- 7 priority areas I.Smoking II.Physical Activity III.Sexual Health & BBV IV.Oral Health V.Mental Wellbeing VI.Alcohol VII.Prisoner Capacity Building Copyright - Scottish Prison Service with permission

8. Why focus on Prisoner Capacity Building? Prisoners can be part of the solution in designing and delivering health promotion and health improvement programmes- peer educators much more effective means of engagement and peer modelling; can promote more effective uptake of positive health; behaviours e.g. smoking cessation. Sustaining change beyond the prison gate is possible and positive Change can be driven by actions of ex-prisoners- Positive Prisons/New Routes Recruit with Conviction Purposeful Activity

9. Future- Health & Social Care Planning for older prisoners- Social Care Wider Justice system- Engaging with those on community orders Prison staff- Assets based approaches Throughcare- Integrated Case Management

10. “Inspiring hope for a different future”