Towards a Health-informed Approach to Penal Reform? Evidence from ten Countries

Drawing on ICPR’s unique World Prison Brief database and research in ten countries across all five continents, the report highlights the serious public health risks caused by today’s unprecedented levels of prison overcrowding worldwide.

Recent surges in prisoner numbers across much of the world have produced a global prison population of well over 11 million; and chronically overcrowded, under-resourced prisons. These are prisons, the report argues, in which health problems proliferate – particularly as regards communicable diseases, mental illness, substance misuse and increased risk of violence, self-harm and suicide. Severe risks to health are posed not only to prisoners but also to staff, the families of prisoners and staff, and wider communities.

The report features personal accounts from people who have experienced incarceration in overcrowded prisons in England, Thailand, Kenya, South Africa and Brazil. Their harrowing descriptions attest to the damage that prison so often causes to inmates’ physical and mental health – damage that can last years beyond their actual sentence. Prisoners describe:

• being unable to access medication and treatment, even for serious conditions like diabetes, tuberculosis and HIV
• continual hunger, weight loss, sickness, self-harm and deaths in custody
• babies and children, imprisoned with their mothers, regularly falling ill with diarrhoea, cholera and skin diseases
• lack of opportunity for exercise, causing frustration and violence
• endemic drug use, with more prisoners picking up habits than becoming clean while inside
• sleeplessness, anxiety, confusion and fear, persisting long after release.

(2.35 MB) | 19. June 2019 | Author: Catherine Heard, Director, ICPR’s World Prison Research Programme