Prison setting
The purpose of this page is to;
introduce a Prison environment
introduce common terms which you may come across
identify ways that the setting works
identify ways you can prepare to engage and recruit in the prison environment
The following video introduces why do Research in Prison and some key considerations for you to think about.
Jonathan Davies: Research Nurse Delivery Support Team from the West Midlands
Watch the video here to learn more about Research in Prisons from Jonathon Davies from the West Midlands team.
Learn more about the West Midlands Prison Leaflet and how the West Midlands are building relationships with Prisons. You can also learn more about the Prison Research Network microsite which the West Midlands Network have created here.
Prison qr 1-720p-231030.mp4Prison Study Delivery Presentation 07.11.22.mp4Janet Field and Eleanor Hartill from Yorkshire and Humber Agile Research Team have kindly put this video together to introduce their experiences of engaging and recruiting in a prison setting.
Here is a direct link to the video;
https://drive.google.com/file/d/1Jq-UD-G4FQuUE3RqTQ1Cl3fq8MZSWtJp/view?usp=sharing
Below are some examples of case studies of research which the NIHR has funded in prisons:
The NIHR funded study investigating cancer diagnosis and care in English prisons has highlighted the importance of former prisoners’ providing their ‘lived experience’.
This case study looks to explore whether using telemedicine between English prisons and hospitals is feasible and acceptable to service providers, frontline staff and patients.
The overall aim of the project here looks at the Physical and Mental Health of Older Prisoners (PAMHOP). Its aim is to co-produce a tool kit for older prisoners with physical and common mental-health disorders (depression and anxiety).
The report here from the NIHR discusses the link between social care needs and prisons. The prison population is growing and the number of older prisoners is increasing along with longer prison sentences. Due to this, the level of social care needs in prisons is increasing. A series of reports in recent years have found the quality of social care in prisons is extremely varied and in some prisons, it is none existent.
Since April 2015, due to the Care Act, local authorities in England have a newly defined responsibility for the social care of prisoners. In particular, those authorities that have prisons within their boundaries are responsible for identifying and assessing inmates with social care needs, and where these meet the new national eligibility criteria, for providing appropriate support.
In England and Wales, prisoners are categorised based on:
risk of escape
harm to the public, if they were to escape
threat to the control and stability of a prison
This page provides an overview of the different security categories in our prison service, ranging from category A (highest security) down to category D (lowest security).Here you will find a helpful A-D guide on prison categories
Key terms you may come across
Categorisation - Risk level and accommodating individuals appropriately
The categories in the UK prison estate range from higher security categories (Maximum Security), A, B, C cat and the lowest security D cat (resettlement prisons) - known as open conditions. To understand more about the categories you can find more on this government page.
In England and Wales, prisoners are categorised based on:
risk of escape
harm to the public, if they were to escape
threat to the control and stability of a prison
This page provides an overview of the different security categories in our prison service, ranging from category A (highest security) down to category D (lowest security). This page also has a helpful overview of male and female prisons and youth offenders institutions.
CSU - Care and Separation Unit
CSU is a recent rebranding of Segregation unit to reflect a move towards compassion and rehabilitation.
DBS - Disclosure and Barring Service
Maintain a database of criminal convictions and related intelligence and provides access to approved organisations for DBS checks.
Line Route
Means all main gates are opened in the prison and gates on the "Route" to work or education are opened with staff stationed at various points .
Key considerations for working in a prison;
The Governor is in charge of the prison
You may not be able to take everything you want in to a prison i.e. smart watch and phones
Prisons can sometimes be very noisy with lots going on
You will need to wear sensible clothes and shoes
Lanyards will need breakaway
You must wear an ID at all times.
You may need to plan toilet trips
You may be patted down before entering the prison.
Remember prisons are not flexible you will need to fit around their routine, think about if you require space for a confidential conversation. You will need to be aware you may have a wasted journey, the night before something may have happened so you need to be resilient and be prepared to be flexible, give yourself a large window for completing measures and data as you may need it and remember to keep your team and manager updated on progress.
Top tips for working in a prison;
You will need to be inducted in to each prison - each one is different.
There are different categories of prison A,B,C.
You are not able to move around a prison easily- Usually there are set routes and times of day to avoid i.e. when prisoners are moving from wings to work areas.
Get familiar with the prison and it’s routine so you can feel more comfortable.
Be aware of the noise level.
You may need to set up a PIN for phone calls.
A study may take many months to set-up.
Be aware in the prison the DBS needs to be enhanced and a paper copy of the certificate that is 12 months in date. Be aware the subscription service may cause issues when working in the prison service as they want to see the original paper copy.
Start HMP security checks early, these take a long time to complete. Have someone in your own team to liaise with the prison service and keep in touch with them about when these checks come back.
Prisons use a booking system and list for prisoners to see GP etc - consider if this could be used to help your engagement and recruitment.
Prisons have different IT systems but generally many prisons use SystmOne (which holds healthcare information) and NIMOS (which holds information and a profile on in-mates).
Many prisons use the IT platform Quantum - this can give access to a secure HMPPS email address which can be useful when managing participant identifiable data or data transfers.
Most prisons have prison minister or chaplaincy, they get involved with education, life skills and helping them to adjust when they get out of prison.
Try to set up a meeting before hand, so that you have a desk/ space to access and link to a liaison person (head of department possibly head of healthcare) in the prison health care team. This is also helpful in case there is any kind of issue so having a liaison person is key to supporting and helping you.
Prisoners may refer to you as sir or madam, depending on the prison, prison officers may prefer you to use this too - if in doubt ask.
Consider the following points for managing safety and staff expectations;
Buddying up and shadowing the PI
debrief and team emotional resilience
Possible breakaway training and de escalation techniques.
Staff going into the prison should have the opportunity to shadow staff who have already been working in this setting. This should happen until the individual feels comfortable with the environment.
Who to contact regarding escalation points for prisoner wellbeing and escalation points for staff safety concerns
What can we offer to prisons for their support with research:
Opportunities for prisoners and prison staff to input into research study design
Any research study which is offering a vocational skill, mental health tools or help to prisoners for getting a job is a huge selling point.
Support with health and wellbeing initiatives/training, including mental health
Meetings with Governors and Healthcare Providers to speak about research and areas of interest for individual prisons
Research findings to inform evidence base and contribute to policy and practice
Support for other organisations and charities to conduct research
Key Lessons learned in our supra-network;
Gaining security access may prove timely. Some establishments where the category of prisoner is higher may take more time than others.
Each member of delivery staff will need to undertake a prison induction. This ranges from one day to one week and can include key training where staff will be given their own set of keys to go through the prison.
We can only offer prison specific research studies to prisoners.
Once in the prison, it is important to familiarise oneself with a department (most appropriate would be healthcare). It is important to have a buddy within the prison.
Conducting research in a prison should fit in with the prison regime. The Governor and head of healthcare need to be on board with the research study.
Healthcare in some prisons uses the medical database system one, so we would be able to conduct searches of medical records for the purpose of research.
Retention of prisoners in studies may be difficult as prisons can move prisoners around with no warning, and some only have short custodial sentences.
There are a few barriers to research: number of prison specific studies on the Portfolio, administration and governance, time, gaining the trust of the prison staff and prisoners.
Some prisons have electronic kiosks for prisoners to choose meals, book visits and submit applications and therefore a simple questionnaire-based study may be able to be implemented using this method.
Some prisons offer prisoners a phone and access to a laptop in their cells. These are censored but may enable communication with prisoners to be slightly easier.
Follow ups for research may take longer in a prison environment - there can be a central system which tells you prison whereabouts but it is not always up-to-date. The prison telephone service can be useful to suport follow ups.
it can be helpful to gain support from early from healthcare organisations supporting prisons, they may have their own governance needs to be taken in to account.
Thank you so much to Jonathan Davies, Research Nurse in the West Midlands and Harvey Gough, Clinical Research Practitioner in the East Midlands for their contribution to this section.
Wellbeing and Resilience
Your wellbeing and your resilience is extremely important especially when working in Prison.
Working in prison settings can be distressing at times. It’s okay to feel this way – we wouldn’t be human if we didn’t feel upset at times. You will need to seek a network to help you manage any distressing feelings. We recommend looking in to wellbeing and resilience support or if you require further support consider;
Clinical supervision,
Talking therapies,
Spiritual support,
Mindfulness,
Meditation.
REMEMBER working in this type of setting is extremely rewarding however it is important to acknowledge that working in a prison isn't for everyone and you will need to make a decision as to whether this is the right space for you.
There are further resources in the awesome table
This page has been created with the help and support of contributors including;
Yorkshire and Humber Learning and Development Team
Janet Field and Eleanor Hartill from Yorkshire and Humber Agile Research Team
Amanda E Perry, PhD, C.Psychol and HCPC Registered Forensic Psychologist, Senior Lecturer in Applied Health Sciences - University of York