With one of many lowest incarceration charges globally, Norway is recognised as having one of many world’s most progressive and humane approaches to jail with a deal with rehabilitation and reintegration (Berger, 2016). However, like most jail populations, there’s a excessive stage of psychological well being and social care want amongst individuals in Norwegian prisons. In a nationwide survey, there was proof of psychological dysfunction in 92% of incarcerated people (Cramer, 2014).
The beliefs people maintain concerning the explanations or causes for his or her psychological well being issues have an effect on how they assume and reply to them and affect their help-seeking behaviour. ‘Prisonization’ refers to psychological modifications that happen as a consequence of jail life (Haney, 2001). Elements that affect these modifications embrace a lack of autonomy and being separated from assist networks. The setting and regime of jail may have a damaging impact on psychological well being.
So as to have the ability to meet the psychological well being wants of incarcerated people, you will need to perceive how they conceptualise their psychological well being and the way these conceptualisations affect their coping preferences. The subject of this weblog is a examine by Solakken et al. (2023) who aimed to fulfill this want.
‘Prisonization’ can change how somebody thinks, feels, and behaves. There’s restricted perception into how this would possibly affect their beliefs about psychological well being and methods of coping.
Strategies
A qualitative design was used, and a relativist ontological stance was adopted, recognising subjective realities and co-construction of data between researchers and individuals. Fifteen in-depth interviews had been performed throughout three male prisons in Northern Norway. Members had been predominantly Norwegian residents with a mean age of 44 years. Their expertise of jail various, however all had skilled psychological well being issues in jail.
The semi-structured interviews lasted 60 to 90 minutes and aimed to discover psychological well being, jail tradition, and help-seeking. Evaluation used parts of Grounded Idea, together with line by line coding and creating conceptual classes from the info. A collaborative, reflexive course of guided interpretation.
Outcomes
Three themes (with related subthemes) had been recognized: views on psychological well being, beliefs in regards to the impression of imprisonment on psychological well being and beliefs about administration of psychological well being issues.
Members described psychological well being as a multifaceted idea involving steadiness and well-being, figuring out coping methods comparable to train and social contact. They felt that jail life had altered their views on psychological well being, highlighting the significance of social connections and significant actions. Self-isolation was thought-about to be an apparent signal of psychological well being issues and signs of despair had been most continuously described. Members emphasised the connection between psychological well being and social setting, noting the impression of stressors in jail on worsening psychological well being points. Psychological well being issues had been felt to be attributable to a wide range of elements together with expertise of parental neglect, poverty, violence, and trauma.
Jail was inextricably linked to individuals’ definitions of psychological well being, with a transparent connection between the prisonization course of and deterioration of psychological well being. Nervousness associated issues had been generally mentioned. Many people shared tales of friends’ experiences and spoke about jail situations, the period of time spent alone, lack of autonomy and significant actions as being damaging to psychological well being.
When it comes to preferences for administration of psychological well being issues, friends had been seen as essential for assist and there was a desire for psychosocial methods over treatment. Though the efficacy of treatment was acknowledged, there have been considerations about unintended effects and dependency. Nevertheless, ADHD was seen otherwise; this was thought-about as a extra acceptable analysis in jail and individuals had been extra accepting of treatment. ADHD was additionally mentioned by individuals as being an evidence for his or her offending behaviour.
Members perceived that jail situations comparable to time spent alone and lack of autonomy had a marked impression on psychological well being.
Conclusions
The principle discovering of the examine was that individuals’ beliefs about psychological well being, and the way points are managed, could be very a lot built-in with the expertise of jail.
Members various of their understanding of psychological well being however tended to attribute psychological well being issues to stressors within the jail setting quite than inside causes. Each importation idea (Irwin & Cressey, 1962) and deprivation idea (Sykes, 2007) supply views on how individuals’ beliefs about psychological well being are built-in with their jail expertise, and the complicated interaction of things: importation idea highlights the affect of pre-existing traits, whereas deprivation idea emphasises the impression of the jail setting itself. Social assist and significant actions had been highlighted as essential elements for well-being and non-medical interventions had been most well-liked when it got here to administration of psychological well being issues.
Prisoners beliefs about psychological well being are strongly built-in with the expertise of jail itself.
Strengths and limitations
The adoption of a qualitative strategy is a power of Solakken et al.’s (2023) examine. This enabled an in-depth exploration of individuals’ views on psychological well being throughout the jail context. The examine additionally included a pattern of individuals with various experiences of jail from three completely different jail institutions.
Nevertheless, as with all analysis, there are some limitations price noting. The authors acknowledge that the self-selecting nature of the pattern is a limitation of their work; that the views of those that volunteer to participate could also be completely different to those that don’t volunteer. Certainly, the authors do warning that the outcomes solely apply to the people who took half within the examine, and so they make no broader claims in regards to the generalisability of the work to prisons in Norway or farther afield. Nonetheless, though some context in regards to the jail system in Norway is offered, it could have been useful to grasp how consultant the prisons included had been of the broader system. Likewise, the authors, rightly, don’t present an in depth description of participant demographics to make sure that anonymity is preserved, however some touch upon whether or not individuals had been broadly consultant of the jail inhabitants would have been helpful to higher contextualise the outcomes.
There’s a detailed description of the evaluation course of which gives stage of transparency, however the lack of a positionality assertion is a limitation. Though the epistemological stance of the researchers is made specific, understanding how the researchers’ backgrounds and views influenced evaluation would have offered a extra nuanced understanding of their interpretation of the info.
The qualitative nature of the examine allows an in-depth exploration of psychological well being within the jail context, although this might have been higher contextualised by way of the Norway jail system.
Implications for follow
Regardless of some limitations, these findings have implications for the event and implementation of psychological well being interventions and insurance policies inside jail settings. In Norway particularly, the authors spotlight that enhancing companies for individuals in jail types a part of the Norwegian governments’ ten- yr psychological well being plan.
The discovering that folks in jail perceived their psychological well being as interconnected to the jail setting emphasises the necessity for holistic approaches that take into account the broader social, environmental, and cultural elements that affect psychological well-being, in addition to medical signs. The authors recommend it can be crucial that clinicians discover and acknowledge sufferers’ beliefs concerning their psychological well being to allow efficient communication between the well being skilled and repair consumer, guaranteeing remedy is adjusted in accordance with want. As well as, recognising the challenges of the jail setting in relation to sufferers’ psychological well being, is required to reinforce engagement with remedy.
When it comes to coverage, the findings stress the significance of psychological well being promotion in jail suggesting that offering individuals in jail alternatives to have interaction in significant exercise, work and schooling is essential to advertise wellbeing. That is in step with the healthy prison test adopted by HM Inspectorate of Prisons in England and Wales; purposeful exercise is among the 4 standards judged to find out whether or not a jail is ‘wholesome’. Purposeful exercise is outlined as individuals in jail having the ability, and anticipated, to have interaction in exercise that’s more likely to profit them. Coverage makers ought to take into account methods to reinforce the alternatives for this within the restrictive setting of jail.
Equally, social isolation is recognised as a danger issue for poor psychological well being outcomes (Grav et al., 2012) and this examine provides to the proof base advocating the significance of social connectedness. The examine recognises friends as a vital part of social assist to advertise well-being in jail. Though jail does present alternatives to keep up contact with family and friends locally, that is restricted in a number of methods. Consequently, the significance of peer relationships as a type of accessible assist is elevated. Peer relationships in jail will not be with out challenges and subsequently analysis exploring and evaluating peer interventions, comparable to The Samaritans Listener scheme, to facilitate social assist is required. Enhancing well being outcomes (and beliefs about optimistic well being outcomes) of individuals in jail is probably going to enhance the probabilities of profitable reintegration on launch. Additional analysis could also be useful to grasp how beliefs about psychological well being impression individuals’s motivation for rehabilitation post-release.
These findings recommend that prisons ought to undertake a holistic strategy in enhancing psychological wellbeing, taking into consideration the broader social, environmental, and cultural elements that affect psychological well-being, in addition to medical signs.
Assertion of pursuits
None.
Hyperlinks
Major paper
Solbakken, L. E., Bergvik, S., & Wynn, R. (2023). Beliefs about mental health in incarcerated males: a qualitative interview study. Frontiers in Psychiatry, 14, 1242756.
Different references
Berger, R. (2016). Kriminalomsorgen: A Take a look at the World’s Most Humane Jail System in Norway. Obtainable at: https://ssrn.com/abstract=2883512
Cramer, V. (2014). The prevalence of psychological problems amongst convicted inmates in Norwegian prisons. Oslo College Hospital. Obtainable at: Hel_oppdatert_Victoria_Cramer_rapport_engelsk.pdf (sifer.no)
Grav, S., Hellzèn, O., Romild, U. & Stordal, E. (2012). Association between social support and depression in the general population: the HUNT study, a cross-sectional survey. Journal of Medical Nursing, 21,111-120.
Haney, C. (2001). The psychological impression of incarceration: Implications for post-prison adjustment. College of California. Obtainable at: The Psychological Impact of Incarceration: Implications for Post-Prison Adjustment | ASPE (hhs.gov)
Irwin, J., & Cressey, D. R. (1962). Thieves, convicts and the inmate culture. Soc. Probs., 10, 142.
Sykes, G. M. (2007). The society of captives: A examine of a most safety jail. Princeton College Press.
