Learning from the impact of and recovery from COVID-19 within prisons: the effect of COVID-19 management and the environment on wellbeing and harm.

Lead Research Organisation: Swansea University
Department Name: College of Human and Health Sciences

Abstract

COVID-19 is a particular challenge within the prison setting given the vulnerable nature of the population (in terms of emotional dysregulation, mental health difficulties, rates of suicide, self harm and violence); the characteristics of individuals (e.g. high rates of BAME) and the physical conditions (e.g. difficulties of introducing social distancing without the potential for exclusion). This research uses a carefully selected subgroup (those accessing the Offender Personality Disorder Pathway across 34 prison sites) as a case study from which to generalise across the prison context. The combination of quantitative methods (using linear mixed modelling to examine extensive and existing data) and qualitative research (based on interviews with a purposive sample) will enable this research to determine a) the impacts of prison restrictions implemented in response to COVID-19 and the subsequent easing of these on psychological and behavioral outcomes and b) to identify key factors associated with differences in response to restrictions / easing. Understanding and learning from the impact of COVID-19 and the resultant management responses within prisons is essential in order to identify how to build resilience in readiness for further restrictive measures which may be needed during subsequent 'outbreak waves'. Such findings will also have long term implications with regard to effective practices in the context of a return to standard operating status which might enhance the existing prison regime. Finally, this research will also allow us to examine whether certain groups (e.g. ethnic groups) experience a disproportionate impact in prison, as occurs in the wider/non-prison community.
 
Description Analysis of the routinely collected behavioural data amongst the Offender Personality Disorder Pathway service revealed that the additional restrictions and lengthy periods of in-cell confinement resulting from the COVID-19 management response within prisons were associated with reductions in recorded incidents of overtly harmful behaviour to others and to the self. As has been found in previous studies outside the context of COVID-19, older age was associated with lower rates of adjudications (e.g., sanctions for assaults on prisoners and staff, possession of controlled substances), whilst being white, female and younger age were associated with higher rates of deliberate self-harm. Although the reasons for these behavioural changes is outside the scope of the routinely collected data, it is possible they reflect a reduction in interpersonal conflict (one possible trigger for harmful behaviour) arising from the physical separation and isolation of individuals. It is also possible that some behaviour previously recorded was not identified. These findings indicate important areas for consideration around future research such as the role of regime delivery and change in the presentation and recording of key behavioural outcomes.

Interviews with people in prison (within the Offender Personality Disorder Pathway) revealed the impacts of the COVID-19 management restrictions on wellbeing and progress as well as the healthy and helpful adaptations made in response to these. Together these give rise to ten recommendations which could be incorporated into routine practice within prisons to a) foster and support meaningful and healthy connections between people in prison and between people in prison and staff teams; b) support health and wellbeing through structure and meaningful opportunities for engagement and c) promote the positive operations of power through giving appropriate 'voice and choice' to people in prison. These recommendations may be especially pertinent when custodial establishments require people in prison to spend longer periods in their cells (e.g. at times of staff shortage).


Three methodological points from this study are that
• it was possible to obtain a large and useable dataset for formal analysis although the process for obtaining this was complex, resource intensive and heavily dependent on collaboration with HMPPS study partners. It was also possible to develop ways to effectively link and prepare the data resulting in increased 'research readiness' amongst the research team and the partner organisation. The importance of the collaboration between organisations cannot be overstated in enabling this research.
• the quality of some routinely collected data was low meaning it could not be included in the data modelling undertaken. It is suggested that the structure and robustness of data and its collection (i.e., whether observational or self-report, mandatory or voluntary) is closely examined in the planning stages of future prison studies to ensure aims are data informed and resources can be efficiently allocated.
• prison sites and people in prison supported and engaged with the study despite the operational challenges and personal difficulties being faced during the period of this study.
Exploitation Route The findings provide information that could be used to help inform and develop routine prison practice / care to enhance individual experience and outcomes. Indeed, dissemination work is planned over the next year which will see the recommendations for routine practice derived from this research shared with those leading work on practice change within the prison estate. It is expected that impact(s) from this can be reported in due course.
Sectors Healthcare

Government

Democracy and Justice

Other

 
Description Presentation to Offender Personality Disorder Pathway Commissioners and Leads 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact An invited presentation to share emerging findings with those who commission specialist prison services and those who lead the delivery of pathway services in England and Wales. Discussion and questions to inform how those in attendance might make use of the emerging findings. Invitation to provide further presentation when all work completed.
Year(s) Of Engagement Activity 2023
 
Description Presentation to WG COVID TAG 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Presentation with following Q&A to the Welsh Government COVID-19 Technical Advisory Group subgroup on research and development. This group is responsible for co-ordinating advice and guidance for the WG relating to the pandemic. There were several questions and a request to present again once the study findings are known.
Year(s) Of Engagement Activity 2021