When prisoners receive better healthcare while incarcerated and after release, both their health and that of the community will improve, according to a new study by St. Michael’s Hospital in Toronto, Canada. The study was published in the American Journal of Public Health.
“Improving health in people in jails and prisons can also improve the health of the general population, improve the safety of our communities and decrease health care costs,” said Dr. Fiona Kouyoumdjian, a public health physician and a post-doctoral fellow with the Centre for Research on Inner City Health of St. Michael’s Hospital. “For example, treating infectious diseases can prevent ongoing transmission, treating people with mental illness can decrease crime, and providing access to primary care can cut down on expensive Emergency Department use.”
Offering prisoners referral services to family doctors or psychiatrists, or treatment upon release can lead to less mental health problems, chronic diseases, more usage of health services, and a reduced risk of infectious disease, says the study. Dr. Kouyoumdjian’s findings were based on a review of 95 international studies regarding health care treatments in prison or after release. Interventions led to prisoners having improved health in 59 studies.
“The fact that there is promising evidence suggests we should be paying close attention to these interventions and if we think they’re relevant, then we should be implementing these interventions in Canada,” said Dr. Kouyoumdjian. The study shows that prisoners were in poor health and that their release into the general population could cause an increase in communicable diseases such as hepatitis C, HIV, tuberculosis, and sexually transmitted infections. If mental health needs are not addressed, there can be an increase in reincarceration and criminal activity. Healthcare costs rise as well as costs associated with substance abuse and relapse into crime.
“Linking people with primary care after they are released from jail could improve health and decrease emergency department use,” said Dr. Kouyoumdjian. “Despite having significant physical and mental health problems, many people in Canada are currently released from prison without a family physician, and this may lead to unnecessary and expensive use of emergency departments.” When prisoners are informed about the state of their health and the community services that could help the prisoners when they are released, they are more likely to seek primary care and get their lives in order.
“For people who are addicted to opiates such as heroin, starting methadone while in prison can lead to less drug use and less risky behaviors like injecting drugs and sharing needles,” said Dr. Kouyoumdjian. “Addictions are a common and serious problem for many people in jails and prisons in Canada. The time in custody can provide a unique opportunity to initiate a substitution treatment like methadone, which can improve their health and general well-being. Many people in jails in Canada do not have access to these substitution therapies.” Dr. Kouyoumdjian says that more research is needed into treating prisoners for physical and mental problems while in custody and after release.