Locked Up and Locked Down: How the Covid-19 Pandemic has Impacted the Mental Health of Male Prisoners and Support Staff

Background: The impact of the Covid-19 pandemic on prisons across the world has been of much concern due to the increased risk of virus spread among a particularly vulnerable population. Efforts made to prevent spread of the virus have resulted in a range of restrictive measures with the aim of reducing contact between prisoners and staff. Unfortunately, restrictions have also resulted in increased time confined to cells, reduced occupation, and restricted access to services. The potential impact of this on a population that already presents with high rates of mental health difficulties requires consideration. Male prisoners may be at particularly high risk of experiencing negative outcomes. Methods: This study evaluated the impact of the pandemic and related changes upon the mental health of prisoners and staff within a male urban prison in the United Kingdom. A mixed methods approach with a convergent parallel design was used. Correlational and feature selection analysis was conducted on quantitative data. Qualitative data were subject to a thematic analysis. Findings were integrated at the point of summary and interpretation. Results: Prisoners and staff reported finding it hard to cope with changes and stressors associated with the pandemic. For prisoners, time spent locked in one’s cell with limited access to activities and support was associated with poor mental health outcomes, and salient themes emerged of feeling trapped, isolated and neglected. For staff, concerns about prisoner welfare and worry about catching the virus was associated with increased anxiety and worry. Additionally finding it hard to cope with constant changes at work and reduced staffing resulted in unhealthy coping behaviours such as drinking and smoking. Conclusions: Findings suggest that the implementation of additional restrictions, within the already restricted prison environment, has had a significant negative impact on the mental health of both prisoners and staff. The potential long-term mental health difficulties resulting from this require further investigation, as does the likely negative impact on staff wellbeing and staff turnover. The effects of the pandemic appear to have heightened an already desperate need to consider the mental health and wellbeing of prisoners and prison staff which must be urgently addressed.

Covid-19; pandemic; prison staff; prisoner; prison inmate; mental health; psychological wellbeing

[1] Khan KS, Mamun MA, Griffiths MD, Ullah I. The Mental Health Impact of the COVID-19 Pandemic across Different Co-horts. International Journal of Mental Health and Addiction. 2020. (in press)

[2] Ahorsu DK, Lin C-Y, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scale: development and initial val-idation. International Journal of Mental Health and Addiction. 2020. (in press)

[3] Sakib N, Bhuiyan AI, Hossain S, Al Mamun F, Hosen I, Ab-dullah AH, et al. Psychometric validation of the Bangla Fear of COVID-19 Scale: Confirmatory factor analysis and Rasch analysis. International Journal of Mental Health and Addiction. 2020. (in press)

[4] Saltzman LY, Hansel TC, Bordnick PS. Loneliness, isolation, and social support factors in post-COVID-19 mental health. Psy-chological Trauma: Theory, Research, Practice, and Policy. 2020; 12: S55–S57.

[5] Watson A, Lupton D, Michael M. Enacting intimacy and social-ity at a distance in the COVID-19 crisis: the sociomaterialities of home-based communication technologies. Media International Australia. 2021; 178: 136–150.

[6] Fullana MA, Hidalgo-Mazzei D, Vieta E, Radua J. Coping be-haviors associated with decreased anxiety and depressive symp-toms during the COVID-19 pandemic and lockdown. Journal of Affective Disorders. 2020; 275: 80–81.

[7] Mackolil J, Mackolil J. Addressing psychosocial problems asso-ciated with the COVID-19 lockdown. Asian Journal of Psychi-atry. 2020; 51: 102156.

[8] Montoya-Barthelemy AG, Lee CD, Cundiff DR, Smith EB. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58: 888–891.

[9] Dutheil F, Bouillon-Minois J, Clinchamps M. COVID-19: a prison-breaker? Canadian Journal of Public Health. 2020; 111: 480–481.

[10] Wurcel AG, Dauria E, Zaller N, Nijhawan A, Beckwith C, Nowotny K, et al. Spotlight on Jails: COVID-19 Mitigation Policies Needed now. Clinical Infectious Diseases. 2020; 71: 891–892.

[11] Hewson T, Shepherd A, Hard J, Shaw J. Effects of the COVID-19 pandemic on the mental health of prisoners. The Lancet Psy-chiatry. 2020; 7: 568–570.

[12] Johnson L, Gutridge K, Parkes J, Roy A, Plugge E. Scoping re-view of mental health in prisons through the COVID-19 pan-demic. BMJ Open. 2021; 11: e046547.

[13] Sorge A, Bassanini F, Zucca J, Saita E. “Fear can hold you, hope can set you free”. Analysis of Italian prisoner narrative experi-ence of the COVID-19 pandemic. International Journal of Pris-oner Health. 2021. (in press)

[14] Excellence NIfHaC. Mental health of adults in contact with the criminal justice system. NICE guideline [NG66]. 2017.

[15] Morse Sir Amyas. Mental Health in Prisons. 2017. Available at: https://www.nao.org.uk/wp-content/uploads/2017/06/Ment al-health-in-prisons.pdf (Accessed: 22 February 2022).

[16] Halliday, M., Hewson, A., Kwong, R. Bromley Briefings Prison Factfile. 2019. Available at: http://www.prisonreformtrust.or g.uk/portals/0/documents/bromley%20briefings/old%20editi ons/Winter%202019%20Factfile%20web.pdf (Accessed: 22 February 2022).

[17] Birmingham L. The mental health of prisoners. Advances in Psy-chiatric Treatment. 2003; 9: 191–199.

[18] Douglas N, Plugge E, Fitzpatrick R. The impact of imprisonment on health: what do women prisoners say? Journal of Epidemi-ology & Community Health. 2009; 63: 749–754.

[19] De Viggiani N. Surviving Prison: Exploring prison social life as a determinant of health. International Journal of Prisoner Health. 2006; 2: 71–89.

[20] Jordan M. The prison setting as a place of enforced residence, its mental health effects, and the mental healthcare implications. Health & Place. 2011; 17: 1061–1066.

[21] MacDonald M. Overcrowding and its impact on prison condi-tions and health. International Journal of Prisoner Health. 2018; 14: 65–68.

[22] Ismail N. The politics of austerity, imprisonment and ignorance: a case study of English prisons. Medicine, Science and the Law. 2020; 60: 89–92.

[23] Spinaris CG, Denhof MD, Kellaway JA. Posttraumatic stress disorder in United States corrections professionals: Prevalence and impact on health and functioning. Desert Waters Correc-tional Outreach. 2012; 1–32.

[24] Bourbonnais R, Jauvin N, Dussault J, Vézina M. Psychosocial work environment, interpersonal violence at work and mental health among correctional officers. International Journal of Law and Psychiatry. 2007; 30: 355–368.

[25] Bell S, Hopkin G, Forrester A. Exposure to Traumatic Events and the Experience of Burnout, Compassion Fatigue and Com-passion Satisfaction among Prison Mental Health Staff: an Ex-ploratory Survey. Issues in Mental Health Nursing. 2019; 40: 304–309.

[26] Denhof MD, Spinaris CG. Depression, PTSD, and comorbidity in United States corrections professionals: Prevalence and im-pact on health. Desert Waters Correctional Outreach: Florence. 2013.

[27] Dennard S, Tracy DK, Beeney A, Craster L, Bailey F, Baureek A, et al. Working in a prison: Challenges, rewards, and the im-pact on mental health and well-being. The Journal of Forensic Practice. 2021; 23: 132–149.

[28] Kothari R, Forrester A, Greenberg N, Sarkissian N, Tracy DK. COVID-19 and prisons: Providing mental health care for people in prison, minimising moral injury and psychological distress in mental health staff. SAGE Publications Sage UK: London, England. 2020.

[29] Kothari R, Forrester A, Greenberg N, Sarkissian N, Tracy DK. Providing mental health services in prisons during the covid-19 pandemic - challenges and opportunities for growth. Clinical Psychology Forum. 2020; 2020: 18–23.

[30] Stewart A, Cossar R, Stoové M. The response to COVID-19 in prisons must consider the broader mental health impacts for peo-ple in prison. Australian & New Zealand Journal of Psychiatry. 2020; 54: 1227–1228.

[31] Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for per-sons in detention suffering with mental illness during the Covid-19 outbreak. Forensic Science International: Mind and Law. 2020; 1: 100013.

[32] Coronavirus: more than 9,000 fines for lockdown breaches. In British Broadcasting Company (BBC). 2020. Available at: http s://www.bbc.co.uk/news/uk-52489943 (Accessed: 18 February 2022)

[33] Capraro V, Barcelo H. The effect of messaging and gender on in-tentions to wear a face covering to slow down COVID-19 trans-mission. arXiv. 2020. (in press)

[34] White A. Men and COVID-19: the aftermath. Postgraduate Medicine. 2020; 132: 18–27.

[35] Prison Reform Trust. Categorisation–Policy Framework. 2020. Available at: http://www.prisonreformtrust.org.uk/ForPrisoner sFamilies/PrisonerInformationPages/Categorisation/Categorisa tionMensprisons/CategorisationPolicyFramework (Accessed: 22 February 2022).

[36] Kothari R, White D, Craster L, Vicianova E, Dennard S, Bailey F, et al. The impact of integrating mental health services within a prison setting. Mental Health Review Journal. 2022. (in press)

[37] Medical Research Council and NHS Health Research Authority. 2022. Available at: http://www.hra-decisiontools.org.uk/ethics/(Accessed: 18 February 2022).

[38] Harrell Jr FE, Dupont C. R Hmisc Package (version4.6-0). 2021. Available at: https://hbiostat.org/R/Hmisc/ (Accessed: 22 February 2022).

[39] Sammut C, Webb GI. Encyclopedia of machine learning. Springer Science & Business Media: New York. 2011.

[40] Kuhn M. Building predictive models in R using the caret pack-age. Journal of Statistical Software. 2008; 28: 1–26.

[41] Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3: 77–101.

[42] Lincoln YS, Guba EG, Pilotta JJ. Naturalistic inquiry. Sage: USA. 1985.

[43] Cohen J. A power primer. Psychological Bulletin. 1992; 112: 155–159.