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British Journal of General Practice

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Editorials

The role of primary care in supporting imprisoned women with mental illness

Tammi Walker, Joyce Kallevik, Jake Hard, Emma Mastrocola and Carolyn A Chew-Graham
British Journal of General Practice 2021; 71 (710): 392-393. DOI: https://doi.org/10.3399/bjgp21X716813
Tammi Walker
Durham University, Durham.
Roles: Principal of St Cuthbert’s Society and Professor of Forensic Psychology
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Joyce Kallevik
Director, Wish.
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Jake Hard
Royal College of General Practitioners Secure Environments Group, London.
Roles: Chair
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Emma Mastrocola
HMP Eastwood Park, Hanham Secure Health, Bristol.
Roles: Lead GP
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Carolyn A Chew-Graham
School of Medicine, Keele University, Keele.
Roles: Professor of General Practice Research
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WOMEN IN PRISON

People with severe mental illness (SMI) have a life expectancy that is reduced by up to 20 years compared with the general population, and primary care has a key role in reducing this mortality gap.1 Providing primary care in the prison setting requires special consideration. People in prison have multiple complex health and social care needs.2 There are up to 80 000 people in prison in England and Wales at any one time, and imprisoned women make up around 5% of this population.3 Women in prison often have disproportionately higher levels of serious SMI, substance use disorders (SUD), and self-harm compared with men in prison.4 Complicating these high rates is the high comorbidity and complex needs arising from experiences such as Adverse Childhood Experiences (ACEs), trauma, abuse, being separated from their children and family, homelessness and unemployment, and a relatively high proportion have a history of substance and alcohol misuse.5 According to the Prison Reform Trust, 25% of women in prison reported symptoms indicative of psychosis. The rate among the general population is about 4%.5

There are no reliable data reporting whether women with SMI in prison access primary care services pertaining to their physical healthcare needs (such as cardiometabolic problems, and access to screening services including cervical and breast screening) and whether these physical health needs are being adequately met. It is likely that these will differ between different female prisons in England.

WOMEN’S PRISON HEALTH POLICY AND STRATEGY

Since 1999 there have been several policies that aim to improve the way in which health care is provided in prisons. Initiatives are guided by the principle of ‘equivalence of care’, that is, prisoners have the right to the same standard and range of physical and mental health services as they would have in the community.6 …

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British Journal of General Practice: 71 (710)
British Journal of General Practice
Vol. 71, Issue 710
September 2021
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The role of primary care in supporting imprisoned women with mental illness
Tammi Walker, Joyce Kallevik, Jake Hard, Emma Mastrocola, Carolyn A Chew-Graham
British Journal of General Practice 2021; 71 (710): 392-393. DOI: 10.3399/bjgp21X716813

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The role of primary care in supporting imprisoned women with mental illness
Tammi Walker, Joyce Kallevik, Jake Hard, Emma Mastrocola, Carolyn A Chew-Graham
British Journal of General Practice 2021; 71 (710): 392-393. DOI: 10.3399/bjgp21X716813
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    • WOMEN IN PRISON
    • WOMEN’S PRISON HEALTH POLICY AND STRATEGY
    • PRIMARY HEALTH CARE IN PRISONS
    • WHAT CAN WE LEARN FROM GENERAL PRACTICE?
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More in this TOC Section

  • Continuity of GP care: using personal lists in general practice
  • Creating space for gut feelings in the diagnosis of cancer in primary care
  • GP workforce crisis: what can we do now?
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Print ISSN: 0960-1643
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