Introducing ‘Release’ – understanding access to health services after release from prison

Dr Catriona Connell, Research Fellow, Salvation Army Centre for Addiction Services and Research, University of Stirling

A young man in a counselling session.

We are excited to be starting a new project to understand how people access health services for their mental health and substance use challenges after release from prison. In this blog, I will explain who we are, why we are doing the project and how, and what we will do with the results.

The team

Dr Catriona Connell and Professor Kate Hunt at the University of Stirling will lead a team with experience in different types of research (health, criminology, data science, statistics, social policy, qualitative methods) from the Universities of Stirling, Glasgow, Strathclyde and Edinburgh Napier University. The team includes people with experience of being in prison in Scotland, having family members in prison/involved in the justice system, and working with people in prison and afterwards.

Why are we doing this project?

People involved in the justice system often have mental health and substance use challenges in their lives. Research in Scotland showed that people released from prison are more likely to die from suicide, from drug and alcohol use, or health conditions linked to drug and alcohol use. This worries us, because everyone in Scotland should be able to thrive in our communities.

In other countries, people released from prison don’t use their GP and mental health services as much as we would expect. But they use of emergency services more. If this is happening in Scotland too, there might be something we can do to help people access to the right support earlier.

Before services can make changes, we need to understand how people access (or not) health services in Scotland and why – so that any changes make sense. That is why we are doing this project.

What are we going to do?

We spoke to people with experience of release from prison and providing support services, members of the public and other researchers. This led us to plan a two-part study.

Part One

We will find out when and where people released from prison are using health services for mental health and substance use needs. We will compare this to people who haven’t been in prison. We will also look at differences based on age, sex, ethnicity, and liberation type (for example if someone is on parole or not).

If we can, we are also going to look at differences based on other characteristics. This is because people with experience pointed out that being in a minority group can affect your mental health and confidence to access services. The numbers might be too small, but we will try.

To do this, we will analyse records from the Scottish Prison Service and health services in Scotland.

We will look at a group of people released from prison, to see where they use health services over 5 years (for inpatient and outpatient care, mental health and substance use services and prescriptions). We will only have access to ‘pseudo-anonymised’ records. This means some information is taken out or changed, so we can’t identify individual people.

Part Two

We will explore the reasons why we found out what we did in part one.

We will hold small discussion groups with people with experience of Scotland’s prisons, providing support services, and designing policies. The groups will look at the results and talk about what they think is going on. We hope to hold some online and some in person so that we can talk to people all over the country. We will analyse all these discussions to look for ‘themes’ that explain why people are accessing services (or not) the way they are.

What will we do with the results?

We will hold a workshop for people with experience of release from prison, support providers (including families, friends, and organisations), and policymakers. We will share our results and have open discussion about what this means, what we could change now, and where we need more research.

We will give free seminars and write update blogs (like this one) along the way, as well as formal academic presentations.

We want this research to be the start of a conversation, and more research, so that Scotland has the information it needs to help all people to achieve the best in life.

If you would like to know more, you can contact me at @DrCConnell 

Catriona Connell is a Research Fellow at the Salvation Army Centre for Addiction Services and Research based at the University of Stirling. This blog post first appeared on the Scottish Centre for Crime and Justice Research blog in June 2022.

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