Tara's Case Study: Mental and Physical Healthcare in Prison

This case study examines the healthcare experiences of women in prison, focusing on a fictional case involving a woman named Tara. The study presents findings from interviews, exploring themes such as the reasons women are incarcerated, their expectations versus the reality of treatment, and the purpose of imprisonment. It delves into gender differences in health challenges, standards of care, and interactions with healthcare professionals. The analysis highlights the importance of addressing mental health issues, including depression, stress, and trauma, and emphasizes the accountability for providing adequate care. The study also touches upon the well-being of transgender prisoners. Key findings reveal the prevalence of mental health issues stemming from pre-existing conditions and experiences of trauma, highlighting the need for comprehensive healthcare services, including primary, physical, and mental health support, to ensure the well-being of incarcerated women.

Case-study

Table of Contents
INTRODUCTION......................................................................................................................3
FINDINGS.................................................................................................................................3
Theme 1 – Reasons which lead females to prison.................................................................3
Theme 2 – Expectation regarding the treatment a person should receive in prison..............3
Theme 3 – Difference between expectation and reality of treatment in prison.....................4
Theme 4 – Purpose of Imprisonment.....................................................................................4
Theme 5 - Gender differences in Health and well-being challenges presented in prison.....4
Theme 6 - Standards in healthcare based on 'Gender Specific'..............................................5
Theme:7 Interaction between healthcare professional and women prisoner.........................5
Theme8: Primary and physical healthcare to women in Prison.............................................5
Theme9: Accountability for women’s well-being in prison..................................................6
Theme10: Mental health issues..................................................................................................6
Theme10.1: Mental health issues experience by women in prison........................................6
Theme10.2: Origin of mental and physical health issues......................................................7
Theme 10.3 - Issues for females related to mental health......................................................7
Theme 10.4 - Main sign for having mental health and well-being problems........................7
Theme 11 - Prison in terms of Health and well-being, is it compulsory to put primary focus
on preventing the health problems.........................................................................................7
Theme 12 - Your understanding on physical health issues....................................................7
Theme13: Seriousness of mental health elements (Depression, stress, anxiety, trauma).....8
Theme14: Accountability for assuring women primary and mental health care services in
prison......................................................................................................................................8
Theme15: Real provision for women in the prison................................................................8
Thmem16: Custodial sentence needs to be given after analysing the current situation of the
prisoner...................................................................................................................................8
Theme17: Well-being provision for trans-gender prisoner....................................................8
CONCLUSION..........................................................................................................................9
REFLEXIVITY..........................................................................................................................9
APPENDIX..............................................................................................................................10
2 | Page

INTRODUCTION
This report explored the topic mentioned in the story of Tara. On the basis of which
interview was conducted of 2 participants. In this Tara was accused of domestic abuse
because of various problem she is facing in her personal life. She was also referred to a
mental specialist to ensure her mental health can improve. The study had conducted interview
of people to understand their perceptions and understand more about the problem. These
conducted interview will eventually provide the information about the management in prison
and how this can be understood. With the help of these interview information can be gathered
the problem which arise in the country. The participants were male and female who were
interviewed for analysing their viewpoint.
FINDINGS
The results of thematic analysis in associated with:
Theme 1 – Reasons which lead females to prison
According to the response of participant 1 answered that “They could have committed
drug or property offences”. These reasons are mainly related to their mental health as if they
have healthy mental health they will not be committing such crimes. It can be that they were
depressed and started the alcohol habit which will make them violent. These females are
related to various category which are present in the UK. They are either white, black and
various others. The females are committing various other crimes which are not good for the
society which leads them in prison. The females in prison are also connected to the crime
which have been done physically as there are females who commit murder and various other
crimes. These reasons are very less compared to the reason for which they go to prison.
Theme 2 – Expectation regarding the treatment a person should receive in prison
The Participant 1 expects that “my wellbeing should still be important” They also
want respect which is essential for a person to have wherever he is living. It was also quoted
that “I would expect to take part in education and activities aimed at rehabilitation” . As they
think that it will not be possible for them to stay in prison for very long time and does not any
sort of activities which will keep them occupied. They want special units which will ensure
that the females who have committed the crimes which are risky for the other females in
prison. This is to ensure that they will not face any sort of problem when they are living in the
prison.
3 | Page

Theme 3 – Difference between expectation and reality of treatment in prison
The participant 1 answered that “n some respects, they wouldn't match but in general
I think these are rights that prisoners should have.”. As the prisoner have right to be
protected from bully or any racial harassment which is similar to their expectation of safety in
the prison to ensure that they are relieved. They did not expect that if they do something
wrong in the prison they will also be getting punishment while living in prison. The
punishment they receive in prison is they are not allowed to leave their cell for certain period,
or they will be leaving later than the allotted time limit of the stay in prison. They did not
expect that they will be getting the healthcare services for free in the prison which is
beneficial for them. As they will be getting treatment when they are facing some problems.
Theme 4 – Purpose of Imprisonment
The answer received from the participant 1 is “he act of punishment for the crimes
they have committed”. Interviewee thinks that the main purpose of imprisonment is to ensure
the committed crime will not take place again by the person. It will eventually be expected
from the prisoners that they will not commit the same mistake again to ensure peace in the
country. Another can be to punish the prisoner for the crimed which is committed by them
which is affecting the peace of the country. It will ensure that they will understand the
outcomes of their crime which is committed by them. The imprisonment also ensure that they
will not have any power with the help of which they will be committing the same mistake
again. The interviewee also thinks that one of the purpose is to ensure the mental health of the
person will be restored.
Theme 5 - Gender differences in Health and well-being challenges presented in prison
As per the view of participant 1 “There is likely to be gender differences however in
general preventing and treating health problems are still fundamentally the same.” From the
answer received from the interview it is analysed that the health care services provided to the
females are better than the services provided to the males. Such as if the female is in
maternity period she will be provided extra care to ensure her safety during that period. It is
to ensure that they will be getting the care which is necessary for a woman to have. The
females are not that violent in the prison which is reducing the need for health care staff in
the prison for the females. There are various such medical condition which are specific for
4 | Page

the females, so they ensure that the females are provided with extra care during the period
they are spending in the jail for their health safety.
Theme 6 - Standards in healthcare based on 'Gender Specific'
The participant answered that “They are designed to complement existing national
and international health standards and guidance for women in prison. Also the measures
reflect fairly wellbeing of men and women separately.”. There are various standards in health
care which are based on the gender of the person. Such as general health and well being the
prisoner when they enter into the prison have to undergo various test which include the use of
alcohol, mental health and various others. It will ensure that the people will get the treatment
which is essential for them to get to recover. Another standard is to transfer medical records
to the health care facility to ensure that they will be able to get the treatment which is
necessary for them to have to recover from the problems they are facing. It will ensure that in
case of emergence the health care staff will be aware of the problems they should address
while treating the person. Another is related to this is that the medicines should be provided
on time and regularly to ensure that the person can recover.
Theme:7 Interaction between healthcare professional and women prisoner
Interaction among the healthcare professionals and women prisoner must be taken in
appropriate manner that involves complete health care team. The contact must be carried out
in safe and secure manner. Already women prisoners are concerned with high sense of fear
that triggers mental traumas in them. In such situation, it is highly important that they must
get effective care services that are associated with safe and secure manner so they can
effectively experience care services. Major things that needs to be taken in consideration is
that, equal care services have to be provided to all women prisoners. Many-time the prisoners
get judged in context of crime that has been done by then. Therefore, while implementing
contact among women prisoners and healthcare professionals the interaction must be taken in
consideration within maintaining safe, secure and equality attributes.
Theme8: Primary and physical healthcare to women in Prison
The 1 interviewee said over this “It should be the job of the prisons to provide this”. It
has been identified from interview that women in prison often comes from different
5 | Page

background who have faced large number of physical or sexual abuse. In such women
alcohol and drug dependency is extreme high therefore, it is important to provide primary and
physical healthcare to women in prison. The prison management is associated with looking
upon this element. The primary and physical healthcare to women includes providing
necessary prenatal and postnatal treatment that provides the assurance of effective physical
health in women. Often, large number of women tries to do suicide and harm themselves in
prison as they experience mental traumas. In context of harming self as well women in prison
must give special care and mainly the prison management is accountable for scheduling all
these things.
Theme9: Accountability for women’s well-being in prison
Interviewee 1 has shown their opinion over this within saying, The major
accountability for women well-being in prison is of government and prison management.
Mainly, female prisoner from typically economically culture faced variety of health issue that
impacts their over-all health. Therefore, it is important to provide gender specific health care
needs to women in prison.
Theme10: Mental health issues
The results of interview have cleared the vision about the concept of mental health
issues. It has been reviewed by 1 participant that, mental health issues are the biggest issues
among all as it often impacts physical health of an individual. Also, women in prison mainly
faces mental health issues that act as a biggest threat for them. Mental health issues are
derives from the unexpected and drastic life events that creates long-lasting impact over an
individual. Often, it leads to create higher dependency over drug and alcoholic substances.
Thus, it has been evaluated that, if women have certain mental health issues and they are in
prison then, there is high threat in context of harming self and others as well. Therefore,
effective care services have to be assure over the mental issues.
Theme10.1: Mental health issues experience by women in prison
The interview session has shown major findings over this and that depicts that, women
in prison are feels, depressed, stressed, they have sleeping problems and all these elements
are common sign of mental health issues in women. Participant 2 has shown their thoughts by
6 | Page

saying, Women in prison have faced sexual assault, domestic violence and dependency over
alcohol and drug. Thus, all these experience creates higher extent of traumas and depression
in women. Often, this creates situation in which women in prison do not have control on self
and this leads to attempt suicide. This clearly states higher level of mental health issues in
women.
Theme10.2: Origin of mental and physical health issues
It has been analyse from the results of interview that, the origin of mental and physical health
issue does not deprive in prison. Participant 1 said that, “No, these also occur outside of
prison”. It mainly occurs from external environment and increases up-to an extent in prison.
In outside world people face large number of issues and problems that taken them into the
path of criminology. Such people are concerned with mental health issues or traumas due to
drastic life events. Thus, the origin of mental and physical health issues mainly comes from
outside of the prison. However, ineffective environment of prison impacts the extent of
physical and mental health issues in people. Therefore, it is highly important to perform
effective prison management that focuses over the well-being of people in prison. Especially
in case of prison it is highly important to provide specific care in prison that can deal with
their mental and physical health issues.
Theme 10.3 - Issues for females related to mental health
The participant 1 answered that “Anxiety, depression, and self-harm are fundamental
issues that women may experience”. According to the interviewee perspective there are
various mental health issues. Some of them are depression, anxiety, eating disorder, phobias
and various others.
Theme 10.4 - Main sign for having mental health and well-being problems
As per the view of participant 1 “feeling anxious or worried, depressed, sleep
problems, weight or appetite changes etc.”. According to the response interviewee there are
various signs for mental health issues. Some of them are tiredness, loneliness, changes in
moods and various others.
7 | Page

Theme 11 - Prison in terms of Health and well-being, is it compulsory to put primary focus
on preventing the health problems
The participants 1 answered that “Preventing health problems”. According to the
interviewees aspects it is important for the prison to focus on the health of the prisoners. As it
will ensure that both the parties will not be facing any problem. Also it is the right of the
prisoners that their health should be considered.
Theme 12 - Your understanding on physical health issues
Over this participant 1 said “Physical health issues would be anything such as an illness or
injury that effects your body directly”. According to the interviewee 2 perspective there are
various physical health issues. Some of them are asthma, heart attack, cancer, diabetes and
various others.
Theme13: Seriousness of mental health elements (Depression, stress, anxiety, trauma)
This attributes of mental health issues are highly serious as they impact the mind of the
person and often force them to attempt suicide.
Theme14: Accountability for assuring women primary and mental health care services in
prison
It has been reviewed from interview that, in prison, large number of females are often
pregnant. Therefore, special care needs to be assure to those females so the child can be safe.
Also, throughout maternity period proper check-ups and primary care should be provided to
women. As a result, there is no negative experience has been gain by female in prison. The
analysation of interviews often reveals that higher authorities have made certain standards in
“Prison Handbook”. Thus, in accordance with prison handbook the prison management needs
to be done.
Theme15: Real provision for women in the prison
Participant 1 said that, in prison it is highly important to keep focus over checking such
women who are facing mental health issues. Along with this, the care needs to be provided
that can deal with the mental issues of women. However, participant 2 has said, it is the duty
of prison manager that they should have knowledge in context of mental traumas have been
experience by women in prison.
8 | Page

Thmem16: Custodial sentence needs to be given after analysing the current situation of the
prisoner
Over this participant 1 has said, “Depends on the crime but I do think certain provisions
should be put in place for pregnant women in prison”. In similar manner, participant 2 shows
their opinion while saying, Custodial sentence needs to be given on the basis of the crime that
has been committed by an individual. however, special case has to be assured in the prison if
an individual is suffering from any serious situation.
Theme17: Well-being provision for trans-gender prisoner
Over this, the interviewee 1 has said “Their full wellbeing should be taking into account
and ensuring that they still get equal treatment to other inmates”. Thus, Well-being
provision that has been given to male and female should be provided to trans-fender prisoner
as well. No discrimination has to be follow in this context. Also, a keen focus needs to be
made whether no one irritate and bully the trans-gender prisoner.
CONCLUSION
In conclusion, the findings were related to the well-being of women in prison as it is
the human right of the prisoner that they must get the fair and well treatment at the prison.
Findings have often shown that there are large number of misconception about male and
female gender treatment in prison. However, the standard rules and regulation depicts that,
prisoner must get the effective treatment in the prison. Harsh treatment towards the women in
prison can lead to create large number of mental issues. Also, the second participant has
evaluated that, there is need to provide effective well-being conditions so, they do not get any
trouble. Along with this, mail participant has said that, there is still up-to a certain extent
gender difference has been done in prison. The findings have often shown clear
understanding in relation of gender specific standards of health care in prison. It has been
found that specific health care standards have been determined for women in prison. Also,
specific health care standards have been determined for men and women specifically in the
prison. Thus, the interview comes over final conclusion and that is aligned with using
effective and fair practices in prison for women and men specifically.
9 | Page

REFLEXIVITY
From the current case study it is understood that there are various problems which a
person face because of the problem of bipolar disorder and the issues which arise from the
misuse of alcohol. I learnt various skills while completing the current file which helped in
fulfilling the objective of the interview. I learnt communication skills as it helped me in
interviewing the people and gathering various information. This helped in gathering the
information which is necessary for arriving at the conclusion. I learnt analytical skills as I had
to analyse the given case study for interviewing the people in better manner. As it will help
while interviewing people to ensure the responses collected will be relevant for the study. I
also learned what are the reasons the women end up in prison and the issues which are faced
by them in the prison. It is also learnt from this the differences in the gender which is faced
by the people who are in prison. While conducting the report it is understood various physical
and health issues which are faced by the people whose body is directly affected by injury or
illness. This report also taught what are the mental issues faced by people.
APPENDIX
Appendix A: Raw questionnaire
Single case, semi-structured interview: Health and Well-being, for Women in prison in
England, a Thematic Analysis
Questions for an interview with one or more participants:
Introductory statements:
 This interview is about a socially sensitive topic (health and wellbeing of women in
prison), are you happy to proceed?
10 | Page

 If at any point you feel uncomfortable, indicate you want to stop and also state if you
want all data concerning you, destroyed.
 Data collected will be stored safely, with limited access; before being destroyed after
use.
1. Participant Characteristics (can include rather not say):
 How would you describe your gender?
 How old are you?
 Employed or student?
 Married / live-with partner or single
 Any children?
 Any experience with the prison service (if yes, please outline)?
 Have any of your family or friends had any experiences with the prison service (if
yes, please outline)?
 How would you describe your physical health?
 How would you describe your mental health?
 Have you a favourite TV series or movie concerning prisons?
11 | Page

2. Main body of interview (The interviewee can be asked to
expand points from their responses):
 For what reasons do you think women end up in prison?
 How would you expect to be treated if you received a prison sentence?
 Considering your last answer, do you think reality and expectation may not match?
2a. How would you describe the purpose of imprisonment?
 In terms of health and wellbeing, should prison’s primary focus be on preventing
health problems or treating health problems?
 Are there gender differences in the health and wellbeing challenges that prison
presents?
2b. What do you understand by ‘gender specific’ standards in healthcare?
 What do you understand by physical health issues?
 What do you understand by mental health issues?
 Do you think mental and physical health issues are pre-existing and imported into
prison?
 Do you think mental and physical health issues are primarily created by being in
prison?
 What are the main issues for women regarding mental health and wellbeing?
 What are the main signs for women having mental health and wellbeing problems?
 How serious do you consider the following:
12 | Page

Depression
Self-harm
Risk of suicide
Substance abuse
Sexual health
Pregnancy
Diet
Weight control
 Who do you think is responsible for women’s wellbeing in prison?
 Who should provide women with primary, physical healthcare?
 Who should provide women with primary, mental healthcare?
 How should contact occur between health professionals and women prisoners?
3. Most of what you have said is probably based on ideals, what do you think is the real
provision for women in prison and how should it be improved?
4. Some other areas for consideration:
 Do you think anything you have said or think, should be considered as mitigating,
before giving a custodial sentence (eg. should a pregnant women/young mother be
sent to jail)?
 What do you think of mother and baby units in prisons?
13 | Page

 What wellbeing provisions should the prison service provide for full or partial trans-
gender prisoners?
Appendix B. Responses to surveys (x 2)
Male Participant
● This interview is about a socially sensitive topic (health and wellbeing of women in
prison), are you happy to proceed?
● If at any point you feel uncomfortable, indicate you want to stop and also state if you
want all data concerning you, destroyed.
● Data collected will be stored safely, with limited access; before being destroyed after
use.
Participant Characteristics (can include rather
not say):
● How would you describe your gender?
Male
● How old are you?
23
14 | Page

● Employed or student?
Student
● Married / live-with partner or single
Single
● Any children?
No
● Any experience with the prison service (if yes, please outline)?
No
● Have any of your family or friends had any experiences with the prison service (if
yes, please outline)?
No
● How would you describe your physical health?
I would say I have good physical health.
● How would you describe your mental health?
I would say I try to take care of my own mental wellbeing as its very important to health. At
the moment my mental health is in good condition.
Have you a favourite TV series or movie concerning prisons?
Orange is the new black
Main body of interview
15 | Page

1.1 For what reasons do you think women end up in prison?
They could have committed drug or property offences. Also they may have been sentenced for
violence against a person or robbery.
1.2 How would you expect to be treated if you received a prison sentence?
I would still expect to be treated with respect and not be discriminated against. I would
expect my religious beliefs to be respected as well as my cultural precepts. Furthermore, my
wellbeing should still be important, and I would expect to take part in education and
activities aimed at rehabilitation.
1.3 Considering your last answer, do you think reality and expectation may not
match?
In some respects, they wouldn't match but in general I think these are rights that prisoners
should have.
2.1 How would you describe the purpose of imprisonment?
I would say prison is the sharp end of our justice system and ultimately protects the public
from dangerous individuals. It is also the act of punishment for the crimes they have
committed.
16 | Page

3.1 Prison In terms of health and wellbeing, should prison’s primary focus be on
preventing health problems or treating health problems?
Preventing health problems
3.2 Are there gender differences in the health and wellbeing challenges that
prison presents?
There is likely to be gender differences however in general preventing and treating health
problems are still fundamentally the same.
3.3 What do you understand by ‘gender specific’ standards in healthcare?
They are designed to complement existing national and international health standards and
guidance for women in prison. Also the measures reflect fairly wellbeing of men and women
separately.
3.4 What do you understand by physical health issues?
Physical health issues would be anything such as an illness or injury that effects your body
directly.
3.5 What do you understand by mental health issues?
Health impacts on the mind and the wellbeing of an individual psychologically and
emotionally.
17 | Page

3.6 Do you think mental and physical health issues are pre-existing and
imported into prison?
No I believe prisons can lead to these health issues especially mental health issues.
3.7 Do you think mental and physical health issues are primarily created by
being in prison?
No, these also occur outside of prison.
3.8 What are the main issues for women regarding mental health and
wellbeing?
Anxiety, depression, and self-harm are fundamental issues that women may experience, and
prisons may exacerbate these issues.
3.9 What are the main signs for women having mental health and wellbeing
problems?
They may be feeling anxious or worried, depressed, sleep problems, weight or appetite
changes etc. These are common signs of mental health problems.
3.10 How serious do you consider the following:
Depression
Self-harm
Risk of suicide
Substance abuse
Sexual health
Pregnancy
18 | Page

Diet
Weight control
19 | Page

These are all important for an individual’s mental health, however in particular substance
abuse, self-harm, and depression are of key importance in preventing mental health problems.
4.1 Who do you think is responsible for women’s wellbeing in prison?
The medical and mental health care and ultimately its the government's responsibility to ensure
prisoners are kept in good health whilst in prison.
4.2 Who should provide women with primary, physical healthcare?
It should be the job of the prisons to provide this.
4.3 Who should provide women with primary, mental healthcare?
This should again be provided by the prison.
4.4 How should contact occur between health professionals and women prisoners?
Should be carried out by the healthcare team in a safe and secure manner.
4.5 Most of what you have said is probably based on ideals, what do you think is the
real provision for women in prison and how should it be improved?
They would get essential health care but in reality, it probably isn't sufficient.
5. Some other areas for consideration:5.1 Do you think anything you have said or think, should be considered as
mitigating, before giving a custodial sentence (eg. should a pregnant
women/young mother be sent to jail)?
1

Depends on the crime but I do think certain provisions should be put in place for pregnant
women in prison.
5.2 What do you think of mother and baby units in prisons?
I agree with them on some aspects as they allow the mother and baby to live together in a
peaceful safe place.
5.3 What wellbeing provisions should the prison service provide for full or partial
trans-gender prisoners?
Their full wellbeing should be taking into account and ensuring that they still get equal treatment
to other inmates.
FEMALE PARTICIPANT
I have answered the characteristics part and also 9 of your questions.
Participant Characteristics (can include rather not say):
• How would you describe your gender? Female
• How old are you? 27
• Employed or student? Employed & Student
• Married / live-with partner or single Married
• Any children? 1 Child
• Any experience with the prison service (if yes, please outline)? No
• Have any of your family or friends had any experiences with the prison service (if yes, please
outline)? No
2

• How would you describe your physical health? Relatively healthy
• How would you describe your mental health? Relatively healthy
• Have you a favourite TV series or movie concerning prisons? Criminal Minds/Special Victim
Unit/NCIS
Main body of interview
• For what reasons do you think women end up in prison? Perhaps mostly due to domestic
violence, and what may seem self-defence
• How would you expect to be treated if you received a prison sentence? Perhaps how I look may
affect how I would be treated due to the colour of my skin and religion. So, unless I do not find a
group that look like me, I assume I would be treated unfairly.
• Considering your last answer, do you think reality and expectation may not match? I fear the
reality and expectation may be quite similar.
• How would you describe the purpose of imprisonment? Not much to do with rehabilitation, but
rather a reinsertion of power by the elites.
• In terms of health and wellbeing, should prison’s primary focus be on preventing health
problems or treating health problems? I believe inmates should be provided with the same level
of care as those outside of prison, and so health would be just as prioritised as all other important
3

aspects in the outside world.
• Are there gender differences in the health and wellbeing challenges that prison presents? I’m
not so sure I would know the answer to this, sorry.
• What do you understand by ‘gender specific’ standards in healthcare? I was unaware that
standard in healthcare was gender specific. Within the UK, I believe that equality in this
retrospect is achieved, especially between gender. Perhaps not to much when comparing class,
ethnicity, or those kind of segregated topics.
• What do you understand by physical health issues?
• What do you understand by mental health issues?
• Do you think mental and physical health issues are pre-existing and imported into prison? I feel
everyone has a tendency to slip into a mental health or physical health crisis. Going into prison
could therefore be a gateway to this. It does not necessarily mean that everyone that goes into
prison experienced mental or physical health issues. It could just be a stressor that affects and or
increases such issues.
• Do you think mental and physical health issues are primarily created by being in prison? I
would not say created by being in prison, but perhaps assisted for some people who may not
have had issues outside of prison.
• What are the main issues for women regarding mental health and wellbeing?
• What are the main signs for women having mental health and wellbeing problems?
• How serious do you consider the following:
Depression
4

Self-harm
Risk of suicide
Substance abuse
Sexual health
Pregnancy
Diet
Weight control
• Who do you think is responsible for women’s wellbeing in prison?
• Who should provide women with primary, physical healthcare?
• Who should provide women with primary, mental healthcare?
• How should contact occur between health professionals and women prisoners?
• Most of what you have said is probably based on ideals, what do you think is the real provision
for women in prison and how should it be improved?
5