Dataset Information

Deterioration, drift, distraction, and denial: How the politics of austerity challenges the resilience of prison health governance and delivery in England.

ABSTRACT: Extant scholarship has demonstrated that macroeconomic austerity disproportionately harms marginalised end-users. Its impact on the governance and delivery of health provisions on such individuals, however, has received less attention. Drawing on interviews with 27 policy elites involved with England's prison health policy, interviewees perceive that austerity policies have shaped and constrained the prison health system through the politics of deterioration, drift, distraction, and denial. The deterioration of the prison workforce size has been linked to diminished prisoner access to healthcare, attendant with an increased number of riots, assaults, acts of self-harm, and suicides. Concurrently, the microeconomic structure of organised crime is filling the void in prison governance, thus conducing to heightened abuse of psychoactive substances, as well as a surge in associated medical emergencies and violence. Successful prosecution of prior sexual offences, continued incarceration of those imprisoned for indeterminate sentences, and harsh sentencing practices have created policy drift, unremitting overcrowding, and reinforced excessive dependency on prison healthcare resources. The rapid turnover of justice ministers and intensified push for prison privatisation have enabled widespread distraction. Moreover, despite well-documented crises besetting English prisons, politicians seemingly remain in a state of denial. Preventive imprisonment, recurrent spending, and enhanced financial and political accountability measures are necessary to mitigate the effects of austerity and germane policies fomenting inimical impacts on England's prison health system.

SUBMITTER: Ismail N

PROVIDER: S-EPMC7505109 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Deterioration, drift, distraction, and denial: How the politics of austerity challenges the resilience of prison health governance and delivery in England.

Ismail Nasrul N

Health policy (Amsterdam, Netherlands) 20200921 12

Extant scholarship has demonstrated that macroeconomic austerity disproportionately harms marginalised end-users. Its impact on the governance and delivery of health provisions on such individuals, however, has received less attention. Drawing on interviews with 27 policy elites involved with England's prison health policy, interviewees perceive that austerity policies have shaped and constrained the prison health system through the politics of deterioration, drift, distraction, and denial. The ...[more]

PMID: 32988648

Similar Datasets

Project description:Non-technical summaryOur analysis shows that the framing of social vulnerability is shaped by a narrow definition of resilience, focusing on post-disaster return and recovery responses. This perspective does not account for the dynamism and non-stationarity of social-ecological systems (SES) which is becoming increasingly important in the face of accelerating environmental change. Incorporating social-ecological resilience into social vulnerability analysis can improve coastal governance by accounting for adaptation and transformation, as well as scale and cross-scale interactions.Technical summarySocial vulnerability analysis has been unable to deliver outcomes that reflect the reality of vulnerability and its consequences in an era characterised by accelerating environmental change. In this work, we used critical discourse analysis and key informant interviews to understand different framings of social vulnerability in coastal governance and management, globally and in New Zealand. We found that the framing of system vulnerability could vary depending on the definition of resilience adopted, which has critical ramifications for coastal governance of linked systems of humans and nature. We found that the framing of social vulnerability in coastal governance is mainly influenced by engineering, community and disaster resilience, focusing on return and recovery governance responses to environmental change (e.g. hurricanes, wildfires). Instead, we suggest a novel perspective based on social-ecological resilience, which more accurately reflects the dynamics of linked systems of humans and nature (SES). This revised perspective, general vulnerability, accounts for the dynamics of Earth's systems across various spatial and temporal scales in the face of accelerating environmental change. Accounting for social-ecological resilience and its core aspects (i.e. panarchy, adaptation and transformation) is essential for informing coastal governance of SES (Do we adapt? or Do we transform the SES?).Social media summarySocial-ecological resilience is essential for social vulnerability analysis in the face of accelerating environmental change.

Project description:ObjectiveInsomnia is highly prevalent in prisoners and is a risk factor for poor mental well-being, depression, suicidality and aggression, all common concerns in this vulnerable population. Improving sleep management options in prison offers the potential to impact positively on a number of these common risk factors. The study aim was to design a treatment pathway for insomnia in prisons informed by stakeholders with professional or lived experience of insomnia and prison-based interventions.DesignA modified Delphi technique, adapted to the stakeholder (either receiving controlled feedback online or face to face on a series of statements), was used over three rounds to gain consensus on a final treatment pathway design.ParticipantsAcademic sleep researchers, prison staff and prisoners were invited to develop the treatment pathway.ResultsFifteen stakeholders took part in round 1 and thirteen in round 2. There were six statements of contention that comprised concerns over the inclusion of sleep observations, sleep restriction therapy and promethazine. Consensus was high (>80%). Thirteen stakeholders agreed the final pathway in round 3. The final treatment pathway comprised a standardised stepped-care approach for insomnia in prison populations. The pathway resulted in five main stages: (1) transition from community; (2) detection and assessment; (3) treatment for short-term insomnia; (4) treatment for long-term insomnia and (5) transition from prison to community or another establishment.ConclusionsThe treatment pathway is designed to promote early detection of insomnia, potentially reducing unnecessary prescriptions and medication trading, misuse and diversion in the prison setting. It should make a substantial difference in reducing the large number of sleep complaints and positively impact on prisoners, staff and the prison environment. Specifically, improving sleep should have a positive impact on prisoners' mental and physical well-being and aid smooth running of the prison.

Dataset Information

Deterioration, drift, distraction, and denial: How the politics of austerity challenges the resilience of prison health governance and delivery in England.

Publications

Deterioration, drift, distraction, and denial: How the politics of austerity challenges the resilience of prison health governance and delivery in England.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets