Health-promoting Imprisonment Is Being Deprioritised

For several decades, Norwegian prison research has focused on the pains of imprisonment, isolation and the harm that prison does.

But what is needed for a prison to actually promote health, personal growth and hope?

Research shows that what is needed is something quite different from the developments currently under way in Norway.

According to criminologist Pernille Nyvoll, the Norwegian authorities are currently investing in large, modular high-security prisons. Small low-security prisons are being scaled back. Yet it is these that work best for prisoner health and wellbeing.

- In smaller settings, it is easier to preserve the prisoners' identity and autonomy, while building close, trust-based relationships between prisoners and staff, says Nyvoll.

Low-security prisons also offer a clear socio-economic benefit. They cost almost half as much to run as high-security prisons, according to the Norwegian Correctional Service's annual report for 2024, while also providing a significantly better foundation for rehabilitation.

Health is more than just the treatment of illness

If we are to focus on health and rehabilitation during imprisonment, it is not enough simply to treat illness when it arises. Health in a prison context is about much more than just the health services provided in the prison.

It is about creating a safe and secure environment where prisoners are treated as human beings, where they are gradually given more responsibility and experience stability in their daily lives. It is very much about how you feel you are treated as a human being.

To understand these mechanisms, Nyvoll has spent a great deal of time with both prisoners and staff to observe how the prison functions in practice.

- I've looked at everything that influences whether you have a good or a bad day in prison. I've spoken to both prisoners and staff.

Nyvoll explains that in several of the new prisons, it is more difficult to maintain a good prisoner-staff relationship.

- It is not the absence of control and security that makes the low-security prisons successful, but the presence of trust, responsibility and humanity, she explains.

- Since we don't have life sentences in Norway, they will inevitably return to society after serving their sentence. And we naturally want people to be released in better health, particularly in terms of their mental health. Both so that they can lead normal lives and not reoffend, and so that they can find work and be of use to one another.

Health-promoting prisons

Small, open low-security prisons, such as Leira and Bastøy, are far better placed to promote health and wellbeing than large high-security prisons.

- Not all prisons can offer swimming lessons in the sea, but they can at Bastøy. At Leira, it's possible to go for walks with dogs, says Nyvoll.

It is about more than just outdoor activities. The prison's design, natural surroundings and social setting have a direct impact on the prisoners' mental, physical and social health.

When asked what the concept of 'health-promoting prisons' entails, she replies:

- Traditional prison research has largely focused on the restrictions imposed by prison. That it causes pain, discomfort and frustration. In my research, I've looked more at the opportunities that exist, and at how prisons can contribute to greater wellbeing and incorporate health-promoting elements, says Nyvoll.

At the same time, she reminds us of an absolutely fundamental principle:

- Prisoners also have the right to good health.

The forgotten groups in the prison system

Norway is internationally recognised for its open low-security prisons. But Nyvoll's research shows that this applies to only a small number of prisoners. Highly vulnerable groups are excluded from these health-promoting prison conditions.

Three groups in particular suffer as a result:

- Women lack access to open low-security prisons equivalent to those for men; people with severe disabilities lack universal design features such as lifts; and foreign nationals are often placed in high-security facilities due to a presumed risk of escape, she explains.

Harmful versus constructive pains

Imprisonment inevitably involves pain and discomfort. But pain during imprisonment is not necessarily negative, provided it is linked to positive processes of change, argues Nyvoll. Such processes may involve pursuing education, establishing good daily routines and confronting one's own past in a supportive environment.

It is therefore crucial to distinguish between harmful and constructive pains.

- Harmful pains are things like the damage caused by isolation, or other purely negative consequences. Constructive pains may be linked to the challenges of changing routines and the greater expectation that they take responsibility.

A misguided policy direction

The Norwegian Correctional Service currently faces some tough decisions about priorities. However, Nyvoll's research reveals a clear contradiction between research-based knowledge and the current policy direction. As a result, fewer prisoners benefit from health-promoting prison conditions. Ultimately, this may lead to poorer rehabilitation and an increased risk of reoffending.

Nyvoll sums it up like this:

- My findings confirm previous findings. That smaller prisons are better, and low-security prisons are better.

- If the Norwegian prison system is to maintain its reputation for being humane and rehabilitative, it might be wise to stop building large closed prisons and instead focus on smaller, open units that allow for real change, as the research shows.