Protecting mental health in prisons during COVID

Burnet researchers are calling on state and federal policymakers to consider the mental health of people in prison in their responses to COVID-19.

In a letter to the editor of the Australian & New Zealand Journal of Psychiatry (ANZJP), Burnet Head of Public Health Professor Mark Stoové, and Burnet Research Assistants, Ashleigh Stewart and Reece Cossar, expressed their concerns about the impact COVID-19 control strategies could have on the mental health of incarcerated people.

The authors wrote that "custodial settings have seen an emergent emphasis on physical distancing and quarantining", warning those measures "pose a significant risk for people with mental illness.

"Rates of severe mental illness and mental health morbidity and mortality are substantially higher among people in prison compared to general populations."

Ms Stewart said that people in prisons have high rates of chronic illness, high rates of respiratory disorders, and smoke at a much higher rate than the general population.

Despite these risk factors, she said that "people in prison are the last people the public health response really covers.

"We know that if COVID-19 was to get into the prison system, it would be quite devastating. But we are also conscious that implementing harsh rules and circumstances for people in prison could have a really huge impact on mental health."

Ms Stewart, who is working on Burnet's Prison and Transition to Health (PATH) study as part of her PhD, said the parallels between COVID-19 isolation and solitary confinement, in practise or perception, could have detrimental consequences.

"These are prisons. They are not equipped to quarantine people in hotels or quarantine people in nice settings in their houses. In that sense, it just really amplifies that effect on mental health," she said.

The authors noted that visitation restrictions in Italian prisons resulted in rioting and said that "opportunities for contactless social engagement and periods spent outdoors need to be integrated" into responses.

Ms Stewart said that prisons need to do more to make contactless communication possible to lessen mental health impacts.

"If people aren't coming into the prison system, can we allow them to have better contacts through increased phone calls?" she said.

"At the moment, it costs for phone calls. Take away the charge, allow people to have freely available phone calls."

The authors concluded that "there is considerable public dialogue" around "balancing strategies to protect mental health and well-being in the community alongside COVID-19 control imperatives".

"The same considerations must be applied to measures implemented in prison," they wrote.

To read the full letter:

Impact of COVID-19 on Mental Health in prisons

Know-C19 Hub

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