Availability and use of healthcare resources in prisons according to the transference model: a comparative study in Spain.

OBJECTIVE: In most European countries, correctional healthcare provision is under strain or in the process of change regarding its management model and the implications that such modifications may entail for the improvement of inmates' health. This paper compares the functioning and the results of health management in a facility whose healthcare service is integrated within an autonomic health system and others which depend on the department of corrections. MATERIALS AND METHODS: Cross-sectional study where the study unit is the facility itself. From the data collected from the record of Monthly Health Statistics of Penitentiary Institutions we have constructed a series of indicators according to the recommendations of the National Health System. RESULTS: The physician to nurse ratio per inmate is higher in the transferred facility. Only the transferred establishment has telemedicine resources. Attendance to primary health services is higher that in all non-transferred establishments, while the mean attendance to specialized consultation in the transferred facility doubles that of the remaining centers. DISCUSSION: We have observed greater access to specialized care in the correctional facility managed by the community health system when compared to that of the facilities managed by Penitentiary Institutions. This statement is based on a series of effectivity indicators and results that have provided significantly improved outcome in the transferred facility.

[Participatory design guide for mental health promotion in prisons]. / Diseño participativo de una Guía para la Promoción de la Salud Mental en el medio penitenciario.

OBJECTIVE: [corrected] The main aim was to describe the issues and the participatory process required to design a Guide to promotemental health in prison through group activities. MATERIAL AND METHOD: We reviewed the bibliography, the mental health policies, the workshops about healthy mental habits, and a video about protection and risk factors. We identified the stakeholders and sought their points of view about the topics included in the Guide. We decided on the contents of the Guide and the incorporation of the health assets model and the perspectives provided by gender and cultural diversity. After the initial design of the modules and sessions, we started a pilot in the Prison of Valencia and the Prison of Zaragoza with women and men from different cultures, incorporating the suggested improvements, unifying contents and the discursive style. RESULTS: The guide is formed by: a preface, introduction, description, modules, sessions and evaluation. It has 6 modules and 19 sessions on: health and motivation; self-esteem; health and emotions; more assets to improve health: relax, positive thinking, keeping calm, communication and problem resolution; progress is possible: resiliency and starring in my own change. Each session consists of: activities (objectives, material, allocated time and development), theoretical material and tabbed sheets for activities. The guide is available in print and online versions. CONCLUSIONS: A guide has been elaborated with involved stakeholders and the opinion of the prison population.

[A new prison health care model: the experience of the Basque Country]. / Un nuevo modelo asistencial penitenciario: la experiencia del País Vasco.

A year after the transfer of prison health care functions and services from the State Administration to the Autonomous Community of the Basque Country, the process up to completion of the transfer, the current status of the transferred services and remaining challenges are described.

Un nuevo modelo asistencial penitenciario: la experiencia del País Vasco / A new prison health care model: the experience of the Basque Country

Un año después del traspaso de las funciones y servicios de la Administración del Estado a la Comunidad Autónoma del País Vasco en materia de sanidad penitenciaria, se describe el proceso que se ha seguido hasta la culminación de la transferencia, la situación actual de los servicios transferidos y los retos pendientes(AU)

A year after the transfer of prison health care functions and services from the State Administration to the Autonomous Community of the Basque Country, the process up to completion of the transfer, the current status of the transferred services and remaining challenges are described(AU)

[Health care strategies for mental health problems in the prison environment, the Spanish case in a European context]. / Estrategias asistenciales de los problemas de salud mental en el medio penitenciario, el caso español en el contexto europeo.

INTRODUCTION: A review was carried out of scientific literature on health care strategies for mental health problems in the prison environment. Data is given about the main activities put into practice by prison administrations as a response to the worrying information that has come to light in recent epidemiological studies on mental disorders in prison, with figures that, when compared to the general population, give results of double the number of cases of Common Mental Illness (CMI) and four times the number of cases of Severe Mental Illness (SMI) amongst prison inmates. MATERIALS AND METHODS: A review was made of the most important bibliographical databases containing health care policies for mental health problems in prison published by prison administrations in the last 10 years. This information was completed with other data obtained from an analysis of the indicators available in Health Care Coordination on its health care strategies for mental health in centres run by the Secretary General of Prisons, in Spain. RESULTS: There is little in the way of scientific literature that clearly states health care policies for mental illness in the prison environment. Those that do tend to agree with a number of affirmations that include the obligation to offer a therapeutic response of equal quality to that received by patients in the community, the need for a multi-disciplinary team responsible for caring for this type of patient, along with a coordinated effort between the medical, social, legal and prison administrations that at a given time have to care for them.

Estrategias asistenciales de los problemas de salud mental en el medio penitenciario, el caso español en el contexto europeo / Health care strategies for mental health problems in the prison environment, the spanish case in a european context

Introducción: Se ha revisado la literatura científica sobre estrategias de atención a los problemas de salud mental en el medio penitenciario. Se aportan datos de las principales actuaciones puestas en práctica por las administraciones penitenciarias para responder a las preocupantes cifras que señalan los más recientes estudios epidemiológicos de trastornos mentales en prisión, con tasas que comparadas con la población general, duplican los Trastornos Mentales Comunes (TMC) y cuadriplican los Trastornos Mentales Graves (TMG) entre las personas que se encuentran en prisión. Material y métodos: Se han revisado las bases de datos bibliográficas más importantes sobre las políticas asistenciales a los problemas de salud mental en el medio penitenciario, que han sido publicadas por los responsables de las administraciones penitenciarias en los últimos 10 años. Estos datos se han completado con datos obtenidos con el análisis de los indicadores disponibles en la Coordinación de Sanidad sobre las estrategias propias en materia de asistencia a problemas de salud mental en centros dependientes de la Secretaría General de Instituciones Penitenciarias, en España. Resultados: Hay poca literatura científica donde se enuncien las políticas asistenciales de las diferentes administraciones sobre la asistencia a problemas de salud mental en el medio penitenciario. Las que lo hacen están de acuerdo en una serie de afirmaciones: se debe ofrecer una respuesta terapéutica de igual calidad a la recibida por los enfermos en la comunidad, debe ser un equipo multidisciplinar el encargado de atender a este tipo de pacientes, es preciso un esfuerzo de coordinación entre las administraciones que en un momento determinado deben atender a estos pacientes, la asistencial, la social, la judicial y la penitenciaria(AU)

Introduction: A review was carried out of scientific literature on health care strategies for mental health problems in the prison environment. Data is given about the main activities put into practice by prison administrations as a response to the worrying information that has come to light in recent epidemiological studies on mental disorders in prison, with figures that, when compared to the general population, give results of double the number of cases of Common Mental Illness (CMI) and four times the number of cases of Severe Mental Illness (SMI) amongst prison inmates. Materials and methods: A review was made of the most important bibliographical databases containing health care policies for mental health problems in prison published by prison administrations in the last 10 years. This information was completed with other data obtained from an analysis of the indicators available in Health Care Coordination on its health care strategies for mental health in centres run by the Secretary General of Prisons, in Spain. Results: There is little in the way of scientific literature that clearly states health care policies for mental illness in the prison environment. Those that do tend to agree with a number of affirmations that include the obligation to offer a therapeutic response of equal quality to that received by patients in the community, the need for a multi-disciplinary team responsible for caring for this type of patient, along with a coordinated effort between the medical, social, legal and prison administrations that at a given time have to care for them(AU)

Public health gains from health in prisons in Spain.

An epidemic of HIV infections which occurred in Spanish prisons at the turn of the century led to the establishment of a comprehensive set of harm reduction measures including needle and syringe exchange in prisons throughout the country. This article outlines the measures taken and the impact they had in greatly reducing the infection rates of HIV and the cases of AIDS.

[Results of the Spanish experience: a comprehensive approach to HIV and HCV in prisons]. / Resultados de la experiencia española: una aproximación global al VIH y al VHC en prisiones.

AIMS: to measure the results of prevention, health promotion and damage reduction programs for the health of the prison population via the progress of a number of illnesses in these contexts. MATERIALS AND METHODS: The information was taken from reports, bulletins, specifications, central records and other documents containing health information from 1993 to 2009 RESULTS: The prevalence of HIV has diminished 3.5 times and HCV has gone down by 50% in the last ten years. The rates of seroconversion within prisons have gone down by 85% in the case of HIV and by 71% for HCV. The incidence of tuberculosis and AIDS has decreased by 85% and 93.7% respectively. The number of users of damage reduction, methadone maintenance and syringe exchange programs has progressively increased to the point where the number of IDUs has begun to diminish, while the health mediators program has been implemented in practically all prisons. DISCUSSION: In response to WHO criteria, a series of activities were set in motion in the 90s by prisons, which focused on improving the situation of the prison population, including illness prevention and control, and damage reduction and health promotion programs. These have significantly contributed to improving the health of a population that comes from what only can be regarded as a highly vulnerable situation outside prison.

Resultados de la experiencia española: una aproximación global al VIH y al VHC en prisiones / Results of the spanish experience: a comprehensive approach to HIV and HCV in prisons

Objetivo: determinar, mediante la evolución de algunas de estas enfermedades, los resultados de los programas de prevención, promoción de la salud y reducción de daños en la salud de la población reclusa. Material y método: La información se ha recogido de informes, boletines, memorias, registros centrales y otros documentos con información sanitaria desde 1993 hasta 2009. Resultados: La prevalencia de VIH ha disminuido 3,5 veces y la de del VHC se ha reducido a la mitad en los últimos diez años. Las tasas de seroconversión dentro de la prisión han descendido un 85% en VIH y un 71% en VHC. La incidencia de tuberculosis y de sida han descendido un 85% y un 93,7% respectivamente. Los programas de reducción de daños, mantenimiento con metadona e intercambio de jeringuillas, han aumentado de forma progresiva sus usuarios hasta que empezó a disminuir el número de UDIs en las prisiones, mientras que el de mediadores en salud se ha implantado en la práctica totalidad de los centros. Discusión: La puesta en marcha por parte de Instituciones Penitenciarias a principios de los años noventa, siguiendo los criterios de la OMS, de una serie de actuaciones encaminadas a mejorar la situación de la población reclusa, incluyendo programas de prevención y control de enfermedades, programas de reducción de daños y de promoción de la salud ha contribuido a mejorar de forma significativa la salud de una población que proviene de una situación que se podría considerar de vulnerabilidad en el exterior de la prisión(AU)

Aim: to measure the results of prevention, health promotion and damage reduction programs for the health of the prison population via the progress of a number of illnesses in these contexts. Materials and methods: The information was taken from reports, bulletins, specifications, central records and other documents containing health information from 1993 to 2009 Results: The prevalence of HIV has diminished 3.5 times and HCV has gone down by 50% in the last ten years. The rates of seroconversion within prisons have gone down by 85% in the case of HIV and by 71% for HCV. The incidence of tuberculosis and AIDS has decreased by 85% and 93.7% respectively. The number of users of damage reduction, methadone maintenance and syringe exchange programs has progressively increased to the point where the number of IDUs has begun to diminish, while the health mediators program has been implemented in practically all prisons. Discussion: In response to WHO criteria, a series of activities were set in motion in the 90s by prisons, which focused on improving the situation of the prison population, including illness prevention and control, and damage reduction and health promotion programs. These have significantly contributed to improving the health of a population that comes from what only can be regarded as a highly vulnerable situation outside prison(AU)

Estudio de utilización de psicofármacos en el centro penitenciario de Zuera en 2006: análisis comparativo / No disponible

No disponible