Is mental heal care in women's prisons adequate?

Some individuals and groups, find it difficult to seek healthcare, including prisoners. This group is recognised as needing input but are often difficult to engage, yet failure to meet their needs can be devastating for the health of individuals and have wider implications on society. This qualitative study explored the perceptions of female prisoners who had not yet consulted the mental health team. I aimed to find out what support these women seek out while in prison, what difficulties they encountered in getting psychological help and whether they avoided statutory mental health services. Participants revealed during semistructured interviews that continuing to have a caring role for their families encouraged them to feel more positive and supported. Support from family members, specialist prison officers and the multi-faith centre staff team was also highly regarded. Some of the participants reported experiencing problems self-referring to prison mental health services, for example when transferred to a new prison. They identified the prison application system and inreach administrative failings as weaknesses, alongside other variables. I found that prisoners did not avoid mental health services and often once settled in the prison, they reconsidered their need for statutory support.

Health-related quality of life in hospital inpatients with pressure ulceration: assessment using generic health-related quality of life measures.

The objective of this study was to determine the impact of pressure ulceration on health-related quality of life (HRQoL) and to undertake a pilot study for a future larger study. The study comprised two parts. First, data from a large UK prospective cohort study were analyzed and the HRQoL of 218 people with pressure ulcers was compared with that of 2,289 people without ulcers using the Short Form-36 (SF-36) questionnaire. After adjusting for age, sex, and comorbidities, patients with pressure ulceration had significantly lower scores for both the physical (coefficient=-3.12, p<0.001) and mental (coefficient=-1.50, p=0.04) component summary scores of the SF-36. Second, a small pilot study was conducted to explore use of other tools. HRQoL was assessed in six patients with and 16 patients without pressure ulcers using the SF-36, the EQ-5D and a pain visual analog scale. SF-36 scores indicated that patients with pressure ulcers had significantly poorer physical functioning (d=22.3, p=0.001), role limitations due to physical problems (d=12.9, p=0.02), and vitality (d=20.6, p=0.04) than those without. EQ-5D scores were also poorer for patients with pressure ulceration, for both the visual analog scale (d=19.2, p=0.02) and the index (d=0.29, p=0.08). Patients with pressure ulceration had more perceived pain than those without; however, this difference was of borderline significance (d=-23.9, p=0.06). Pressure ulceration therefore has an impact on HRQoL that is measurable and persists after adjusting for potential confounding.