Abstract
People in prison have a larger burden of disease than the general public. The high prevalence of disease in this population is recognized as a significant public health issue. Given the high turnover of the prison population, prisons present a complex challenge for public health. Addressing the health needs of the prison population can also have a positive impact on the wider community.
SEHSCT has the remit to provide Healthcare in Prison in the 3 Northern Ireland Prisons for a population of approximately 1600 people. A multidisciplinary team provide primary and secondary care. The Health Engagement team are providing support to health and wellbeing. The time of committal into custody is recognised as a time of high risk for many. In-depth interviews were conducted with 160 people entering custody the regional survey 10000 Voices was adapted for a prison The survey highlighted the need for improved communication at the time of committal about the accessing healthcare services, the prison regime and how to keep well in prison.
In 2019 Healthcare Peer Mentors were introduced to HMP Maghaberry. Their initial role was to navigate people towards healthcare services and support people in their time of entering custody.
Ask HIM (Health Information Mentor) Peer Mentors connect with people in the first 48 hours of entering custody, focusing on those first time in prison, helping navigate complex prison systems. Mentors lead induction sessions, health information groups and are a rich source of referrals across all Healthcare in Prison (HiP) services. They have had over 2000 engagement encounters since the pilot resulting in more than 1100 healthcare referrals.
To systemise the peer mentor network it was essential to establish an inter-agency Peer Mentor Hub. The steering committee included NI Prison Service governors, in-reach agencies, people in custody, HiP clinical and support staff with senior management sponsorship to support and operationalise plans. A mapping exercise was conducted to understand the current status of mentoring and an iterative design process was adapted to establish the Hub. This has developed a new way of working across organisations, coproducing the Peer Mentor Hub with the mentors themselves.
Peer Mentor Hub Core Pillars:
- Standardised Recruitment process for all agencies mentors
- Training Courses in advocacy and mentorship by Belfast Met College.
- Supervision of mentors with the HiP psychology team
- Monthly mentor sessions to meet share food and relax
Outcomes of Peer Mentor Hub
A robust evaluation measurement plan includes:
- Quality of Life Measures
- Impact on Incidents
- Impact on Complaints
- Mentor Qualifications
The Peer Mentor Hub and Network have been evaluated and are evidencing the improvement of the committal time of custody, reducing risk, demystifying the regime and increasing access to care. The impact on the mentors has been positive with reported increase in confidence, qualifications and hope. A Peer Mentor Network is a challenge to cede power and challenge to command and control hierarchy, in a prison it take braves leadership to recognise the potential of social capital.