Womens health in prison

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Womens health in prison

• By Ingrid Lycke Ellingsen
• Spec. psychiatry

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Women a neglected minority in the prison
context?

• 2-10 of the total prison population.
• Women seek medical attention more often than men.
• Women have, in addition to common ailments,
  different gender-specific problems/disorders.

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• Why are female detainees seeking the medical
  service more often than male?
• Has the prison environment a greater negative
  impact on women than men?

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Overcrowding
Malnutrition
Lack of hygiene
General weakness
Insufficient water
Drinking
Washing
Toilets
Flies and mosquitos
Infections
Contagious diseases
Risk of epidemics
Risk of mortality
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4 main groups

• Somatic diseases
• Mental health problems/diseases
• Women-specific health-related problems/diseases
• Others

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Somatic diseases

• Chronic (e.g. heart/lung, diabetes, epilepsy,
  cancer)
• Musculoskeletal
• Neurological
• Transmissible diseases (e.g. TB, HIV/Aids,
  hepatitis)

• Dependency (drugs, alcohol, tobacco,
  legal/illegal medicines)
• Dental
• And many more

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Mental health

• Depressive reactions, anxiety, stress
• Sleep disturbances
• Personality disorders
• Self harm
• Suicide attempt/suicide
• Psychosis

• Drug related disorders
• ADHD
• PTSD

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Women-specific health related problems/disorders

• Amenorrhea, irregular bleedings
• Infections (e.g. HIV, Chlamydia, Gonorrhea)
• Sequele after sexual abuse/violence
• Abort, pregnancy, birth

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Other vulnerable groups

• Ill-functioning women
• Physically or mentally disabled
• Brain damaged
• Victims of exploitation, bullying, trafficking

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By reception 3 questions to ask

• Is the person dangerous to herself? (Is she
  seriously ill? Has she withdrawal symptoms? Is
  there a risk for self harm/suicide?)
• Is the person dangerous to others? (Has she a
  transmissible disease? Is she in mental unbalance
  which can result in violence?)
• What measures shall be taken by the health care
  service?

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Prevention treatment - rehabilitation

• Easy access to doctors/nurses (initial screening,
  regular consultations, emergency treatment)
• Equivalence of care
• Staff (adequate numbers, competence, and
  professional independence)
• Suitable equipped infirmary/hospital ward

• Adequate supply of medicines
• Facilities for physiotherapy
• Consent and confidentiality
• Specific protection of the most vulnerable
  (children, youth, mentally diseased, chronically
  ill, terminally ill)

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