Women’s health in prison

Women are paying a higher price in prison than men. Women entering prison are often victims of abuse, have problems with the use of illicit drugs and or alcohol, care and provide for children and have mental disorders. They enter prison often having lived at the margins of society and being poorly educated and disadvantaged both socially and economically.

Despite the major differences in the policies and practices across Europe to address the special needs of women in prison, the evidence for what should be done is clear. The criminal justice system as a whole must ensure gender equality, provide services to address the main health problems of women in prison and work in the interests of any children involved. The prison environment and those working within it should recognize and accommodate the specific, individual health needs of women and guarantee that their human rights are maintained.

To help policy-makers, senior management in women’s prisons and prison staff, WHO/Europe and the United Nations Office on Drugs and Crime have developed three checklists to ensure greater safety and better quality health care for women in prison. The checklists provide a way to assess the current situation and detect the areas of service that could be improved.

The checklists will be released at the WHO Network Meeting for Prison Health taking place on 4–5 October 2011 in Abano Terme, Italy.

Health issues for women in prison
•Although women constitute a very small proportion of the total prison population in Europe, 4–5% on average, the number of women in prison is increasing rapidly. There are about 100 000 women in prison in Europe on any given day. Most offences for which women are imprisoned are non-violent and related to property or illicit drugs. Women who are sent to prison bring with them complex problems, needs, anxieties, illnesses and distress. Prison worsens these problems and increases the vulnerability of most of these women.
•Incarcerated women are far more likely to have had traumatic experiences in early childhood than incarcerated men, such as early sexual, mental and physical abuse. Half have experienced domestic violence.
•Many women in prison are mothers and usually the primary or sole carers for their children. About 10 000 children in Europe are estimated to be affected by their mother’s imprisonment. In most European countries, young children can stay in prison with their mothers: three years is the most common age limit. Facilities vary widely between countries.
•At least 75% of women entering prisons in Europe are estimated to have problems with the use of illicit drugs and alcohol. Further, women prisoners are more likely than male prisoners to inject drugs.
•Mental disorders are overrepresented among women prisoners; 80% of women in prison have an identifiable mental illness. Two thirds of women prisoners have post-traumatic stress disorder. One in ten has attempted suicide before being imprisoned. Women prisoners are more likely to harm themselves and commit suicide than male prisoners, whereas suicide is more common among men outside prison.
•Women prisoners often have a higher prevalence of HIV and other infectious diseases than male prisoners.
•Women prisoners have specific needs related to reproductive health issues such as menstruation, pregnancy and menopause. This includes access to regular showers and a greater need for adequate nutrition and personal care products.
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