Health Care in Prison or Jail

Skip anything

Every question is optional. No one has to retell painful events, name a diagnosis, or choose a religion or identity to begin.

Pause or stop

Stop at any point. Nothing is sent anywhere, and nothing is shared unless the person chooses it in the sharing review.

Whose words

Record who said each thing: the person, a caregiver or surrogate, or a professional. A caregiver's needs get their own field.

Support to take part

Extra time, a quieter place, pictures, an interpreter or a trusted person can help someone say what matters. Ask what helps.

Barriers are not preferences

Cost, travel, work, housing, caring for others and digital access are written down as barriers, not as what the person wants.

Meaning, religious or not

Hope, purpose, faith, relationships and identity can be part of the conversation if the person wants. None is assumed.

• Prison health doctor or nurse: Care, medicines and referrals while in custody.
• Mental health worker: Support with stress, mood and adjustment.
• Social worker or release planner: Family contact and continuing care after release.
• Peer supporter: Lived experience and practical support, where programs exist.
• Chaplain or spiritual-care provider: Meaning, distress, hope and relationships, for people of any faith or none.
• Interpreter or communication specialist: Language and communication support so the person's own words come through.
• People the person chooses: Family, friends, or a community or faith contact, only if the person wants them. Never assumed safe, available or wanted.

Roles, titles and training differ by country and service. Not every role exists everywhere.

A small set of places chosen for contrast, not a ranking or a representative survey: Multi-country, United Kingdom, United States, South Africa, Brazil, Israel, Thailand, Bangladesh, Australia, Canada. Each example states what its source establishes and what it does not. Policy on paper is not proof that a service is available.

• Multi-country · Measured outcome · 2023

  In WHO Europe's 2022 status report (2020 data from 36 of 53 Member States), informed consent was most commonly obtained before any health intervention in prison, but only 15 Member States (41.7%) documented it.

  What others could learn: Asking for consent and writing it down are separate steps; the report finds the first far more common than the second, and two Member States said they did not seek informed consent. The report quotes Mandela Rule 24: people in prison should enjoy the same standards of health care available in the community.

  Conditions, limits and source

  Conditions that matter:

  The report notes the Mandela Rules offer guidance and are not legally binding, and that the European Committee for the Prevention of Torture audits consent and confidentiality during prison visits. Continuity also varied at release: 17 of 36 Member States (47.2%) had a service to register people with community health services.

  Cannot be inferred:

  Does not show how often consent is obtained in any single prison or country. Does not compare countries. Does not show whether documented consent was informed or voluntary in practice. Does not describe countries outside the responding Member States.

  Limits:

  Self-reported by national focal points, not audited at prison level. Only 36 of 53 Member States responded, and the report says some large non-responding countries hold an important share of the Region's prison population. Data are mainly for 2020. The survey records whether consent is obtained and documented, not how consent conversations happen or how people in prison experience them.

  Source: World Health Organization Regional Office for Europe, Status report on prison health in the WHO European Region 2022 (Section 2.3.4.3 'Acceptability', printed p. 42 (PDF p. 58), Fig. 37; Mandela Rules 24 and 25 and the continuity-of-care rule quoted in the Introduction, printed pp. 1 to 2 (PDF pp. 17 to 18); release findings at printed p. 38 and Key findings). Where: Multi-country (36 of 53 Member States of the WHO European Region). Population: People living in prison in responding Member States (613 497 people reported in prison establishments). Published 2023-02-09; retrieved 2026-10-12.

• United Kingdom · Service in operation · 2020

  In 2019 telephone interviews with representatives of all 17 Scottish adult hospices, five (30%) had provided direct care at the prison or the hospice, and 11 (65%) supported prisons by sharing knowledge and expertise.

  What others could learn: Hospice support ranged from facilitating family visits from relatives in prison to identifying and caring for people at the end of life in prison. Listed activities include consulting prison staff on compassionate release decisions and supporting prison psychiatry and chaplaincy to provide spiritual and bereavement support.

  Conditions, limits and source

  Conditions that matter:

  Depends on collaboration between each prison and the hospice serving its area, since specialist palliative care in Scotland is only available from local hospices or providers. Care at the hospice can involve people under escort by custody officers. The authors call for national-level collaboration between prisons and hospices.

  Cannot be inferred:

  Does not show how many people in prison received palliative care or how they experienced it. Does not show outcomes of hospice involvement. Does not describe hospice support in other UK nations or other countries.

  Limits:

  Accounts from hospice leaders, not from people in prison, families or prison staff. Short telephone interviews (about 15 minutes), which the authors say may have limited depth. Describes support in 2019; services may have changed since.

  Source: Palliative Medicine (McParland C, Johnston B), Caring, sharing, preparing and declaring: how do hospices support prisons to provide palliative and end of life care? A qualitative descriptive study using telephone interviews. (Abstract, Results (Palliat Med 2021;35(3):563-573); Table 3 'Types of support provided by hospices to prisons'; Limitations section). Where: United Kingdom (Scotland). Population: Representatives (chief executives or nominees) of all 17 Scottish adult hospices; people in Scotland's 15 prisons with palliative care needs as the population served. Published 2020-12-10; retrieved 2026-10-12.

• United States · Reported experience · 2026

  In 55 interviews with US physicians and nurses who had worked in federal or state prisons or jails, participants perceived multiple challenges to privacy and confidentiality but differed on how important protecting them was against other concerns.

  What others could learn: The abstract notes that incarcerated people have stigmatized conditions at higher rates, which makes privacy and confidentiality ethically essential. A care conversation in custody can say plainly who may overhear or see health information and what is shared with custody staff.

  Conditions, limits and source

  Conditions that matter:

  Prison and jail layouts, custody staff presence and correctional rules shape what privacy is possible. The article's keywords name HIPAA and National Commission on Correctional Health Care (NCCHC) standards as the relevant frameworks.

  Cannot be inferred:

  Does not show how often confidentiality is breached or what people in prison experience. Does not describe any single facility or state. Does not show which approach to privacy works better.

  Limits:

  Abstract only: the PMC full text was under embargo and the publisher host was unreachable, so the specific challenges, interview dates and recruitment methods were not reviewed. Clinicians' perspectives, not those of people receiving care. Single-author study; the abstract does not say how many participants worked in prisons versus jails.

  Source: Journal of Correctional Health Care (Walker RL), "Everyone Hears Everyone's Business": Health Care Provider Perspectives on Privacy and Confidentiality in U.S. Prisons and Jails. (Abstract (J Correct Health Care 2026;32(5):328-338); PMC full text under embargo at retrieval). Where: United States (federal and state prisons and jails). Population: Physicians and nurses who have worked in federal or state prisons and/or jails (n=55). Published 2026-07-02; retrieved 2026-10-12.

• United States · Measured outcome · 2025

  Massachusetts passed medical parole legislation in 2018. Reviewing 87 deaths in state prison custody from 2021 to 2023, the authors found 43% had chronic conditions documented before death and could have been identified for medical parole.

  What others could learn: Medical parole in Massachusetts covers terminal illness or permanent incapacitation. The authors report that most deaths were from acute causes and 70% occurred in an inpatient setting, and they call for an expedited review process and expanded eligibility criteria.

  Conditions, limits and source

  Conditions that matter:

  Release depends on a petition and a decision under state law. The authors cite fewer than 10% of applicants granted medical parole in fiscal year 2020, and few applications in 2018 and 2019 because the law was little known. Clinicians' documentation and referrals shape who is identified.

  Cannot be inferred:

  Does not show how many people applied, were eligible or were refused. Does not show what people in prison or their families wanted at the end of life. Does not describe other states or federal compassionate release.

  Limits:

  Describes law and practice as of 2021 to 2023; later changes were not checked here. Whether people could have been identified for medical parole is the authors' judgment from records, not a review of applications. The period includes the COVID-19 peak. The population was mainly male, as one of 13 facilities houses people designated female.

  Source: BMC Public Health (Kler JS, Victory A, Chao S, Suh M, Mushero N), Retrospective review of deaths in the Massachusetts department of corrections after passage of medical parole. (Discussion, first paragraph; Background on the 2018 legislation and fiscal year 2020 grant rate; Methods on timeframe; Limitations (BMC Public Health 2025;25(1):2465)). Where: United States (Massachusetts). Population: People who died in Massachusetts Department of Correction custody, 1 January 2021 to 31 December 2023 (n=87). Published 2025-07-15; retrieved 2026-10-12.

• South Africa · Reported experience · 2022

  In 16 interviews (2019 to 2020) with men living with HIV who had left prison in South Africa, participants most valued supportive relationships, non-judgmental peer facilitators and perceived treatment support in transition community adherence clubs.

  What others could learn: Respect and a non-judgmental group mattered to participants; one said the mutual care made him feel human. Several attended partly to help others facing the same post-release challenges. Transport and clinic queues for medication were the main burdens.

  Conditions, limits and source

  Conditions that matter:

  Needs trained peer facilitators, venues close to where people live, and medication supply at group sessions; the planned delivery of HIV medicines at sessions was not fully implemented, partly because of COVID-19. Interviews ran in Sepedi, isiZulu, isiXhosa, Setswana or English.

  Cannot be inferred:

  Does not show that the clubs improved adherence or retention in care. Does not describe women's experience. Does not describe care inside prison or other provinces.

  Limits:

  Small sample (16) of men only; the trial arm included six women, none of whom were recruited for interviews. Participants were people who stayed engaged enough to be interviewed; some selected participants were lost to follow-up. COVID-19 disrupted the intervention. Acceptability, not measured adherence or viral outcomes.

  Source: BMC Health Services Research (An Y, Ntombela N, Hoffmann CJ, Fashina T, Mabuto T, Owczarzak J), "That makes me feel human": a qualitative evaluation of the acceptability of an HIV differentiated care intervention for formerly incarcerated people re-entering community settings in South Africa. (Abstract, Results (BMC Health Serv Res 2022;22:1092); intervention description in Background and Methods; Results on affective attitude and burden; Limitations). Where: South Africa (one province; location masked by the authors). Population: Men living with HIV re-entering the community after incarceration, assigned to the intervention arm of a pilot trial (n=16; median age 34.5). Published 2022-08-26; retrieved 2026-10-12.

• Brazil · Policy · 2023

  A 2023 editorial describes Brazil's 2014 National Policy for Comprehensive Healthcare for Persons Deprived of Liberty (PNAISP) as aiming to guarantee that people deprived of liberty can access comprehensive care within the Unified Health System.

  What others could learn: Policy on paper is carried out by prison primary care staff whose values and judgments shape what people receive. The author argues that improving prison health care means looking beyond formal policy to how those staff implement it.

  Conditions, limits and source

  Conditions that matter:

  According to the editorial, a prison primary care team must include at least a doctor, a nurse, a nursing technician or assistant, a dental surgeon and an oral health technician or assistant; larger teams may add psychologists, social workers, nutritionists and physical therapists. Overcrowding strains prison infrastructure.

  Cannot be inferred:

  Does not show that the policy improved access or health. Does not describe any state or prison. Does not show how people deprived of liberty experience care.

  Limits:

  A single-author editorial, not the policy text and not an evaluation. Describes the 2014 policy as of 2023; the policy instrument itself was not retrieved and later changes were not checked. No data on how many prisons have primary care teams or what care people receive.

  Source: International Journal of Public Health (Bartos MSH), Access to Healthcare in Brazilian Prisons: Why is it Important to Look at the Bureaucracy and Policy Implementation? (Editorial text, paragraphs 2 and 3 (Int J Public Health 2023;68:1605266)). Where: Brazil. Population: People deprived of liberty in Brazil (835,000 people incarcerated, per the editorial). Published 2023-01-12; retrieved 2026-10-12.

• Israel · Reported experience · 2025

  In 18 interviews in 2023 with formerly incarcerated women in Israel, some said mistrust of prison health staff and perceived low-quality care led them to delay treatment until release.

  What others could learn: Women described not wanting prison staff to know their personal health issues, shackling during outside treatment, the constant presence of guards in hospital, and families not being notified of hospitalization. Hospital staff were described as sympathetic, but guards often refused requests to remove handcuffs.

  Conditions, limits and source

  Conditions that matter:

  The authors call for integrating prison health services into the national health system and for trauma-informed, gender-responsive, continuity-based care. Limited Hebrew discouraged one participant from seeking care. Security rules govern escorts and restraint during outside treatment.

  Cannot be inferred:

  Does not show how common delayed care is among women in prison in Israel. Does not describe care for men or for women held under the security classification. Does not show health outcomes of delay.

  Limits:

  Small sample (18) recruited from a single organization; women with children in prison, women in substance use treatment programs and women held in separate detention centers under the security classification were not included. Interviews were translated from Hebrew and Arabic into English by the first author. Recollections after release, not observed care.

  Source: BMC Public Health (Agbaria N, Stöver H, Davidovitch N, McMahon SA, Winkler V, Bärnighausen K), Women's healthcare needs and access across the incarceration pathway in Israel: a qualitative study. (Results, theme 'Mistrust in the prison healthcare system' and subtheme 'Medical treatment outside the prison: shackling and lack of privacy'; Limitations (BMC Public Health 2025;25:4278)). Where: Israel. Population: Formerly incarcerated women recruited through the Prisoner Rehabilitation Authority (n=18; median age 40; 8 Arabic-speaking). Published 2025-11-22; retrieved 2026-10-12.

• Thailand · Service in operation · 2026

  At Thailand's Central Correctional Institution for Young Offenders, 100 men in prison were selected as prison public health volunteer leaders and trained in ten participatory sessions over five weeks covering physical, mental, social and environmental health.

  What others could learn: Peer volunteers were trained to support older, bedridden or disabled peers and people with chronic illness, and to keep paper health records with attention to confidentiality and ethics. Where peers handle health information, a service can set out what volunteers may record and who sees it.

  Conditions, limits and source

  Conditions that matter:

  Needs nurse-led training, prison health staff approval and supervision, and support from correctional administrators and a local hospital. The authors cite a 2015 Cabinet Resolution affirming the right of people in prison to equitable health care, alongside a limited correctional health workforce.

  Cannot be inferred:

  Does not show effects on the health of other people in the institution. Does not show how people receiving peer help experienced it. Does not describe other Thai prisons or women's prisons.

  Limits:

  Single site, single group, no control group. All outcomes were self-reported; the authors note no system-level indicators such as referral rates or documentation accuracy were assessed. Volunteers were selected for good behavior records, education and leadership potential, so they are not typical of the institution's population.

  Source: Belitung Nursing Journal (Tanthanapanyakorn P, Chanmalee S, Mungkhunthod S, Praserttai C, Khantikulanon N), Evaluation of the holistic health care program to develop the capacity of prison public health volunteer leaders (PPHVs) in Thailand: A participatory action research. (Abstract, Methods (Belitung Nurs J 2026;12(3):382-393); intervention matrix (sessions 4 and 7); Limitations and Conclusion). Where: Thailand (Central Correctional Institution for Young Offenders, Pathum Thani Province). Population: Men in prison aged 20 or older selected as Prison Public Health Volunteer Leaders (n=100; mean age 31.4), from an institution population of 4,532 men. Published 2026-06-28; retrieved 2026-10-12.

• Bangladesh · Service in operation · 2021

  A 2021 review, drawing on interviews with seven psychiatrists and a clinical psychologist, reported that psychiatrists did not visit Bangladesh's prisons, so people in prison were escorted by two police officers to mental health assessments.

  What others could learn: Interviewees described no formal psychiatric services inside prisons and no systematic mental health screening. Bringing assessment into the prison, or reducing the escort burden, could change what a person in prison experiences when asking for mental health help.

  Conditions, limits and source

  Conditions that matter:

  According to the review, prison medical officers have limited mental health training; essential psychotropic medicines are free but others must be bought by patients; the one prison psychologist post was vacant in 2016. A 2018 Mental Health Act replaced the Lunacy Act. Non-governmental organizations provide counseling and post-release support.

  Cannot be inferred:

  Does not show how many people in prison need or receive mental health care. Does not show outcomes. Does not describe current practice after 2021.

  Limits:

  Describes services as of 2021, based on literature and eight clinicians from the authors' professional networks, two of whom are co-authors; not a formal survey. The authors found no formal prevalence studies of mental illness in Bangladesh's prisons. Prison statistics date from 2016.

  Source: BJPsych International (Khan AA, Ryland H, Pathan T, Ahmed HU, Hussain A, Forrester A), Mental health services in the prisons of Bangladesh. (Section 'Mental health in prisons in Bangladesh', paragraphs on referral and assessment (BJPsych Int 2021;18(4):88-91); prison statistics in 'The prison system in Bangladesh'). Where: Bangladesh. Population: People in prison with mental health needs (73 177 people held in 13 central and 55 district jails in 2016). Published 2021-11; retrieved 2026-10-12.

• Australia · Reported experience · 2025

  In a 2022 Australian study of people released from prison at 50 or older (45 or older for Aboriginal or Torres Strait Islander people) and staff, early post-release priorities included medical records, medication and medical devices.

  What others could learn: One participant said one week's medication on release was not enough. Participants described fragmented services across justice, health and community sectors, and stakeholders said stigma can affect access to aged care. Rebuilding family ties and regular health appointments marked a more settled stage.

  Conditions, limits and source

  Conditions that matter:

  Older age in custody is defined from 50 (45 for Aboriginal or Torres Strait Islander people) because of earlier age-related health decline. The author reports only a very limited number of prison beds dedicated to care for older people. Transition case management and informal caregivers were described as central.

  Cannot be inferred:

  Does not show how many older people leave prison without medication or records. Does not show outcomes after release. Does not describe all Australian states or people with limited English.

  Limits:

  Small sample (15 people with lived experience, 15 staff), mainly from New South Wales, single author. Phone interviews required English sufficient for a 60-minute call. The author describes the framework as preliminary and focused on early stages of release.

  Source: PLoS One (Hwang YIJ), "Place-finding" as the key to reintegration after release from prison in older age: A transdisciplinary, holistic and strengths-based reintegration framework using grounded theory. (Results, 'crisis mode' stage; participant quotes on release medication, fragmented services and access to aged care; Limitations and further work (PLoS One 2025;20(6):e0325497)). Where: Australia (mainly New South Wales). Population: People released from prison aged 50 or older (45 or older if Aboriginal or Torres Strait Islander) after at least 12 months in custody (n=15; 6 Aboriginal or Torres Strait Islander), and 15 staff and stakeholders including 3 prison health providers. Published 2025-06-17; retrieved 2026-10-12.

• Canada · Reported experience · 2023

  In seven online focus groups with 25 chaplains in provincial prisons in five Canadian provinces, chaplains described a non-judgmental approach and said lockdowns, security codes, pandemic restrictions and lack of private space limited their access to people in prison.

  What others could learn: Chaplains said people in prison took part voluntarily because chaplains had no agenda and did not judge them. They described difficulty finding a private place to talk, and one reported one and a half chaplains serving 400 people.

  Conditions, limits and source

  Conditions that matter:

  Chaplaincy was described as a faith-based service within a secular institution. Chaplains reported reliance on part-time and volunteer chaplains, few chaplains per person in custody, and fewer outside volunteers after COVID-19 restrictions began in March 2020.

  Cannot be inferred:

  Does not show effects of chaplaincy on health, well-being or life after release. Does not report the views of people in custody. Does not describe federal prisons.

  Limits:

  Chaplains' views only; people in prison were not interviewed. Small sample of chaplains who answered an email invitation, mostly Christian, with little participation from minority faiths. Provincial prisons only; federal chaplains were not included. Focus group dates are not stated.

  Source: International Journal of Offender Therapy and Comparative Criminology (Akca D, Ammar NH, Shoemaker B, Cesaroni C, Ouellet M), Joy, Compassion, and Job Satisfaction: Insights into the Canadian Prison Chaplaincy. (Findings, 'Environmental Working Conditions and Facilities', 'Non-judgmental Approach' and 'Employment Conditions'; final limitations paragraph (Int J Offender Ther Comp Criminol 2026;70(4):271-286; PMC12819885 full text)). Where: Canada (provincial prisons in five provinces; nearly half of participants from Ontario). Population: 25 prison chaplains (76% Christian, 16% Muslim, 4% Jewish, 4% Buddha-dharma; 80% men; 72% serving at male-only institutions). Published 2023-11-26; retrieved 2026-10-12.

• The sourced examples include measured outcome, service in operation, reported experience, policy. Each quote was matched to the source text; that is not independent expert review.
• The prompts and fictional case are original. They have not been tested with patients, caregivers or clinicians.
• Whether this workflow helps anyone is an open research question.
• Content is in English. Interface translations are not reviewed for this topic.