People released from prison in Scotland are facing a mental health and substance use crisis, according to new research.
The study tracked more than 8,000 former prisoners over four years to assess their contact with health services following release.
The research discovered that 24% of people released from prison had contact with the ambulance service for mental health and substance use concerns in the four years after leaving jail and 21% with A&E.
Only 2% of the comparison group, who had not been in prison, had contact with the ambulance service and A&E over the same time period.
Increased support
The authors of the study have called for increased support from health and social services for ex-prisoners, particularly in the light of pressures on the NHS and on prison capacity. They say the issue is having a “huge” impact on health services and public health, leading to higher costs and individual harm.
The University of Strathclyde was a partner in the study, which was led at the University of Stirling. It has been published in BMJ Open.
Professor Amanj Kurdi, of Strathclyde Institute of Pharmacy and Biomedical Sciences, supported the clinical interpretation of the study’s findings from a medicines and pharmacy perspective and contributed to the development of the medicines lists for mental health and substance use definitions.
He said: “By securely linking prison, health service and mortality records, we are able to understand what actually happens to people after release rather than relying on small or fragmented datasets.
The findings show that many individuals experience complex mental health and substance use needs and, without coordinated follow-up care, their risk of crisis and emergency service use increases substantially. From a medicines perspective, transitions of care are a particularly vulnerable point.
“Ensuring timely access to treatment, medication review and community support after release could prevent avoidable harm and reduce pressure on emergency and acute services. These results also highlight the important role pharmacists and community services can play in maintaining treatment continuity and supporting engagement with care.”
The study, which forms part of the RELEASE project, looked at every person released from Scottish prisons in 2015. Researchers compared their rate of contact with a sample of more than 40,000 people – matched on sex, age, postcode and deprivation indices – who had not been in prison in the previous five years.
The research, which was funded by the Scottish Government’s Chief Scientist Office, used data from the Scottish Prison Service, Public Health Scotland and National Records Scotland.