Natasha Sindano, Project Supporting Officer, explains some thought provoking findings from the ongoing Prison Project that was started last year.
If nothing else, I'd like you to remember these three facts:
- Men aged 50 and over have been the fastest growing prison population for over 10 years.
- Prisoners' bodies age faster than the general population. So much so that by the time they reach 50 years old their biological age (how well the body functions) is 10 years advanced of their actual age.
- The prevalence of alcohol and substance misuse, smoking, blood-borne viruses and non-communicable diseases among prisoners can be up to 15 times higher than the general population.
Dementia diagnosis among prisoners is very low, but keeping in mind the three points and taking into account the high prevalence of multiple diagnoses, it is quite plausible that the prevalence of dementia among prisoners is higher than the general population.
How The Prison Project started
Having been fortunate enough to receive funding from the Innovation Fund, Karen McCrudden (West London Operations Manager) and I began scoping what dementia support provision was available in prisons, with a view to capturing what the prevalence of dementia is among prisoners, the types of dementia more commonly seen and how Alzheimer's Society could most effectively provide support to prisoners and their families. Initially we focussed on HMP Wandsworth and HMP Wormwood Scrubs simply because they were in our locality, but as the project developed we were able to make strong connections with HMP Pentonville as well. Two critical findings:
- The level of awareness of dementia among the prison officers and prisoners is very low and symptoms are not identified or misdiagnosed due to pre-existing conditions.
- A very rigid regime means that no allowances are made, and so healthcare appointments tend to last no more than 10 minutes, which is insufficient for an assessment.
Despite this there has been such willingness from all prison staff to work with us to so that they can support prisoners with dementia as best as they can.
Raising awareness of dementia in prisons
Our key aim for this year has been to raise the awareness of dementia among staff and prisoners and through doing this, increase the diagnosis rate. We have been doing this through:
- Working with the healthcare teams to introduce dementia screening tools that can be used on entry to prison and during follow-up assessments.
- Dementia Friends sessions to prisoners and healthcare teams.
- Delivering workshops to the healthcare teams.
- Dementia support work at HMP Pentonville by supporting the healthcare team with the management of two prisoners who have dementia.
- The development of training for prison officers.
The next steps
Karen and I will continue to share our learning with the East Midlands team, who will be extending our work to HMP Lincoln. We have also extended our work to HMP Isle of Wight, which has a mature prison population (50 years and older) of 47% and it is suspected that a significant proportion of the prisoners may have dementia that is undiagnosed. The Society has also started to look at some of our factsheets to develop them into an 'easy read' format for the prisoners. We will also begin working with probation teams who have a critical role in managing and supporting prisoners when they have been released.
Thinking back to February 2015, when I first walked through the South West London office doors, I never envisaged that we would publish an article in a nationwide prison newspaper, or that the National Dementia Helpline would be made accessible to all prisons, or that the Ministry of Justice would set up a National Clinical Reference Group looking at the development of dementia support in prisons.
With five months left of the project, I can only be excited about the endless possibilities of how our work will continue to develop.
And to think that this all started with a Google search, 'dementia in prisons'.