Strengthening connections and continuity of healthcare

The strong response to my last article on the Mental Health Bill and the urgent need for reform in prison mental health care has made me think even more about wellbeing in prisons. Mental health does not exist in isolation – it is deeply connected to our relationships, our sense of purpose, and the continuity of care and support we receive both inside and outside prison walls. In prison, these factors are often fragile or disrupted. If we are serious about improving mental health outcomes for people in prison, we must look beyond clinical care and address the wider conditions that allow people to feel hopeful about their future.

Maintaining contact with loved ones is a lifeline for many in prison. Regular visits, phone calls, and letters reduce feelings of isolation, and support mental and emotional wellbeing. The Chief Inspector of Prisons’ most recent report highlights that women in prison consistently identify family contact as their top priority. Despite this, the report finds that visiting arrangements in women’s prisons lack the creativity and flexibility seen in some men’s establishments. Inspectors also note that opportunities to maintain these vital connections are often limited for both men and women, particularly in the early days of custody. 

Too often, people lose their homes after being sentenced, creating a cycle of instability that continues after release

Prisons have a responsibility to support these vital relationships. Services like the Prisoners’ Families Helpline offer guidance and reassurance to families who may be left in the dark about their loved one’s wellbeing. We must ensure families are listened to – especially when they raise concerns about mental or physical health. Healthcare teams should be encouraged to engage with families, where appropriate, to build a fuller picture of someone’s needs.

Within prison walls, work and education can be powerful tools for preparing for life beyond the gate. However, the Chief Inspector’s annual report found that purposeful activity remains the weakest area across the prison estate. Many people in prison are locked in their cells for long periods, with too few engaged in meaningful work or education – making it harder for them to turn their lives around and increasing the risk of reoffending after release. 

In thinking about mental wellbeing, it is crucial to recognise that stability in key areas of life – such as housing – plays a significant role in providing security and hope for the future. Too often, people lose their homes after being sentenced, creating a cycle of instability that continues after release. I encourage prisons to work closely with local authorities and housing charities to help individuals maintain or secure accommodation before release, supporting their recovery, rehabilitation, and reintegration into the community.

Finally, continuity of care remains a critical issue. Too many people experience a disruption in their treatment when they enter prison or after release, which can have serious consequences. We need to ensure better communication between community and prison healthcare providers, and clear plans for ongoing support to ensure people receive the care they need.

Your Voice Matters

As always, I want to hear from you. Have you been able to stay in touch with your family? What support have you or your loved ones received from prison staff or healthcare teams? Have you been able to maintain your housing or employment skills? Your experiences help shape our understanding and inform our recommendations to ministers and officials. Write to me at: Freepost IAPDC, 102 Petty France, London – no stamp or anything else on the envelope is needed. I look forward to hearing from you.

Lynn Emslie is Chair of the Independent Advisory Panel on Deaths in Custody (IAPDC)