Prisoners

People who are incarcerated have palliative care needs too

People who are incarcerated are often referred to as 'prisoners'. This term refers to people who are remanded in custody within an adult correctional service. As the number of prisoners grows in Australia, there will be more of an aging population within correctional services. Dealing with life-limiting chronic illness in this context can be very difficult.

Why palliative care matters

Many people who are incarcerated identify with other vulnerable population groups such as homelessness and disability. They may have been experiencing barriers to accessing care prior to entering the prison, leading to many unmet and complex health needs. For example, in 2016, around:

• 1 in 6 prison entrants tested positive for Hepatitis B (a common cause of liver cancer), and
• 1 in 5 aged 45 years and over reported that they had cardiovascular disease.

In 2018, one in 15 prison entrants reported having diabetes compared to one in 20 of all Australians. People with diabetes are more likely to experience multimorbidity, with cardiovascular and renal disease being common.

Common barriers and outcomes

The lack of effective policies and processes for palliative care in prisons combined with the unfavourable physical and cultural environment creates a barrier to delivering quality palliative care. 

Although prisoners can be transferred to public hospitals for planned and unplanned treatment, including palliative care services, timely access is often difficult.

Overcoming the barriers

• Low levels of literacy among prisoners may lead to poor understanding of health conditions. Literacy education for prisoners and inclusive health information may improve their understanding of palliative care.
• There is potential for distrust between the prisoners and the prison staff due to discrimination or abuse. Having advocates available to raise awareness of palliative care needs could improve access to services.
  
  

Learn More

To learn more about the barriers to palliative care for people experiencing homelessness visit the Australian Government Department of Health Exploratory analysis of Barriers to Palliative care on people who are incarcerated.