Disrupting ‘healthy prisons’: Exploring the conceptual and experiential overlap between illness and imprisonment
| Published date | 01 June 2023 |
| Author | Thomas Ugelvik,Rose Elizabeth Boyle,Yvonne Jewkes,Pernille Søderholm Nyvoll |
| Date | 01 June 2023 |
| DOI | http://doi.org/10.1111/hojo.12498 |
Received: 16 March 2022 Accepted: 9 June 2022
DOI: 10.1111/ho jo.12498
ORIGINAL ARTICLE
Disrupting ‘healthy prisons’: Exploring the
conceptual and experiential overlap between
illness and imprisonment
Thomas Ugelvik1Rose Elizabeth Boyle2Yvonne Jewkes3
Pernille Søderholm Nyvoll4
1Thomas Ugelvik is Professor, University
of Oslo, Norway
2Rose Elizabeth Boyle is PhD Research
Fellow, University of Oslo, Norway
3Yvonne Jewkesis Professor, University of
Bath
4Pernille Søderholm Nyvoll is PhD
Research Fellow, University of Oslo,
Norway
Correspondence
Thomas Ugelvik, Professor,University of
Oslo, Norway.
Email: thomas.ugelvik@jus.uio.no
Funding information
Norwegian Researc Counci, Grant/Award
Number: VAM300995
Abstract
Our aim in this conceptual article is to theoretically
reimagine the concept of ‘healthy prisons’ in a way that
more thoroughly grounds it in the everyday experiences
of prisoners. Our point of departure is the observation
that there seems to be an intriguing conceptual and the-
oretical overlap between first-person oriented empirical
studies of two spheres of human experience that are
normally seen as separate: serious illness and impris-
onment. Our analysis leads us to reimagine the term
‘healthy prisons’ in a way that increases its usefulness
for anyone interested in making prisons healthier and
more constructive and reinventive institutions.
KEYWORDS
experience of health and illness, experience of imprisonment,
health, healthy prisons, phenomenology
1 INTRODUCTION
The idea that prisons should be healthy institutions has been around at least since the English
prison reformer John Howard (1726–1790) travelled the world to study institutions of confinement
and share his vision on purity, cleanliness and good air circulation to help eliminate contagious
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits
use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or
adaptations are made.
© 2022 The Authors. The HowardJournal of Crime and Justice published by Howard League and John Wiley & Sons Ltd.
204 wileyonlinelibrary.com/journal/hojo HowardJ. Crim. Justice. 2023;62:204–219.
THE HOWARDJOURNAL OF CRIME AND JUSTICE 205
diseases in penal institutions (P. Smith, 2008; Vander Beken, 2016). According to Howard (cited
in P. Smith, 2008, p.66), prisons at the time were so unsanitary and unhealthy that people who
went in healthy were soon ‘expiring on floors, in loathsome cells, of pestilent fevers and the con-
fluent smallpox’.Despite Howard’s pioneering efforts, however, the reality of prison life has often
had little to do with the ideals of health and cleanliness; in fact, prison Inspectorate reports have
frequently, up to this day, highlighted prisons as places of disease and squalor. In recent years,
however, the idea that prisons can, and should, be healthy institutions has gained considerable
traction.
Following an increasedfocus on ‘healthy settings’ since the mid-1980s, the World Health Organ-
isation (WHO) introduced the so-called Healthy Prisons approach in 1995 (Gatherer, Moller &
Hayton, 2005) as a strategy for protecting and improving the health of prisoners. Since the late
1990s and early 2000s, the WHO has followed up on this important first step with the development
of what has become known as the Healthy Prisons Agenda (HPA) (World Health Organisation,
2007). Researchers have followed suit, and todaythere is growing literature on the idea of healthy
prisons (Ismail & de Viggiani, 2017, 2018; Ismail, Woddall & de Viggiani, 2020;Jewkes,2018;
C. Smith, 2000). Regarding practical implementation, government initiatives have often focused
on the prevention and treatment of different kinds of specific illnesses in prison, the successful
deployment of quality health services in prison, and, more broadly, the promotion of health and
healthy environments in institutions of confinement.
These positive developments notwithstanding, the term ‘healthy prisons’ still seems a contra-
diction in terms (C. Smith, 2000), given the large body of research documenting that prisons are
harmful and unhealthy, and that prisoners as a group are statistically over-represented when it
comes to numerous health problems compared with the general population. Serious health issues,
including, but not limited to, mental health problems (Fazel & Seewald, 2012),substance use dis-
orders (Pape, Rossow & Bukten, 2020), health issues resulting from isolation (P.S. Smith, 2006),
self-harm, and increased mortality due to suicide or overdose (Zhong et al., 2021) are all common
in prisons around the world.
Our aim in this conceptual article is to theoretically reimagine the concept of ‘healthy prisons’
in a way that might be useful for anyone interested in making prisons healthier and more con-
structive and reinventive institutions (Jewkes, 2018; Crewe & Ievins, 2019; Liebling et al., 2019).
Webelieve that prisons, despite their many inherent dilemmas and damaging effects, can be more
or less un/healthy institutions. If this is true, it makes sense to try to makethem as healthy as pos-
sible. Our perspective differs from many current initiatives in that we want to suggest a broader
and more first-person oriented approach (as opposed to the third-person or ‘objective’ perspec-
tive that underpins the field of medicine) to examining the meaning and experience of ‘health’ in
prison settings.
Our point of departure is, first, that there seems to be an interesting field of overlap between
first-person descriptions of two different but related spheres of human experience; and, second,
that an enhanced understanding of this overlap may help us reformulate the concept of ‘healthy
prisons’ in what we believe is a more sophisticated bottom-up way. The first sphere is the experi-
ence of serious illness, which includes a wide range of long-term, chronic, debilitating mental or
somatic illnesses. The second is the experience of imprisonment. Once you start looking closely
at the first-person oriented studies focusing on these different human experiences, the similar-
ities are striking. Consider, for instance, the resemblance between Toombs’s (1987) description
of shared features of illness experiences as a series of five ‘losses’ and Sykes’s (1958) analysis of
the common experience of imprisonment as characterised by five ‘pains’ resulting from depri-
vation. Toombs highlighted the loss of wholeness, certainty, control, freedom and the familiar
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