Exercise referral and offender management in relation to mental health: an example from HMP Everthorpe
| Published date | 01 November 2007 |
| Date | 01 November 2007 |
| Pages | 23-24 |
| DOI | https://doi.org/10.1108/17556228200700017 |
| Author | Sean Paterson,Sara Moore,James Woodall |
| Subject Matter | Health & social care |
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Exercise referral and offender
management in relation to mental
health: an example from HMP Everthorpe
Sean Paterson, Offender Supervision Manager at HMP Everthorpe
Sara Moore, National Programme Lead for Public Health and Physical Activity at HSCCJ and Visiting Fellow,
Lincoln University
James Woodall, PhD student, Faculty of Health, Leeds Metropolitan University
The Journal of Mental Health Training, Education and Practice Volume 2 Issue 3 November 2007 © Pavilion Journals (Brighton) Ltd
The prison population is a vulnerable and socially
excluded population. Prior to incarceration, prisoners are
13 times more likely to have been in care as a child and a
similar figure exists with regards to being unemployed
(Social Exclusion Unit, 2002). Experiencing poverty,
disadvantage and a poor education is a familiar story to
many prisoners in the British penal system.
The mental health of the prison population is an ever-
increasing concern. Reports suggest that 90% of all
prisoners have a diagnosable mental health problem,
substance misuse problem or both (DoH, 2002. Other
research has suggested that neurotic disorders are three to
five times more common in prisoners compared to the
population in the community (Marshall et al, 2000).
Traditionally, the management of individuals within the
prison setting has been seen as keeping them secure and
tackling their offending behaviour through referral onto
accredited programmes. For the majority of offenders, this
approach combined with follow up work from personal
officers and other departments is adequate. However, at
HMP Everthorpe the strategy has been to deal with
individuals and to tailor the work done with them during
their sentence to address their needs.
On entering prison, offenders will frequently present
physical and psychological problems on initial
assessment. This can often mean that interventions such
as CARATS (Counselling, Assessment, Referral, Advice and
Throughcare Services) or cognitive behavioural
programmes such as ETS (Enhanced Thinking Skills) may
be indicated. However, in some instances the prisoner is
neither mentally nor physically prepared for the intensity
that may be required for successful completion.
Interventions with prisoners designed to increase levels of
physical activity can hugely improve an individual’s
ability to cope and initiatives such as Walking the Way to
Prison Health (WTWTPH) are now an option for prisoners
to be referred on to. This scheme is being run in a number
of prisons including HMP Everthorpe.
WTWTPH is an extension of the national Walking the
way to Health Initiative (WHI). The aim of the initiative is
to get more people walking in their own communities,
especially those who take little exercise or live in areas of
poor health. Both promote good health through the
dissemination of health information, physical exercise
and education, and target the most disadvantaged
sections of the population, seeking to address the wider
determinants of health. In short, the rationale of the
initiative is based on the premise that walking improves
physical, social and mental health, and it was perhaps this
latter point that aroused the particular interest of staff at
HMP Everthorpe.
With the implementation of a very successful Exercise
Referral programme linked to WTWTPH, and a close
working partnership between the prison and the
programme lead for the government’s Choosing Health
agenda (DoH, 2004), a new and innovative way of working
has been developed. The workforce has adopted a
sophisticated approach to deliver behaviour management
skills. This has been fundamental to achieving positive
outcomes with offenders. The approach has included a
restructuring of the social environment within the prison
to provide support for people trying to change their health
related behaviour. This embraces a whole prison approach
as outlined in the report Health Promoting Prisons: A shared
approach (DoH, 2002). The gym team and offender
management unit at HMP Everthorpe share a similar
vision in that referral for physical activity is not just about
fitness, but also very much about developing confidence,
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