Worldwide more than 10.35 million people are currently being held in penal institutions and the global prison population rate is increasing. Mental illness is especially prevalent in prison populations, by far exceeding the rate of mental disorders in the general population. These mental health issues are exacerbated with age: over 20% of adults aged 60 and over suffer from a mental or neurological disorder (WHO, 2015). As the world’s population ages rapidly, so too the number of the elderly in jails and prisons is increasing at an exponential rate: at a rate 3 times that of the general prison population. MenACE project aims to increase the response to mental health disorders within prisons and the quality of palliative and end of life care services provided by enhancing the competences of management and frontline staff to address prisoners’ mental health needs and the special needs of older prisoners. The project’s specific goals include:1. To develop pedagogical materials and learning processes that support the training of staff and the training of trainers in the field of mental healthcare and geriatrics in prisons;2. To develop and pilot a ‘train the trainer’ course for prison professionals (blended learning) so that they can be able to train continuously their colleagues on mental healthcare and the needs of older prisoners;3. To develop and pilot a training course targeting prison administrators and first line prison staff on basic mental health and age-related health issues.4. To develop and pilot a training course targeting first line prison staff on the recognition and prevention of suicides. 5. To raise the awareness of prison staff, prisoners and their families with information and educational materials about mental problems, and the risk of suicide and self-harm (including awareness of times of risk: when prisoners may be at risk of particular distress and anxiety);6. To enhance cooperation with community health care providers and NGOs, through referral of mentally ill inmates to local or regional mental health care organisations to ensure access to that can provide further evaluation and treatment after incarceration or during community probation measures.7. To raise the awareness of policy makers and judicial staff (namely judges and prosecutors) to the problem of mental health disorders, palliative and end of life care and aging and its consequences to prison systems.To achieve this goals, the MenACE partnership will develop a state of the art analysis and best practices review, followed by the development of a training toolkit with skills blueprint. Then, we will develop 3 training courses divided in three key areas of learning: (i) mental healthcare; (ii) suicide prevention; (iii) geriatrics and palliative care in prison. We will also develop an e-learning course and a train the trainer course. Afterwards, the partnership will create a European Roadmap with policy recommendations on these important topics.The project foresees the direct participation of 411 persons, which includes:a) 216 corrections professionals from different prison departments (guards, administrative, education, economic and reintegration) as direct beneficiaries, encompassing:• 72 trainees in the piloting of the training programme (at least 18 participants per participating country in the pilot), • 72 trainees in the e-learning course (at least 18 participants per pilot country), and • 72 participants in the short term joint staff training events (26 per training event);b) A minimum of 195 participants in the multiplier events: 15 local participants and 15 international participants in each national seminar, plus 30 international participants and 15 locals in the final international seminar.Mid-term expected results are an enhanced prison human capital skilled to cope with emerging and challenging issues in prison healthcare. In specific, we expect:• an enhanced capacity of staff to recognize and manage mental health disorders;• an improved capacity of staff to identify prisoners at risk of particular distress and anxiety (awareness of suicide and/or self-harm risk);• a greater awareness of age-related needs and challenges regarding social rehabilitation of older inmates;• an improved healthcare and palliative care in the targeted prisons, among others.Consequently, we also expect a beneficial impact on the quality of life of prisoners and an improved diagnosis and treatment of mental disorders and age-related diseases in correctional settings. Further, as long-term results, we expect to raise awareness among policy makers about these important challenges that are part of public health, since “good prison health is good public health”.
Worldwide more than 10.74 million people are currently being held in penal institutions and the global prison population rate is increasing. Mental illness is prevalent in prison populations, by far exceeding the rate of mental disorders in the general population. Prisoners are also a high-risk group for suicide and self-harm. These mental health issues are exacerbated with age: over 20% of adults aged 60 and over suffer from a mental or neurological disorder. As the world’s population ages rapidly, the number of the elderly in jails and prisons is increasing as well, at an exponential rate of 3 times that of the general prison population. Palliative care (PC) and dying with dignity are considered human rights to those who need essential pain treatment. This topic is even more important considering that the prison population is getting old and that there are negative attitudes about compassionate release. The aim of the project was to increase the response to mental health disorders within prisons and the quality of palliative and end of life care services provided by enhancing the competences of management and frontline staff to address prisoners’ mental health needs and the special needs of older prisoners. The project includes a partnership composed of 8 public and private institutions working in mental health, geriatrics and in corrections. The strategic partnership brings together multi-agency and cross-sectorial agencies (a PC foundation- HCS, 4 prison administrations – DGRSP, ANP, FOD Justitie, a private company specialized in prison staff training & innovation- IPS, a health sciences faculty- UBI, a university hospital- Helse Bergen, and the European representative of prisons and corrections-Europris) to develop new, innovative and integrated approaches to the field of adult education in prison and probation settings. In order to achieve the project objectives, MenACE partnership undertook the following activities: a state of the art and best practices review was made in the fields of mental health, ageism and PC, with a clear focus on these realities in the prison environment (IO1). Particularly, a questionnaire was developed to collect information in the partner countries. The literature review and collection of approaches underpinned the development of the second and third intellectual outputs, namely the training curricula and program (IO2) and the e-learning training course (IO3), addressing the current and future needs of prison staff in 3 key areas of learning: mental health, geriatrics, PC in prison. The integrated training program was designed to be delivered on a blended format, combining an e-learning course with classroom sessions. In parallel, a train the trainer course (IO4) was developed with the aim of ensuring dissemination and sustainability of the proposed approach over time. All outputs were piloted and fined-tuned by the Romanian, Belgian and Portuguese Prison Services. In the end, the partnership delivered a European roadmap with policy recommendations (IO5), that presents transversal and specific proposals regarding staff training, legal framework and services / resources / infrastructure for the 3 areas under analysis: mental health, geriatrics and PC in prison. The following tangible results were achieved during the project: 1 state of the art and best practices report• 1 panel of experts• 1 training toolkit• 1 training guide with detailed competences, skills and indicators• 6 training courses (The essentials of prison health, Mental health in prison, Geriatrics in prison, Palliative care in prison, Staff health and well-being in prison and Dynamic security) •1 learning management system•1 train the trainer course• 1 European roadmap with policy recommendation• 3 course manual• 304 participants to 6 multiplier event • 71 participants in the short term joint staff training events•133 trainees in the piloting of the training program and e-learning course.The project’s results contributed to the development and enhancement of prison staff’s transversal skills. All participants gained new knowledge and tools which are helpful and useful for their everyday work-related challenges and for the effective identification, supervision and care of prisoners. In specific an enhanced capacity of staff to recognize and manage mental health disorders• an improved capacity of staff to identify prisoners at risk of particular distress and anxiety• a greater awareness of age-related needs and challenges regarding social rehabilitation of older inmates• an improved healthcare and palliative care in the targeted prisons• a beneficial impact on the quality of life of prisoners and an improved diagnosis and treatment of mental disorders and age-related diseases in correctional settings. Further, as long-term results, we expect to raise awareness among policy makers about these important challenges that are part of public health.