Community health and mental health protection: An obligation on prison health services?

A fact too often forgotten in public health is that the majority of prisoners return to the community sooner or later, often bearing with them serious health problems. Two possible failures of prison health, failure to maintain and promote the health of prisoners while imprisoned and failures in discharge planning and continuity of care should be seen as important public health problems. If healthy communities are to promote healthy minds, they will need to find ways of working with prison health services so that they contribute to health rather than to the hard core of hard to reach mentally unhealthy. Two developments are required. First, prisons will have to recognise more than at present that the right to health of prisoners implies also an obligation on prisons to maintain and protect the mental health of inmates, bearing in mind that there is an ‘unavoidable level of suffering inherent in detention'; mental health protection and promotion is neglected in most prisons systems. The second requirement is that community health services and prison health services need to know more about the others' challenges and opportunities. Isolation of prison health services is a public health threat and a barrier to developing healthy communities.