Women’s Health in the Justice System
Lilly Lewis, Women’s Involvement Advisor, One Small Thing
In the next in her series of blogs, our Women’s Involvement Advisor discusses her experience of healthcare in prison. Lilly reflects on how different aspects of health were addressed within prison – from physical and mental health, to support offered to women experiencing menopause – and how change is needed to improve the health and wellbeing of women in custody.
In my experience very few prisons, if any at all, prioritise the physical health of women. Most women, I’d say as much as 80%, were exempt from going to work due to physical or mental health before prison. On the outside they would’ve been signed off sick by the GP. However, all of the prison population have to work every day, some even on a Saturday and Sunday. Your wage for the week would be around £13. If you felt unwell or didn’t want to go to work that day due to any illness or mental health illness, or something that was happening to you personally at home, you would have to attend healthcare to be signed off. However, this was almost impossible.
I remember being notified by my mother that my father had been diagnosed with prostate cancer. I wasn’t feeling up to working and went over to healthcare to explain the situation and that I wasn’t feeling up to mixing with people. The nurse looked at me and said, ‘And what do you want me to do about it?’ It was not unusual to be treated this way by healthcare workers.
The only way to change and improve physical health in prison would be to change the culture of those providing the healthcare, and invest in training so they can properly address the needs of the women they work with. I didn’t come across any empathetic care staff in prison. Most women in prison have multiple needs, and they are further disadvantaged as these basic needs are not being met by healthcare. For example, I do remember being offered cervical screening, however, due to health care being so poor I had very little confidence, and ultimately I did not feel comfortable to have this done.
I would say the largest healthcare issue affecting women in prison is that around trauma and mental health, and also poor physical health induced by substance misuse. Unless these issues are dealt with in an empathetic, therapeutic way, I can’t see how their mental and physical help will improve.
Women’s Health
When I was in custody, I was experiencing mood swings and Night Sweats. The doctor asked if I’d started the menopause. I confirmed that I was still having regular periods, however, she thought my symptoms alongside my age would indicate menopause and prescribed me with menopause medication. This medication did have a positive effect on my overall mood, although upon release, I was told that I would have to stop my periods for at least 12 months before I would be considered for menopause medication. On numerous occasions when in custody that medication was not available due to shortages of it and I would find that my mood would greatly dip through these periods.
In general, menopause needs to be recognised both inside, and outside of prison. The experience of going through the menopause can last for years with different levels of poor health for women – Including brain fog, night sweats, muscle ache, lack of libido, mood swings and extreme fatigue.
I think it’s important for the justice system to address menopause for women in custody due to their living conditions - plastic mattresses, small spaces with little ventilation, all of which would have a negative impact on women going through the menopause.
There were always period products available on our wings, however, there was no extra support. Some women who really struggled through this time of the month would basically just have to get on with it. You would still have to work.
Food and nutrition
The food in prison is very carb heavy. There’s lots of chips, potatoes, bread sandwiches, with a thick layer of ‘spreading fat’ - this was some form of margarine. There was usually a vegetarian option and a fish option. Sunday would be a roast dinner and Saturday morning brunch of bacon and eggs. There is always a desert and usually a choice of biscuits.
It felt impossible to stay healthy and I opted to go vegan so I could access different food. I managed to continue with this for six months. I was able to have almond or soya milk, along with lots of salad and vegetables and peanut butter, I would also purchase eggs and tuna on the canteen. I was able to eat protein as I was using the gym a lot. This period was the healthiest I’d ever been whilst in custody.
I would like to see a healthy nutritional options available for women in prison. Healthy living could even be an option on sentence – supporting women through a course where they could learn about food and what different foods to the body, women could learn about creating healthy meals on a budget. This could also be linked to time out at the gym. I feel this will support both healthy body and healthy minds for women in custody.
Written by: Lilly Lewis, Women’s Involvement Advisor at One Small Thing