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Health needs of long-term women prisoners neglected
Second PRT briefing on "invisible women" finds that the health needs of women serving long prison sentences are neglected.

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Invisible women

Women serving very long sentences feel that their health needs are being overlooked, a new briefing released yesterday (15 February 2023) by the Prison Reform Trust has revealed. Whilst the majority of women entering prison are serving short sentences, there is a small minority serving very long sentences. For instance, 372 of the 2,456 sentenced women in prison are serving indeterminate sentences.

The briefing, written by Claudia Vince & Emily Evison, was produced in collaboration with women who will spend at least eight years in prison, across working groups in three women’s prisons. These groups are part of a wider ‘Building Futures Network’ of over 60 women with lived experience of long-term imprisonment.


The briefing, entitled Invisible Women: Hope, health, and staff-prisoner relationships highlights the key themes raised by the women: maintaining hope, access to healthcare, and staff-prisoner relationships.

In relation to health specifically, many of the women spoke about the lack of specialist support and help available to meet the health needs of long-sentenced women. Many raised concerns about diet, access to exercise and the potential for long-term health problems to go untreated.

For some of the women, the constant worry of health issues felt like a secondary form of punishment, with many seriously concerned about whether they would be healthy, able-bodied, or still alive by the time they are due to be released.


Many women serving long sentences who were consulted for this research suggested that prison health care is insufficient and lacking. Concerns about diet, access to exercise, proper health care services, and the potential for long-term health problems to go untreated mean many spend a lot of time worrying about their health. The women recognise that the fact they are exposed to insufficient health care facilities for such extensive lengths of time means their concerns are felt more acutely.

“We are imprisoned as punishment. Our liberty is taken as the form of punishment. I don’t remember the judge saying ‘oh and by the time you leave you will either be morbidly obese, suffering serious health problems, osteoporosis, diabetes or a combination of some or all due to the appalling diet you will be forced to eat!’”(Amelia)

“Short-termers may have health problems, but they know they’re going home – they can get help when they get out. We are stuck and left to deal with it by ourselves.” (Amira)

Additionally, some women suggested there is not enough recognition of the link between physical and mental health, particularly in relation to the stress and anxiety caused by physical health problems:

“They don’t see the link between physical health and mental health. They were asking me stuff about my childhood and that wasn’t the problem. I know my physical health problems are having a psychological impact.” (Amira)

Many women noted that worsening physical health is closely linked with declining mental health. This is particularly the case for those facing many more years in custody, as their ability to progress and actively engage in the risk reduction process (including offending behaviour programmes and psychological interventions) may be hampered by poor health.

Women’s health problems

As a result of the length of time they will spend in prison, the women in this study were also concerned about their reproductive health, particularly in relation to cervical screening and menopause. A number of the women noted they had not had appointments for cervical screening or breast examinations.

Staff-prisoner relationships

Many women noted the power staff have in defining their experiences of long-term imprisonment. If staff are motivated, caring and understanding, prisoners feel supported and able to approach staff with any issues they have. If staff are dismissive or rude, prisoners are much less likely to want to engage:

“I always ask what made [a new officer] want to work here. They often shrug and say, ‘I don’t know’ or ‘to pay the bills’, and I just think ‘wrong answer mate’. “(Maggie)

Many women gave examples of individual members of staff showing care and compassion in times of need, but most conversations surrounding staff focused on officers not understanding the specific pains of long-term imprisonment. Dehumanising language was regularly raised as an issue, with graphic examples such as “it’s time to let the animals out’’.

There were also some examples of staff – male staff in particular – exploiting their power. The women discussed how many of the principles they were learning in offending behaviour programmes around communication and respect in particular were contradicted by the way that staff spoke to them.

Conclusions and recommendations

The women involved in this study are advocating for more gender-specific provision for women serving long sentences. They believe their distinct pains of long-term imprisonment are not fully understood by prison staff, governors and the wider prison system.

The main recommendation from the study was the need for better staff training on what it means to be a woman in prison and in particular the challenges of serving a long sentence.

It was also felt important for prison governors to give long term women prisoners a regular forum to raise their concerns and discuss solutions on an individual establishment level.


Thanks to Andy Aitchison for kind permission to use the images in this post. You can see Andy’s work here

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