Health promotion in a prison setting: Experience in Villabona prison

Abstract

Aim: The aim of this study was to analyse experiences of a health promotion intervention implemented by the Therapeutic and Educational Unit at Villabona prison in Spain, which aimed to create drug-free spaces as part of a model of social rehabilitation. Design: As part of a larger participatory evaluation study concerning the efficacy of community education, qualitative data were collected from inmates and key informants associated with the unit. Methodology: Information was gathered from 68 informants via 32 in-depth interviews, 6 discussion groups and 4 life stories. Participants included 39 inmates, 10 prison professionals, 5 ex-prisoners, 11 stakeholders and 3 family members. Results: The unit provides a drug-free space that encourages healthy behaviours and strengthens formal and informal social ties to enhance protective factors. Conclusion: The educational and therapeutic model employed may provide a successful methodology for the promotion of health in penal system institutions. Drug-free opportunities to promote good health may be provided through inmates’ participation in therapeutic spaces and the process of change, alongside effective social and community support. The intervention described here offers a successful new social model of health promotion and education for prison inmates.

Dimensions of social rehabilitation: A qualitative interpretive meta-synthesis

“…Another distinctive group that emerged in the studied literature is people with various psychosocial problems due to a difficult background or a history of behavior that does not fit into the standard norms of society, such as criminal activity or other kinds of socially unconventional behavior. Individuals falling into this category include convicts (Becker-Pestka, 2017;Coppola, 2018;Muro et al, 2016), people with a background in sex work (Aborisade & Aderinto, 2008a, 2008b, homeless people (Piechowicz et al, 2014), and teenagers or children with multiple emotional, behavioral, or psychiatric problems (Savard et al, 2013;Sefarbi, 1986).…”

“…Most of them take place in settings such as the home of the client, a caf e, a community center, or other communal facility, for example, in case of discharged traumatic brain injury patients (Ylvisaker & Feeney, 2000), persons with disabilities or reduced work capacity (Hanga et al, 2015), homeless persons (Piechowicz et al, 2014), children with multiple problems (Sefarbi, 1986), and mentally ill patients (Koichi et al, 2009). In addition to the practices described earlier, social rehabilitation takes place within other institutions such as prisons (Becker-Pestka, 2017;Muro et al, 2016), residential facilities for older adults (Arnetz & Theorell, 1987), or hospitals (Portillo et al, 2009;Portillo & Cowley, 2011). A common characteristic of the different social rehabilitation programs is the emphasis on collaboration between different professionals, institutions, and organizations (e.g., Piechowicz et al, 2014;Portillo, 2009;Portillo & Cowley, 2011;Tate et al, 2003).…”

“…Instead, the closed interpretation (of the individual as an object of rehabilitation) represents, to some extent, a rather paternalistic-or correctionalviewpoint, which aims at changing or 'reforming' the individual. In the context of prison (Becker-Pestka, 2017;Muro et al, 2016;Piechowicz et al, 2014), sex work (Aborisade & Aderinto, 2008a, 2008b, a social rehabilitation center for youth (Savard et al, 2013), and homelessness (Piechowicz et al, 2014), the deviance from normal standards is accentuated. The agency of the individual is viewed in a much narrower sense, leaving only little room for autonomy.…”

“…The strong effect of the environment, and, for example, the social stigma, is acknowledged in the rehabilitation of former sex workers, yet the focus of the rehabilitation is centered on what is referred to as the individual's "positive turnaround" (Aborisade & Aderinto, 2008b, p. 1936). In the context of convicts, the negative consequences of social exclusion and the importance of relationships are recognized (Becker-Pestka, 2017;Muro et al, 2016), but the focus of attention remains on the individual. These articles promote an interesting view that the premises of social rehabilitation are somewhat different in prison or other restricted institutional contexts.…”