Prison administration and management Staff training Staff training on mental health should be provided by mental healthcare professionals throughout service, and should involve all staff working in prisons, including prison management. Training should include the different types of mental health conditions, causes and symptoms, and early detection and intervention, including the recognition and prevention of suicide and self-harm. To ensure that prison staff can respond effectively to mental ill-health, prison management need to ensure a safe and constructive environment. Prison managers and policymakers should primarily ensure there are clear policies, procedures and lines of responsibility relating to mental ill-health. Staff should also receive training on the psychosocial needs of prisoners with mental health conditions, and how to communicate with them. There should be a focus on encouraging mental health promotion for both prisoners and staff and breaking down the stigma and discrimination related to mental ill-health. Institutional culture, ‘the shared assumptions and values of staff and detainees, which guide behaviour with the detaining organization’,28 will define the experiences of prisoners with mental ill-health. It is therefore essential that everyone in the prison environment contributes to an institutional culture that recognises individual differences, is responsive to mental ill-health, and does not tolerate abuse and discrimination. This might involve challenging deep-seated beliefs and attitudes towards mental ill-health over a long period, but will result in a more positive and safer environment for both prisoners and staff. Architecture, design and location The physical design, availability of space and prison location are also important factors in the promotion and protection of mental health. Facilities in remote areas usually result in less family contact, and designs with heavy security features such as heavy gates and stark decoration are likely to cause or exacerbate mental ill-health. Conversely, facilities that are designed to be welcoming and user-friendly can contribute to overall mental well-being. This might include the incorporation of therapeutic colour schemes, access to open spaces, and the provision of multi-purpose spaces for rehabilitation purposes.29 Protecting and promoting the health of prison staff Staff themselves may experience physical and mental health problems, which may be caused or exacerbated by working in a prison environment. Promising practice: Improving physical conditions of detention Factors that might affect the mental health and well-being of staff include work stress, lack of contact with family, long working hours, isolation, dangerous working conditions, bullying and intimidation, and exposure to traumatic events, such as suicide attempts and deaths in custody. Staff mental ill-health is also more likely in overcrowded, understaffed and underresourced facilities and amongst staff who feel undervalued and unsupported. The important role of prison staff must be recognised at management level and strategies should be in place to protect and promote their health and well-being. New Zealand’s Department of Corrections has announced a plan to spend over NZD$11 million to create better prison environments and to help prison officers support prisoners with mental health conditions, including improving the physical environment of at-risk units. Statistics show that 62 per cent of those imprisoned in a 12-month period had some form of mental health or substance abuse disorder.30 Multi-agency and community based-approaches Measures that managers can take include counselling and staff support initiatives, anti-bullying initiatives, good management and supervision, good working terms and conditions, and the possibility of advancement and promotion. Approaches to mental ill-health in prisons should be well-coordinated across the different agencies and individuals working in prisons, including the private sector. There should also be good cooperation with community organisations specialised in mental health. 32 33