3.  Damage to health caused by imprisonment physical disabilities including dental problems and eating difficulties (World Health Organization, 2014). Older prisoners’ mental health can be affected by conditions such as dementia, Alzheimer’s disease, memory loss, Parkinson’s disease, depression and fear of dying – particularly dying in prison. Some elderly people are imprisoned with a pre-existing (possibly undiagnosed) cognitive impairment or psychiatric disorder. These conditions can be accelerated or worsened by the physical and social conditions in custody. Prisoners are more prone to developing dementia than the general population because of the risk factors associated with incarceration (Christodolou, 2012). These include inactivity, poor nutrition, smoking and a lack of social interaction. In addition, mental health conditions common among prisoners and associated with dementia (such as depression, traumatic brain injury, and attention deficit hyperactivity disorder) might also contribute to higher rates of dementia among prisoners. On reception prisoners are not routinely screened for cognitive impairment and staff often fail to identify the signs. The prison’s mental health services may be focused on other inmates with more challenging behaviour. Cognitive deficiencies can be harder to detect in prison than when people succumb to them in the community, because prisoners do not usually have to perform the same number of daily tasks as older people living independently (Williams et al, 2012). Prisoners from racial and ethnic minority backgrounds and foreign nationals Prisoners from minority groups may have special healthcare needs as a result of prior socioeconomic marginalisation (World Health Organization, 2014). They may have received inadequate medical care prior to imprisonment. They may also be at a higher risk of some conditions (for example, Indigenous Australians have higher rates of physical and mental ill health than non-Indigenous Australians (Jorm et al, 2012)). Foreign national prisoners have been found to suffer higher rates of both physical and mental health disorders and to find it more difficult to access healthcare in custody (Till et al, 2019). Prisoners in either group can find it difficult to access treatment in custody due to lack of translated or accessible materials and other support. Separation from family and community can also take a heavier toll on prisoners in these groups (World Health Organization, 2014). Prisoners with physical disabilities This growing category of prisoners generally has greater healthcare and rehabilitation needs. An absence of suitably qualified staff and the failure to make necessary adaptations to the physical environment can present risks to their health and wellbeing. Prisoners with sensory disabilities often become isolated in the prison environment, causing difficulties in accessing care and treatment and potentially leading to mental health problems (World Health Organization, 2014). Prisoners with intellectual disabilities People with intellectual disabilities are at significantly higher risk of experiencing fear and anxiety in the prison environment and of being subjected to bullying, segregation, or use of restraint or control techniques (Talbot, 2008). They may incur unwarranted disciplinary sanctions for conduct related to poor judgment or difficulty in complying with rules and instructions. Research has found that many people with these difficulties ‘are left to fend for themselves in a shadowy world of not quite knowing what is going on around them or what is expected of them’ (idem: 75). Prisoners with mental health problems Prisoners with mental health problems are at higher risk of self-harm, suicide, substance misuse, sexual victimisation, and of experiencing and committing violence in custody (Yoon, 2017; World Health Organization 2014). They are also more likely to be segregated or placed in solitary confinement, the adverse health consequences of which have been found to be particularly severe for prisoners with mental health problems (for example Grassian, 2006). 13