HEALTHCARE IN PRISONS Prison staff Prison staff work in dangerous and difficult environments and are regularly exposed to work stress, lack of contact with family, long hours, bullying and intimidation, and exposure to traumatic incidents. In many countries, prisons are in very isolated locations, far from population centres. This has an effect not only on staff but also on their families and their access to schools, medical facilities and other social activities. It is also common for prison staff to be expected to transfer frequently from one prison to another.54 To support the health and wellbeing of staff, a number of measures can be taken, including the provision of counselling, anti-bullying initiatives, and good working terms and conditions.55 In addition, reward and recognition schemes, opportunities for career progression and occupational health services are necessary components in strategies to address stress and poor working conditions.56 complex endeavour. It requires a ‘whole-of-government’ approach whereby prison healthcare is integrated into wider public health and social care systems and is of a standard equivalent to healthcare in the community. There also needs to be a continuity of care between community and prison. Providing adequate standards of medical care not only contributes to the health of prisoners themselves but also to the protection of public health, since the vast majority of prisoners will return to the community. The more their health needs are met, the greater the chances are that they will assume a constructive role in society. Conclusions Prisoners are a vulnerable and underserved group who have complex health needs that are frequently unmet. The right to health for specific groups within the prison population is also violated, including for women, children, prisoners who have mental health issues and those who use drugs. Delivering healthcare in a prison setting is a highly Penal Reform International and Thailand Institute of Justice | Global Prison Trends 2019 |9