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Review
. 2021 Jan 6;17(1):54-68.
doi: 10.1108/IJPH-06-2020-0037.

Time out of cell and time in purposeful activity and adverse mental health outcomes amongst people in prison: a literature review

Thomas Stephenson  1 , Jane Leaman  2 , Éamonn O'Moore  3 , Anh Tran  4 , Emma Plugge  5
Affiliations
Review

Time out of cell and time in purposeful activity and adverse mental health outcomes amongst people in prison: a literature review

Thomas Stephenson et al. Int J Prison Health. .

Abstract

Purpose: The purpose of this study is to synthesise the available peer-reviewed literature on the impact of time out of cell (TOOC) and time in purposeful activity (TIPA) on adverse mental outcomes amongst people in prison.

Design/methodology/approach: The outcomes of interest of this literature review were mental health, suicide, deliberate self-harm (DSH) and violence. Exposures of interest were TOOC, TIPA or a partial or indirect measure of either. In total, 14 studies were included. An abbreviated review methodology was used because of time constraints.

Findings: There was consistent evidence of an association between lower TOOC and TIPA and worse mental health and higher suicide risk. Limited evidence suggests a link between TOOC and DSH. No evidence was identified regarding the relationship between TOOC/TIPA and violence.

Research limitations/implications: A lack of longitudinal studies prevents conclusions regarding causality. Significant heterogeneity of mental health outcomes limits the comparability of studies.

Practical implications: These findings highlight the importance of considering the impact of TOOC and TIPA on adverse mental outcomes for prisoners when designing prison regimes, including during urgent adaptation of such regimes in response to Covid-19. They are likely to be of interest to practitioners and policymakers concerned with prison regime design.

Originality/value: This paper is the first to synthesise the existing literature on the impact of TOOC and TIPA on mental health outcomes.

Keywords: Health promoting prison; Mental health; Prison psychiatry; Self-harm; Suicide; Violence.

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References

    1. Albertie, A., Bourey, C., Stephenson, R. and Bautista-Arredondo, S. (2017), “Connectivity, prison environment and mental health among first-time male inmates in Mexico city”, Global Public Health, Vol. 12 No. 2, pp. 170-184.
    1. Ali, N.A.M., Mohamad, M., Muhammad, N., Yusoff, H.M. and Omar, N. (2016), “The impact of social climate on life satisfaction of drug-abuse inmates in Malaysia prison”, International Journal of Applied Business and Economics Research, Vol. 14 No. 13, pp. 9453-9464.
    1. Borrill, J., Snow, L., Medlicott, D., Teers, R. and Paton, J. (2005), “Learning from ‘near misses’: interviews with women who survived an incident of severe self-harm in prison”, The Howard Journal of Criminal Justice, Vol. 44 No. 1, pp. 57-69.
    1. Buckaloo, B.J., Krug, K.S. and Nelson, K.B. (2009), “Exercise and the low-security inmate: changes in depression, stress, and anxiety”, The Prison Journal, Vol. 89 No. 3, pp. 328-343.
    1. Cashin, A., Potter, E. and Butler, T. (2008), “The relationship between exercise and hopelessness in prison”, Journal of Psychiatric and Mental Health Nursing, Vol. 15 No. 1, pp. 66-71.

Further reading

    1. World Health Organization (2004), Promoting mental health: concepts, emerging evidence, practice (Summary Report), World Health Organization, Geneva.