Hidden Homeless: Addressing the Health, Care, and Wellbeing Needs of Ex-Offenders in Essex

In today’s society, the issue of homelessness often dominates discussions, but there are certain groups whose struggles remain hidden from the public eye. To shed light on these marginalized populations, Healthwatch Essex has launched a groundbreaking report: “Hidden Homeless: An Exploration of the Health, Care, and Wellbeing Needs of Prisoners, Prison Leavers, and Ex-Offenders in Essex.” The report delves into the lived experiences of prisoners, prison leavers, and ex-offenders, aiming to identify their specific health, care, and wellbeing needs and the challenges they face in achieving positive outcomes. Through surveys, focus groups, and individual interviews, the report sheds light on the voices of this group, highlighting challenges and advocating for necessary improvements in support and services.

Among the key themes that emerged from the report, mental health stood out as the primary concern for those engaged in the project.The prevalence of mental health conditions, self-harm, and suicidal thoughts among prisoners emphasizes the urgent need for equitable access to mental health support services within the prison system. While initiatives within the voluntary sector are supportive, they should complement, not replace, proper NHS healthcare provisions. Persistent self-harming, depression, and inadequate mental health support demand a thorough review and consistent plan of action to safeguard prisoners’ mental wellbeing during their incarceration and beyond.

Trauma emerged as another significant challenge faced by prisoners and ex-offenders, with a considerable number of participants revealing highly traumatic experiences in their lives, including abuse, familial separation, and mental health crises. The lack of appropriate support since these traumatic events has left a lasting impact, leading to potential triggers and severe reactions that can be debilitating for individuals. Recognising the comorbidities associated with trauma, such as substance misuse and self-harm, the report calls for timely and comprehensive trauma support within the prison system, alongside structured mental health provision. Linked to this, Addiction emerged as another pressing concern, with a significant number of individuals entering prison with addiction issues, primarily opiates. The report stresses the importance of prison as an opportunity for addiction services to provide support and treatment to prisoners, enabling them to overcome their addictions before release. Greater collaboration between prison and community-based agencies for continuous support post-release is essential to ensure positive outcomes and reduce reoffending.

The report also identifies the need for a streamlined system to address prisoners’ physical and mental health needs promptly. For instance, the ‘apps’ system, relying on notes passed between prisoners and prison staff to access appointments, was found to have pitfalls causing delays in receiving necessary care. Implementing electronic systems, such as the CMS system, can ensure faster and more efficient healthcare delivery.

For prisoners, release can be both a daunting and overwhelming experience, especially for those lacking support networks. To facilitate successful reintegration, the report advocates for greater integrated working between prison staff and community agencies, creating a structured process with individualized plans covering health, housing, employment, and more. Additionally, providing adequate information and resources for individuals upon release can significantly reduce the likelihood of negative outcomes, such as homelessness, poor health, and continued addiction.

The “Hidden Homeless” as a whole, shares powerful stories which reveal the issues faced by prisoners, prison leavers, and ex-offenders in Essex. The lived experiences shared in the report underline the urgent need for comprehensive support in mental health, trauma care, addiction treatment, and reintegration efforts. Investments in these areas not only improve the lives of individuals in this cohort group but also contribute to reducing reoffending rates and the associated costs to society.

Sharon Westfield de Cortez, Information and Guidance Manager at Healthwatch Essex, expressed her gratitude to all the individuals who participated in the project: “Thank you to everyone who shared their experiences with us. Their stories, often personal and emotive, have shed light on the challenges faced by this particular demographic. It is through their voices and the concerted efforts of society that meaningful change can be achieved. By prioritising the health, care, and wellbeing of prisoners, prison leavers, and ex-offenders, we can foster an inclusive community that supports and empowers every individual, offering them a chance to lead a fulfilling life beyond the confines of their past.”

You can read the full report here and we have also launched a podcast sharing one of the participants experiences in more detail.