BLOG - RELEASE: Understanding contact with services for mental health and substance use on release from prison in Scotland

What is the RELEASE Study?

The RELEASE study is investigating contact with services for substance use and mental ill-health after they are released from prison. Prison data are under-explored in Scottish research, and this is the first study with a comprehensive, nationwide, individual-level linkage between prison and health data in Scotland.

We were able to securely link Scottish Prison Service data on all people who were released from a Scottish prison in 2015 with their health data and death records, which included hospital admissions (general hospital and psychiatric), outpatient appointments, specialist drug and alcohol services, prescriptions, NHS24 helpline calls, A&E attendances, ambulance call-outs, and out-of-hours GP appointments. To compare the use of health services by people released from prison, we also defined a comparison group of people who had not been imprisoned in the last 5 years and who were matched on age, sex, geographical location, and the level of deprivation in the area they lived in. Throughout the study we have consulted with a Lived Experience group to make sure our study asked questions relevant to people who have been to prison, and to help us understand and explain what results may show.

Why This Matters

People in prison have very high levels of mental ill-health and substance use problems that prison can sometimes make worse, and that can increase the risk of reoffending. Most people will be released from prison, when they are at high risk of avoidable deaths, poor health and re-offending, especially from and associated with substance use and mental ill-health related causes. This has a big impact on people released, people who care about them, health systems and public health. Understanding contact with services can help policymakers and practitioners make changes to reduce negative outcomes.

Insights into Service Contact Patterns

By comparing substance use/mental ill-health service contacts between people released from prison and the matched comparison group, the study will identify disparities and unmet needs. We are currently preparing our findings for publication.

We are also applying for further funding to continue investigating how service contact impacts health outcomes and what barriers exist for people released from prison. We will further analyse how factors like socioeconomic status, ethnicity, geographic location, and release type influence contact with and outcomes post-release. Identifying gaps in care is pivotal to developing targeted interventions to increase early contact with community services (like primary and outpatient care), reduce emergency care use, and improve overall outcomes.

Informing Policy and Practice

The RELEASE study’s findings will inform policymakers in crafting evidence-based interventions and post-release support systems, and demonstrate the importance and value of population-level data linkage and the utilisation of routinely collected administrative justice and health data.

By highlighting the specific needs of people who have experienced imprisonment, the research supports the creation of tailored programs aimed at improving mental health, reducing harmful substance use and lowering mortality post-release. Researchers can study the effects of such interventions, contributing to a cycle of continuous improvement in health services.

Summary

The RELEASE study lays invaluable groundwork for future research into the intersection of healthcare and the justice system. By leveraging the comprehensive RELEASE dataset and findings, researchers can drive significant advancements in understanding and improving post-imprisonment care, ultimately contributing to better health and social outcomes for this underserved population.

Acknowledgements and Further Reading

The RELEASE study was funded by the Chief Scientist Office (HIPS 21/54). Linkage was supported by eDRIS, Public Health Scotland. We are grateful to our Lived Experience Advisory Panel and the RELEASE team.

Find out more:

- Study Protocol paper

- Blog: The Importance of Including Lived Experience in Big Data Research

- Previous blog from Stirling University about RELEASE study