Health and disability
Health checks when you arrive in prison
What health checks will I have when I arrive in prison?
Sometime on your day of arrival, the receiving officer at the prison will arrange for you to meet with a nurse to have an initial check-up – called a “reception health triage”. A reception health triage basically consists of the nurse asking you questions about your health.
After the reception health triage you’ll have a fuller medical assessment by a nurse (an “initial health assessment”), which may include a medical check-up by a doctor if the nurse is concerned about some aspect of your health.
All arriving prisoners will have a reception health traige, whether they’re first arriving as a remand prisoner or as a sentenced prisoner, or whether they’ve been transferred from another prison. If you have had a previous health assessment within the last two years or are transferred from another site, you will not have another initial health assessment done unless there is a medical reason for one to be completed.
Having a “reception health triage” with a nurse
During this assessment a nurse will ask you a number of questions about your health, including about any current or past illnesses or other health issues. The nurse will create a new Prisoner Health File for you. The nurse will also arrange for any urgent medical needs you may have to be followed up.
The nurse will note down and report on any health needs that your PCO (Principal Corrections Officer – the senior prison officer in your unit) needs to know about immediately. This will include things like any injuries or illnesses you have, any comments the nurse has about what your mental state seems to be, and whether or not you’re an alcoholic or use drugs or substances like glue.
It’s important that you tell the nurse all the relevant information about your health, including whether there’s any ongoing treatment or medication that you’ve been having and need to continue with. Each time you see a new nurse or doctor while in prison it’s best to make sure that the medical notes or file that they have for you is complete and up-to-date.
Your “initial health assessment”
You’ll have an “initial health assessment” during your first 7 days (or sooner if a medical issue has been identified by the reception health triage) in the prison. A nurse will carry out a thorough medical check-up – this will include following up on issues that came up in your reception health triage. The nurse will write an entry in your medical notes on this check-up.
You’ll be asked to sign a “Consent to receive health care”. Your health needs will then be treated if possible, or arrangements will be made for future care by a nurse, doctor or dentist.
If you’ve been in prison before, the health staff will ask which prison you were in and they’ll then get your previous health file.
What exactly will they check at my initial health assessment?
Your personal details will be recorded, including your name and address, your race and religion, your next of kin, and the name of your usual doctor.
The nurse will give you a physical check-up, including your weight and your blood pressure. Depending on your medical needs other measures may be taken, such as blood-sugar levels (usually with a device that pricks a finger to obtain a small drop of blood), or a “peak flow level” to help assess asthma (this involves blowing into a device to measure air flow).
The nurse will also ask whether you have any allergies, and ask you about your medical history and any medication you’re on. You’ll also be asked about the health of your family and partner.
The nurse will also assess your mental health and whether there are any drug/alcohol issues that need to be addressed. Your sexual health will also be assessed, including whether you know if you have any sexually transmitted infections (STIs) or intravenously transmitted diseases like AIDS/HIV or hepatitis. If you don’t know you’ll be asked if you would like to be tested for infectious diseases such as hepatitis or HIV. This is a blood test and it is your choice whether you are tested or not.
If you refuse to answer any question, this will be noted on the assessment form.
Additional information for women
Women prisoners will be asked an extra set of questions about cervical smears and mammograms, and may be given the option of having these. You’ll also be asked if you are, or could be, pregnant.
For information about pregnancy in prison, see the chapter “Family Matters”
Assessing your mental health, sexual health, and drug/alcohol issues
At the initial health assessment the doctor will also assess your emotional and mental health. You may be asked about any previous treatment you’ve had (such as counselling), any medication you’ve taken for a mental health or emotional condition (such as anti-depressants or anti-psychotic drugs), and whether you’ve ever considered or attempted suicide and, if so, why.
You’ll be asked a series of questions about your use of alcohol, drugs (including cigarettes), and substances such as glue or solvents. You may be asked if you’ve ever had any treatment for a drinking problem or drug-related problem. The doctor may arrange for you to have a follow-up assessment about your alcohol or drug use.
Prisons often have alcohol and drug counselling services and sometimes also alcohol/drug rehabilitation units. Even if the doctor doesn’t refer you on to one of these services or units after your initial assessment, you can still ask to get access to this kind of help. You can apply through your case manager or through the PCO in your unit.
You’ll also be asked questions about your sexual health and sexual behaviour, including whether you’ve ever had an STI (sexually transmitted infection) like gonorrhoea. You may also be asked about intravenously transmitted diseases, including whether you’ve ever injected drugs and whether you’ve ever shared needles with someone else, and whether you have any tattoos and where you got them done. You could be asked what your understanding is of risks and preventative measures for STIs or intravenously transmitted diseases.
If you refuse to answer any question, this will be noted on the assessment form.
What happens after my initial health assessment?
At the end of your initial health assessment the doctor will arrange for you to have any treatment that you need and will also recommend any further tests they think are necessary, including tests for HIV/AIDS and hepatitis.
The doctor will also tell the prison staff about your health needs, including anything that needs immediate care or observation, and any signs or behaviour to watch out for and that the prison health staff should be told about.
What if i’ve had an initial health assessment in the last year?
If you’ve already had a thorough medical examination in the last 12 months, you’ll only need a quick check-up. During this check-up you could be asked, for example, if you have any new illnesses or injuries, if you’re taking any new medication, whether there have been any changes in your family situation (for example, whether you have a new partner), and whether there’ve been any changes to your smoking, drinking, drug use, or sexual behaviour.
Signing the consent form: what does this mean?
By signing the Consent to Receive Medical Treatment form you are agreeing that:
- you’ve been told about the health services provided at the prison and that specialist services will be provided through the public health service
- you consent (agree) to be treated by the prison health service and by any public health service that’s recommended to you
- you understand that you can refuse treatment at any time and if you do that then you will be fully responsible for your own health
- you consent to your personal health information being released to any doctor or other health care provider to allow for your treatment or care.
When you sign your form, this will be witnessed by another person, who will also sign the form as the witness.
Will I be examined without my consent?
No. The health centre staff will explain any procedure to you and ask for your consent before carrying out any treatment. You can refuse to have it. If, for example, you have an infectious condition like scabies, you can be separated from the rest of the prisoners, but you still have the right to refuse treatment for it.
What happens if I refuse to give my consent?
You can fill out a Refusal of Health Care/Treatment form. You can still refuse treatment without completing this form, but completing the form means the medical staff will clearly understand your wishes. You can fill out the refusal form in in two ways:
- As a refusal of all health care services at a prison and an acceptance of full responsibility for the consequences of that decision.
- As a refusal of treatment for a specific condition for which you’ve been told you need treatment.
What will happen with my health information?
A Health File is developed for each prisoner. It contains a record of all your health information.
Every entry or change to the Health File must be clearly signed by the person making the entry or change.
Your Health File is securely stored in the prison health centre and goes with you if you’re transferred to another prison.
When you’re released, your file is not destroyed and is stored at the prison in an envelope. It’s kept separately and securely from current prisoners’ files.
Prisoner treatment plans for significant or ongoing needs
A treatment plan is developed for you if you have significant or ongoing health needs. The plan also identifies any prosthesis (like an artificial leg) or aid to daily living that you need.
The plan is prepared in consultation with you, and you’ll be asked to sign it to show you approve of the plan and agree to follow it yourself. Every entry or change to the plan must be clearly signed by the person making the entry or change.
The plan is reviewed at a set date. It will also be reviewed if there is a significant change in your condition or if you’re transferred to another prison.