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  • AgePris | Home

    AgePris The average age has significantly increased in Norwegian prisons in recent years. According to the Norwegian Correctional Services, 7 percent of the inmates were over 50 years old in 2002, while the proportion rose to 29 percent in 2019. In 2021, Norway had the highest average age among inmates in the Nordic countries, with an average of 38 years. The Norwegian Correctional Services believes that this trend will continue, and knowledge about elderly inmates is therefore important. As part of the PriSUD project, the AgePris-project, will focus particularly on substance abuse and mental health within this population. ​ A master's thesis on individuals who were 50 years or older at their first imprisonment, was written in 2023, based on data from the nPRIS cohort . The thesis focused on the offenses for which this group of first-time inmates was convicted, the extent of their multiple incarcerations during that period, their contact with specialized healthcare services, as well as any diagnoses related to substance abuse and mental health.

  • Young people and the elderly | Home

    Young people and the elderly in prison Both the very youngest and the very oldest inmates in prison have different needs and challenges than other inmates. For the young people, their needs are based on ongoing physical, cognitive and social development while for the older inmates it is often focused on an increased need for health services. For the young (15-25 years) incarcerated, their needs focus on physical, cognitive and social development and ongoing education. They need access to schooling and stimuli that give them the same opportunities for development as young people outside prison. We also know that young people who serve time in prison have in many cases had a difficult upbringing, experienced psychological trauma or endured physical injuries. Additionally, there is an increasing proportion of older people (over 50 years) in prison. With increasing age, the need for health services also increases. It is important to gain knowledge about who this group of inmates is, what health services they need and what other needs may separate them from the rest of the prison population. This topic is explored in more detail in subproject AgePris .

  • Contact | Home

    Contact us Anne Bukten Project leader E-mail: anne.bukten@medisin.uio.no Phone: +47 233 68 971 Marianne R. Stavseth Postdoc E-mail: m.r.stavseth@medisin.uio.no Phone: +47 233 68 973 Visiting address: Building 49 , Ullevål Hospital, Kirkeveien 166, 0450 Oslo ​ Submit Thanks for submitting!

  • Women in prison | Home

    Women in prison Women in prison represent a particularly marginalized group, with a high incidence of mental, social and substance abuse problems. Because women usually make up a very small proportion of inmates in prisons, their particular challenges and needs tend to disappear into the background. Although there are indications that there are many important differences between women and men in prison, knowledge of gender-specific factors in this population is limited. Women who are currently incarcerated or have been in prison represent a distinct and particularly vulnerable social group. In many crucial aspects, they differ significantly from both male inmates and women in the general population, which can have significant implications for their experiences during incarceration and post-release. ​ Women who are sentenced to prison often have convictions for different and less serious crimes than men. They frequently receive shorter sentences and are less likely to be convicted of violent offenses. Many of them have backgrounds marked by abuse, mental illness, and substance addiction. The management of several Norwegian women's prisons has pointed out how a significant proportion of their inmates would be better served by psychiatric care rather than the criminal justice system. Many women in Norwegian prisons are convicted for offenses that are a direct consequence of their mental health problems and not receiving adequate help in a timely manner. ​ Furthermore, women constitute a very small proportion of the total prison population. This also has significant implications for their experiences both during and after their time in prison. Firstly, most prisons are built and organized based on the needs and challenges of male inmates. It is known that incarcerated women have completely different needs and challenges compared to men, and this has repeatedly been a concern raised by both the correctional services and the ombudsman. ​ The fact that Norway has few female inmates also means that there are few dedicated women's prisons. This limits the opportunities, to a greater extent for women than for men, to tailor the rehabilitation process. For example, many women may have to serve their sentences far away from their families or, for practical reasons (rather than security concerns), be placed in higher-security facilities than necessary. This can contribute to a heightened sense of isolation, which in turn is a significant risk factor for both poor health and mortality. ​ The objective of the PriSUD project is to describe women in Norwegian prisons, with a particular focus on mortality, the prevalence of substance abuse and other mental disorders, as well as prospects for rehabilitation and reintegration into society after their release. The work on women has been given its own sub-project: WOMPRIS . ​ Publications on the topic Svendsen, Vegard G., Marianne Riksheim Stavseth, Torbjørn Skardhamar, and Anne Bukten. "Psychiatric morbidity among women in Norwegian prisons, 2010–2019: a register-based study." BMC psychiatry 23, no. 1 (2023): 390. https://doi.org/10.1186/s12888-023-04886-7 . ​ Bukten, Anne, Stavseth, Marianne Riksheim, Skurtveit, Svetlana, Tverdal, Aage, Strang, John, and Clausen, Thomas. "High Risk of Overdose Death Following Release from Prison: Variations in Mortality During a 15 ‐ Year Observation Period." Addiction (2017). https://doi.org/10.1111/add.13803 . ​ Bukten, Anne, Lund, Ingunn Olea, Kinner, Stuart A., Rognli, Eline Borger, Havnes, Ingrid Amalia, Muller, Ashley Elizabeth, and Stavseth, Marianne Riksheim. "Factors Associated with Drug Use in Prison - Results from the Norwegian Offender Mental Health and Addiction (Norma) Study." Health & Justice 8, no. 1 (2020): 10. https://doi.org/10.1186/s40352-020-00112-8 . ​ Bukten, A; Stavseth, MR; Skurtveit, S, Lund, IO; Clausen, T. Intoxication and Health situ ation among inmates in the penal care. SERAF report, 2/2016 (pdf)

  • PriSUD-Norway | Home

    PriSUD-Norway: Diagnosing and treating substance use disorders in Norwegian prisons A prison stay should be regarded as a window of opportunity for people with substance use disorders (SUD): screening and diagnosis should take place and evidence-based treatment should be offered. The result would be better mental and physical health, improved quality of life and a better quality of life among the prison population. ​ In reality however, a prison stay remains a black box. Even though research has documented the prison population in terms of their situation before prison, and their risks following release, none has focused on the treatment situation within prison. Hence, we do not know if prisoners are adequately screened and diagnosed with SUD when they enter prison, whether people diagnosed with SUD have access to treatment in prison, or what their treatment outcomes are post-release. ​ To ensure efficient, high-quality treatment services to people with substance use disorders (SUD) in prison, PriSUD-Norway will be the first longitudinal Norwegian study investigating the epidemiology of people with SUD; from the time before prison, during prison and after release. In order to reach the ambitious aims of the PriSUD-Norway study, we have put together a multidisciplinary research group which will analyze survey data and a wide range of existing, high quality national registry data available for research. ​ The overall objective of PriSUD-Norway is to ensure high-quality screening and treatment for people with substance use disorders (SUD) in prison. The project is organized in three main Work Packages focusing on: 1) procedures for screening, receiving and continuing SUD-treatment during imprisonment, 2) engagement in three different types of drug treatment for prisoners with SUD organized by the specialized health services, and 3) investigate post release outcomes related to the type of treatment provided. ​ The detection of SUDs, accompanied by adequate treatment and the introduction of harm reduction measures, will significantly improve the overall health status of the communities from which the prisoners come and to which they return.

  • PriSUD-Nordic | Home

    PriSUD-Nordic: Treatment of substance abuse disorders in the prison population - an opportunity for better public health About half of all inmates have a substance abuse disorder when they go to prison, and after release the risk of overdose death and relapse into substance abuse is very high. Because of this it is important to detect substance abuse disorders upon arrival at the prison and offer adequate treatment for substance abuse disorders during imprisonment, which will lead to better health for people with substance abuse disorders in prison. PriSUD-Nordic will be the first longitudinal study examining inmates with substance abuse disorders in three Nordic countries. The overall goal of PriSUD-Nordic is to develop new knowledge that contributes to better mental and physical health, improved quality of life among people with substance abuse disorders in prison. The project aims to examine inmates in three different periods related to imprisonment: the time before imprisonment, the time during imprisonment and after release. PriSUD-Nordic will build on the Nordic countries' potential for research, including universal health rights for all citizens, national health registries and good public services. To achieve the ambitious goals, we have put together a strong, interdisciplinary research group. The group will collect and analyze data from links of several national registers. In addition, a qualitative study is planned, including ethnographic fieldwork and semi-structured interviews to investigate how drug treatment is implemented and integrated in the prison context. An important goal of the project is also to communicate all research produced to a wide audience including current and former inmates, user organizations, politicians, prison officers and the general population.

  • PRISONHEALTH | Home

    PRISONHEALTH: Prisoner health in healthy prisons: Punishment, marginalisation, and access to welfare In Norway, prisoners retain all rights to welfare provisions while they are incarcerated, including the right to high-quality healthcare services free of charge. At the same time, studies show that a number of physical and mental health problems are relatively common among prisoners. Research also suggests that prison environments in themselves can cause, contribute to and exacerbate health problems. With the PRISONHEALTH project, our aim is to find out whether welfare state health care services reach prisoners, and identify possible challenges and obstacles to healthcare service delivery in prison and how to avoid them in practice. We want to examine the long-term effects of prison healthcare delivery from the perspective of individual prisoners as well as that of general society, including effects on health-related outcomes such as living conditions, criminal activity and post-release mortality. And we want to find out whether prisons can, in some circumstances, provide prisoners with a positive and constructive environment where personal development and growth is possible. PRISONHEALTH findings may have important implications for national and international policy debates surrounding the growth in imprisonment rates and the nature and quality of health coverage in prison. Our findings will be relevant for prison managers, prison officers, and nurses and medical doctors working in prisons in their efforts to create more healthy prisons. Our research will benefit the various voluntary sector organizations working in the field, including organizations trying to help former prisoners reintegrate back into society post-release. Our ultimate long-term goal is to contribute to strengthening healthcare service delivery in prisons and to help prison and healthcare professionals create more constructive and health-promoting prison environments in both Norway and internationally.

  • Publications | Home

    Publications Dissemination of PriSUD project activities is an important part of the work we do. Our research is published in scientific articles, reports, through interviews with journalists and in works from students at all levels. Publications Here you can find all our scientific articles in peer-reviewed journals, as well as reports. In the media Dissemination of our research to the public outside the academic environment is a priority. Read here for more on our project in popular media. Student projects There are always many students at all levels involved in the project. Here is an overview of their completed work (in Norwegian). Scientific publications Master thesis Popular publications PriSUD in media Reports

  • PriSUD-Nordic: Qualitative sub-study | Home

    PriSUD-Nordic: Treating substance use disorders in the prison population ​ ​ Qualitative substudy description: ​ ​ Knowledge needs Harm caused by substance use disorders (SUD), including illicit substances as well as alcohol and other legal substances, is a significant contributor to the burden of disease. Individuals with SUDs have a higher risk of premature death, ranging from a four-fold increased mortality among persons with alcohol use disorder (AUD) (1) to a four to 15-fold increased mortality among persons with opioid use disorder (2) . During 2015, 28 million years of healthy life (disability-adjusted life years, DALYs) were lost worldwide as a result of premature death and disability caused by drug use (3), with a heavier burden among socially disadvantaged groups, such as the prison population. People with SUD in prison thus constitute a marginalized group both in terms of substance use and in terms of incarceration, and suffer disproportionately from poor physical and mental health, infectious diseases, social marginalization and economic disadvantage (4). ​ A continuing challenge in public health is to provide services to the people who need them the most and who are hardest to reach. Prisons may provide an ideal environment for health interventions; a high proportion of prisoners have untreated SUD, and in prison, they are reachable for a set amount of time. The detection of mental health problems and SUDs, accompanied by adequate treatment and the introduction of harm reduction measures, will significantly improve the overall health status of the communities that the prisoners come from and to which they return. From a public health perspective, time in custody could therefore represent a turning point, as a way of promoting SUD treatment among some highly disadvantaged people. However, the global provision of health services in prison is characterized by large diversity, on a spectrum of no health services offered to universal health coverage, with the Nordic countries being examples of the latter (5, 6). Where high-quality health services are offered to prisoners, prison is one of the few arenas where the health services are sure to get in regular contact with marginalized populations living precariously outside. ​ Advancing our knowledge of traditionally marginalized and understudied groups such as people with SUD in prison is important for our understanding of social disparities in health. In addition, this is a precondition for planning the most appropriate interventions among people with SUD in prison. Because of the number of people who cycle through prisons each year globally, improving the health of this population is important for human rights, public health, criminal justice, economic grounds and not least for society as a whole (7, 8). ​ ​ PriSUD-Nordic will be the first longitudinal study to investigate the epidemiology of people with SUD in three Nordic countries. The overall objective of PriSUD-Nordic is to develop new knowledge contributing to better mental and physical health, improved quality of life and better life expectations among people with SUD in prison. The project aims to investigate the epidemiology of people with SUD in the Nordic prison population during three different periods relating to incarceration: the time prior to imprisonment, the time during imprisonment and post-release. ​ To reach the ambitious aims of the PriSUD-Nordic study, we will analyze a wide range of existing, high quality Nordic registry data available for research, combined with analysis of qualitative data based on ethnographic fieldwork and semi-structured interviews. ​ ​ Methodological approach Prisons are situated in complex social, cultural and political contexts, dependent on social, structural and historical factors. This makes a multidisciplinary mixed method approach relevant, as it includes the methodological perspective of both epidemiological, quantitative methods and ethnographic, qualitative methods. Mixed methods enable investigators conceptually and analytically to integrate qualitative research and qualitative data with traditional epidemiological and quantitative methods of research to facilitate translation. Mixed methods help us to understand not just whether an intervention works, but how, why, and for whom (9). ​ ​ When investigating the epidemiology of SUD among people in prison with longitudinal registry data, it is therefore relevant to take the context of the prison into account. Two methodological approaches will be at the center of the qualitative research; the ethnographic fieldwork and semi structured interviews. The ethnographic fieldwork could focus on the SUD treatment situation and the context surrounding this, with the researcher being present in the context of the SUD treatment. This could be the prison wards, the various treatment facilities inside the prison or outside the prison. In terms of the interviews, it would be relevant to talk to prisoners who have been in SUD treatment, prisoners who have not, health care providers, other SUD treatment providers such as therapists or coaches, social workers as well as other people situated in the prison context, whether they have a direct, indirect or no association to the SUD treatment. ​ ​ Qualitative methods can provide descriptive analysis for the epidemiological and statistical analysis, helpful when developing hypotheses and research design. Secondly, the qualitative analysis can help to qualify and validate the interpretation of the quantitative results by developing knowledge of processes, mechanisms and explanatory models behind the results. Thirdly, the qualitative methods can qualify the development and implementation of interventions, guidelines and recommendation of the results from the research project. This can thereby improve the effect of the research and the value of the project to the target populations. ​ ​ The interviews will be conducted following a semi-structured interview guide, based on a scoping review of the current knowledge within the field. Some of the overall themes in the interview guide could be social relations, support and marginalization, health and addiction, motivation for treatment and more. Focus will be on identifying challenges to successful treatment, the prison as an arena for treatment interventions and different ways of understanding the treatment institutions in question from different perspectives and at different times of the sentence/treatment - release preparation - post-release process. ​ ​ Research questions The specific scientific aims for the qualitative study are: Aim QI: Investigate the nature, norms, mechanisms and process of SUD treatment in prisons Aim QII: Investigate post-release narratives among former prisoners ​ ​ Project group The project management is held at the Norwegian Center for Addiction Research (SERAF) at the University of Oslo, and Dr. Anne Bukten is the project leader. Dr. Stavseth will be the project lead analyst and in charge of developing the Nordic syntax for the registry data. Professor Ugelvik will lead and run the qualitative part of the project and supervise the PhD student. Nicoline Lokdam (PhD, PriSUD-Norway) will contribute with experience in qualitative research in the prison population and Johan Lothe will oversee the user perspective. User involvement is integrated in both the Steering committee and the research group, represented by clinicians, policy makers and user organizations. The user organization WayBack (10) provides in-prison services and helps build pro-social networks post-release in order to prevent relapse into crime and drug use (11). WayBack plays an important role in planning the project, recruiting interview participants and in disseminating project results. ​ ​ 1. Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World psychiatry: official journal of the World Psychiatric Association (WPA). 2014; 13 (2): 153-60. 2. Degenhardt L, Bucello C, Mathers B, Briegleb C, Ali H, Hickman M, et al. Mortality among regular or dependent users of heroin and other opioids: a systematic review and meta-analysis of cohort studies. Addiction (Abingdon, England). 2011; 106 (1): 32-51. 3. UNODC. World Drug Report 2017. Executive summary conclusions and policy implications. . Vienna United Nations Office on Drugs and Crime; 2017. 4. Friestad C. Socio-economic status and health in a marginalized group: the role of subjective social status among prison inmates. European journal of public health. 2010; 20 (6): 653- 5. Pratt JJTBjoc. Scandinavian exceptionalism in an era of penal excessPart I: The nature and roots of scandinavian exceptionalism. 2008; 48 (2): 119-37. 6. Ugelvik T, Dullum J. Penal Exceptionalism ?: Nordic Prison Policy and Practice. New York: Routledge; 2012. 7. Kinner SA, Wang EA. The Case for Improving the Health of Ex-Prisoners. American Journal of Public Health. 2014; 104 (8): 1352-5. 8. Kinner S, Young J. Understanding and improving the health of people who experience incarceration: An overview and synthesis. Epidemiologic Reviews. 2018; (in press). 9. Rolfe DE, Ramsden VR, Banner D, Graham ID. Using qualitative Health Research methods to improve patient and public involvement and engagement in research. Research involvement and engagement. 2018; 4:49. 10. LeBel TP. An examination of the impact of formerly incarcerated persons helping others. Journal of Offender Rehabilitation. 2007; 46 (1-2): 1-24. 11. WayBack.no. WayBack 2016 [Available from: www.wayback.no .

  • NorMA: Quality of life | Home

    NorMA: Qu ality of life and training Ley Muller at the National Institute of Public Health researches on prison inmates' subjective assessments of everyday life in prison, social conditions and health. In the NorMA study she has worked on projects related to quality of life and exercise. ​ Quality of life among prisoners: Prison inmates are rarely asked how they feel when they are in prison. In large parts of the world, a prison sentence involves daily reminders of punishment, and it is therefore expected that the quality of life of prisoners is significantly reduced. The Norwegian prison model strives for life in prison to reflect to the greatest possible extent life outside prison, and it is therefore interesting to examine Norwegian prisoners' own assessment of quality of life. ​ An article on quality of life in prison was published in International Journal of Prisoner Health in March 2019. ​ ​ Exercise among inmates: Ley Muller has looked at how NorMA participants trained before imprisonment versus how active they became after incarceration. She has compared these changes with concomitant changes in drug use. The results show that exercise seems to be an important activity for people who had substance abuse problems before they were imprisoned. Facilitating training during imprisonment is both health-promoting and resource-intensive. ​ The article was published in The International Journal of Environmental and Public Health in 2018. ​ ​

  • Researchers | Home

    The research group Anne Bukten PI. PhD, Researcher Marianne R. Stavseth PhD, Postdoc Torill Tverborgvik PhD, Postdoc Vegard Svendsen PhD candidate Suvi Virtanen PhD, Post.doc. Morten Hesse PhD, Associate Professor Thomas Ugelvik PhD, Professor Thomas Clausen MD, Professor Svetlana Skurtveit PhD, Professor Ingrid A. Havnes MD, PhD Nicoline Lokdam PhD candidate Ingeborg Skjærvø PhD, Postdoc Johan Lothe Leader, WayBack Oslo Torbjørn Skardhamar Professor Zheng Chang PhD, Assistant Professor Abdu K. Seid PhD, Assistant Professor Rose E. Boyle PhD candidate Christine Friestad Psychologist, Researcher Eline Borger Rognli PhD, Researcher Ingunn Olea Lund PhD, Researcher

  • Nicoline PhD | Home

    PhD student: Nicoline Lokdam Nicoline's PhD project is based on data from the NorMA study , combined with data from the prison and health registry. The aim of the project is to investigate the needs, treatment and life after imprisonment for people with substance abuse disorders in Norwegian prisons. The project has the working title: "Substance Use Disorders in the Norwegian prison population - Needs, treatment and post-release outcomes." In the following 5-minute video, you can see and hear Nicoline explain her work (in English).

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