title: When prison is "easier": probationers' perceptions of health and wellbeing.
abstract: OBJECTIVE
  There are currently over 300,000 offenders in England and Wales and the majority, around 240,000, are in the community on probation. However, there is a paucity of research on their health and healthcare needs. The purpose of this paper is to explore issues around health and access to health services for those on probation. In particular the paper explores what people on probation consider to be the key health issues currently affecting them, and to identify barriers to accessing healthcare in the community.
  
  
  METHODS
  The authors ran six focus groups with a total of 41 participants; two were with staff and the others with men and women on probation. In each focus group, the researchers used semi-structured guide and the discussions were recorded electronically and then transcribed. The paper adopted a thematic analytical framework and used NVivo 7 to facilitate analysis.
  
  
  RESULTS
  Both probationers and professionals largely agreed about the key issues which included substance use and mental health problems. However, the most important issue for probationers was dealing with the stress of being on probation which was not generally recognised by professionals. All participants recognised the impact of issues such as housing, finances and employment on the wellbeing of probationers and were concerned about the lack of access to health services, in particular mental health and alcohol services.
  
  
  CONCLUSIONS
  This was a small study conducted in one part of England and therefore it is not clear that the findings are generalisable. However, it raises important issues about the mental health needs of probationers and the lack of appropriate services for them. Effective services may have positive impact on re-offending and further research is needed to evaluate models of care.
  
  
  CONCLUSIONS
  The challenge remains for local health service commissioners and providers and the probation service to work together to provide appropriate and accessible services for all those on probation.
  
  
  CONCLUSIONS
  Nearly one-quarter of a million people are on probation at any one time in the UK but the existing evidence on their health is patchy and dated. Little is known about effective health interventions or the extent to which their health needs are met. This study shows that probationers see the stress of being on probation as their most important health concern. Both probationers and staff recognise that mental health and substance use are persistent problems and that these important health needs in these areas are not being met by existing services.
authors.affiliation: University Research Lecturer, based at Department of Public Health, University of Oxford, Oxford, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Plugge
authors.forename: Anees
authors.initials: A
authors.lastname: Ahmed Abdul Pari
authors.forename: Janet
authors.initials: J
authors.lastname: Maxwell
authors.forename: Sarah
authors.initials: S
authors.lastname: Holland
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility / Q000458:organization & administration*; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D011329:Prisoners; D013315:Stress, Psychological / Q000523:psychology*; D019966:Substance-Related Disorders / Q000628:therapy; D006113:United Kingdom
keywords: Criminal justice system; Mental illness; Psychological health; Qualitative research