Tattooing in Scottish Prisons
A healthcare needs assessment
Dona Milne, Specialist in Public Health
Needs assessment objectives:
• To describe the current population in Scottish
prisons and the disease burden related to blood
borne viruses
• To identify current tattooing practices and
associated risks/potential risks
• To elicit stakeholders views: prisoners, staff and
management
• To consider evidence of effective interventions
to reduce risks related to tattooing in prison
• To recommend potential interventions to reduce
risks associated with tattooing
Methods –
epidemiological/comparative
•
•
•
•
•
BBV Surveillance reports
SPS Prisoner Survey
Prevalence studies
Clinical case reports
Published and grey literature search on
effective interventions (limited)
Methods - corporate
Four prisons identified:
• interviews were conducted with a Hall Manager,
Health Centre Manager, and one each of
hepatitis C specialist staff and prison officers
• a one to one interview was completed with a
tattooist and a focus group of prisoners who had
obtained a tattoo whilst in prison
• A short survey of prison doctors (25 approx) was
completed to identify the frequency of clinical
complaints related to tattooing
• Literature review on effective interventions
SPS Annual Prisoner Surveys
reported tattooing activity
amongst prisoners:
• 55% prisoners reported having a tattoo
with 19% reporting receipt of a tattoo in
prison (2007)
• 54% prisoners reported having a tattoo
with 18% reporting receipt of a tattoo in
prison (2008)
Prison
Type of
Establishment
Tattooing rate
Edinburgh
Closed, local,
remand and
short-stay
Closed, local,
remand and
short-stay
22%
Perth
Closed, local,
remand, short and
long-stay
21%
Shotts
Closed, national
long stay
28%
Inverness
25%
Tattooing activity
•
•
•
•
Reasons for getting a tattoo
Tattooing equipment
Sharing and cleaning equipment
Perceived risks from tattooing
Staff views on tattooing activity
• Prison doctors
• Prison Officers
• Health care staff
And responses to interventions…..
Intervention
Prisoners
Prison officers
Prison medical
staff
Total
Numbers of each survey
group
17
8
7
32
Confiscate
components
gun
4
5
9
Increase punishment/better
security
1
1
2
Educational materials such
as leaflets and posters
9
7
7
23
Addictions services provide
cleaning materials and
equipment
8
2
5
15
Provide training on health
and safety
1
1
2
Discussion
groups/induction
7
1
8
Local education project
2
1
3
Increase staff knowledge
2
Provide
service
a
prison
tattoo
12
5
2
6
23
Conclusions
• Prevent tattooing in prisons
• Educate prisoners on the risk of tattooing in
prison
• Provide access to cleaning materials and tattoo
equipment
• A multi-faceted approach
But what can be done in the prison environment?
Recommendations
•
•
•
review existing health promotion materials on
tattooing in prisons with Scottish prisoners to
ensure the relevance of the final materials
information on risks from tattooing in prisons
should be featured in staff training and prison
induction sessions
prisoner survey amended to seek information on
when prisoners got a tattoo within prison, to
better assess current tattooing activity within
prisons
• Sterilisation materials or facilities should be
made available to prisoners providing tattoos,
either through health care or addictions staff
• The Scottish Prison Service health care
standard on blood borne virus prevention, care
and treatment should be updated to reflect the
inclusion of the above approaches within prison
health care services
• SPS should consider a tattoo room pilot in a long
stay establishment
Work by C plus and prisoners in
Edinburgh
Prison Public Health
Don’t forget the community links….
•
•
•
•
Lothian tattooing incident 2010
Unlicensed tattooist
Young women under 16
Common link – tattoo parties