Ethnically minoritised prisoners’ perceptions of accessing a therapy service in prison

It is well-documented that there is disparity in uptake of prison interventions by ethnically minoritised (EM) individuals. It is not fully understood why uptake of prison interventions is lower, although research indicates that experiences of racism and a lack of representation in therapy services may negatively impact accessibility. There has been limited research to date exploring the low uptake of prison psychological interventions. The study aimed to explore the perspectives of EM individuals referred for therapeutic support in prison, to establish what can improve access to prison psychological interventions and make them more equitable.
The study used semi-structured interviews to explore EM individuals’ experiences of accessing therapy in prison, using Thematic Analysis. A purposive sample of ten men from four prisons in England were recruited.
Six superordinate themes were identified; It Mattered Who I Worked With and Needing To Be More Visible are explored in the current article.
Timing of the Study:The study took place at a unique time, when therapy services had already implemented adaptations due to Covid-19 restrictions. The research therefore provided a timely response to changing circumstances to continue and build upon such positive momentum. However, it also made access to establishments extremely difficult. The additional restrictions faced by prisoners during this time may have also meant participants were more inclined to take part in research, as a means of engaging in a different activity.
Sample: Recruitment issues were faced due to covid-19 restrictions still being in place when the study took place. Despite these issues, ten participants were recruited across four prisons. Although the sample was not as diverse as originally hoped, participants were from various backgrounds; some born in the UK and others abroad.
There are several clinical implications that should be considered from the research findings, that could help facilitate access. Several suggestions made by participants are already implemented by other organisations within the prison regime, and could be incorporated in therapy services also.
The five main areas of consideration are:
• Therapy service involvement in the prison induction process
• Increasing visibility in the prison via assertive outreach
• Continuity of measures implemented during covid-19 restrictions that reduced disparity in uptake of interventions
• Implementation of mentoring scheme more broadly across the prisons
• More training for white therapists that incorporates cultural humility, to increase confidence in talking about race and culture with EM clients. This could compliment and build upon the trauma-informed ethos already incorporated in the service, and which is being implemented more broadly across NHS mental health services
The study adds to a growing body of research that challenges the narrative that EM men are hard to engage therapeutically.
The study builds upon the limited research looking at experiences of accessing therapy by EM prisoners. The study gives insight to how therapeutic services can be more responsive to the needs of a diverse prison population by making efforts to be more visible, flexible and promoting choice in accessing support.