Issues and innovations in prison health research: methods, issues and innovations. Matthew Maycock, Rosie Meek & James Woodall (Eds.) London: Palgrave Macmillan. 2020. 277pp. £109.99 (hbk); £109.99 (pbk); £87.50 (ebk) ISBN 9783030464004; 9783030464035; 9783030464011

Abstract

Maycock, Meek and Woodall's edited collection Issues and innovations in prison health research is an invaluable handbook for anyone contemplating a participatory project with people who are living, or have lived, in prison. It consists of 13 substantive chapters, eleven of which are grounded in specific worked examples and all of which speak to the different challenges and opportunities of this kind of research. These insights range from prosaically practical, albeit vital, considerations like stakeholder management and rescheduling due to prison security issues, to complex psychological and theoretical considerations, like the formation of types of masculinities in prison and the efficacy for different methodologies of data analysis.

In the first of the substantive chapters (Chapter 2), Woodall sets the tone for the book by laying out the fundamental principles of establishing a participation project in prisons. It is well evidenced and deals with basic practical issues as well as more complex ethical ones. After this, each of the chapters are distinct and approach their topics in different ways; however, there are a few rough themes that connect chapters throughout the book.

Chapters 3 and 10 both focus on projects that seek to give people in prison agency in their own health education and that of their peers. In Chapter 3, Anita Mehay, Rosie Meek and Jane Ogden examine how peer-based health literacy education can work inside prison and includes an insightful interview-led exploration of the barriers to health literacy in prison. These range from structural barriers, to social problems, to the failures of the prison system itself. In Chapter 10, Ruth Freeman takes a similar peer-led health education model and compares it with a more traditional approach. In doing so she raises an interesting question about the nature of evidence in our discussions of evidence-based practice. By comparing two health education campaigns the chapter demonstrates the importance of using the evidence of prisoner's lived experience, as well as more traditionally scientific forms of evidence.

Chapters 4, 6, 7 and 8 each deal with different research methodologies for examining aspects of prisoners’ lives. Nasrul Ismail's Chapter 4 is a discussion of the use of a constructivist grounded theory methodology as part of a study of austerity in the prison system. This discussion would be useful to anyone considering using this methodological approach, and indeed it includes a number of innovative ideas. However, the chapter puts a lot of focus on the methodological detail, without spending enough time establishing the practical benefits or applicability of the method. The result is that the chapter feels quite heavy amid this accessible and practical book. In Chapter 6, James Fraser describes an interesting study of the experience of accessing health care in prison in Scotland. The experiences were related through a series of interviews with men who had spent time in prison in Tayside. The study itself produces an interesting range of experiences and is extremely informative, especially about the ambiguous role of nurses in the current system. Chapters 7 and 8 both discuss gardening programmes in men's prisons. In Chapter 7, Geraldine Brown, Elizabeth Bos and Geraldine Brady approached this subject from an environmental health perspective assessing the creation of a humanising space inside the prison which encouraged the prisoners’ sense of self-worth and subjective well-being. They offer an interesting, worked example of a programme for the promotion and assessment of wholistic and environmental health within a prison context. Alan Farrier's Chapter 8 goes in a different direction and offers a study of the impact of a gardening programme on an individual prisoner. In particular, it focuses on the use of the biographic-narrative interpretive method as an approach to working with people in prison. The chapter offers a clear explanation of its method and makes a strong case for its benefits as an approach and assesses some of the challenges that it creates.

Chapters 5 and 9 include important self-reflective discussions about the nature of the authors’ research methods. In Chapter 5, David Honeywell examines the role of liminality, stigma and education in the forging of new identities by desisters. Unlike previous chapters this is focused on people who have left prison and gone on to higher education. It explores the complexities of disclosure in a particularly interesting way, as the chapter begins with the author's disclosure of his own history of incarceration, and a fascinating discussion of how that shaped his subsequent research and interactions with his research participants. In Chapter 9, David Woods and Gavin Breslin evaluate a sports-based project aimed at improving mental health outcomes for men in prison. Not only does it clearly lay out a useful methodological approach for this kind of study, it reflects on the challenges of this kind of research, from the ethical issues around recruiting incarcerated people to the potential for testimony to be distorted or withheld, when staff proximity can be a prerequisite of the researcher's access to participants.

Alison Frater's Chapter 11 takes a contrasting approach to the rest of the book. It offers a more top-level and less practically engaged approach than the preceding chapters. It opens with an emotive short fiction, describing a person arriving in prison for the first time. It then discusses the situation of health and health care in prison, in a clear and useful summary. Finally, through a discussion of policy and other issues it makes a strong case for the inclusion of arts programmes in prison. However, this chapter does feel a little out of place in the middle of the book, as it lacks the specific and practical approach which is the hallmark of the rest of the surrounding chapters.

The last three chapters, 12, 13 and 14, all explore gender issues in prisons. Laura Abbot's Chapter 12 discusses the findings of a qualitative study of pregnant women in prison. She uses a series of interviews, daily-routine deconstructions, and interactions with stakeholders to explore the experience of pregnancy in prison and the impact of various prison conditions on it. In light of the previous chapters, it might have been interesting to have included some reflection about how the author's role as a registered midwife shaped her interactions with both the women involved and the prisons’ medical staff. Nonetheless, it is an interesting, and at times harrowing, study. In Chapter 13, Maycock, Alice MacLean, Cindy M. Gary and Kate Hunt examine prison masculinities and how they change in the course of a sports-based health education programme, framing these changes through an interesting discussion of how the research findings do not fully fit into any of the dominant theories of masculinity. The final chapter, by Jamie Grundy and Rosie Meek, is an interesting place to end this book. It is a discussion of research done on football at HMP Prescoed. It stands out for two reasons. First, because it, in part, reversed the participatory relationship which has been such a feature of this book. Rather than people in prison participating in a researcher's project, one of the authors participated in the prisoners’ own football team. The second difference is that much of the chapter is narrativised through the researchers’ field notes and participant contributions. Rather than any summation that attempts to tie together the findings of the book, this chapter leaves the reader enthused and thinking about alternative approaches to both participatory research and to its presentation.

In spite of its breadth, the book is not without its limitations. Its concentration is firmly on people who have spent time inside ordinary prisons and, while it is understandable that the book sets firm boundaries, this does leave some notable lacunae. For instance, it does not attempt to explore the diversity of carceral, semi-, or pseudo-carceral situations that prisoners or former prisoners can find themselves in, from high-security psychiatric hospitals to probation hostels, and while work release is mentioned, its implications for prison research are not addressed. Nonetheless, the chapters individually make useful contributions to a variety of well-established literatures, including the ethics of prison research and prison health governance, as well as emergent topics, including the impact that emotionally challenging research can have on researchers. Moreover, the whole of this book is greater than the sum of its chapters. Its real success is that it offers the reader a broad range of experience-grounded advice, practical study designs, and methodological considerations which should be required reading for anyone setting out to design a prison-based study.