The Netherlands paves the way for improved prison health policies

The Netherlands has the fourth lowest incarceration rate in the WHO European Region - with health policies which strive to provide necessary care to all people living in prisons, leaving no one behind. Currently, the country is taking steps to tackle the major challenge of mental health disorders - the most prevalent health condition in detention facilities. This worrying issue is relevant for the whole Region, and the Netherlands is working on several collaborative projects with WHO/Europe to address this.

"Well-being is crucial for society as a whole, but for people living in prisons, safeguarding mental health is a question of life and death. Co-occurring substance use disorders are very common in detention facilities across the WHO European Region, and suicide rates are 6 times higher than among the general population," said Dr Carina Ferreira-Borges, Regional Advisor for Alcohol, Illicit Drugs and Prison Health, WHO/Europe.

Being aware of this, the Netherlands for many years has had a strong focus on mental health and other noncommunicable diseases (NCDs) in prisons and has taken some major steps.

Health services available for all

According to the latest WHO data, all prisons in the country allow access to mental health counsellors and have established procedures or protocols for transferring those with severe mental health issues to specialized institutions.

Health staffing in prisons a priority

The health workforce ratio within prisons in the Netherlands surpasses that of the general community. There are more nurses per detainee than the recommended minimum. While the number of physicians and psychiatrists falls below the European Region average, the overall health staffing level is significantly higher.

The availability of health workers is especially important given that for many detainees, prison is the first place where they will have accessed health-care services.

Opportunities for those in prison

The Dutch system provides opportunities for education, training and employment in all prisons, not only increasing the well-being of detainees, but also creating a positive cumulative effect on the country's economy and security.

"We need to remember that places of detention restrict freedom - but they should never compromise people's access to quality health care. The Netherlands has been actively collaborating with WHO/Europe to improve its system and learn from the latest available data," said Dr Filipa Alves da Costa, a public health consultant working for WHO/Europe's Alcohol, Illicit Drugs and Prison Health Unit.

WHO/Europe prison health database: informing evidence-based policies

The Netherlands contributes to WHO/Europe's Health In Prisons European Database (HIPED), developed for decision-makers who want to improve health systems in detention facilities in their countries. HIPED data is shared voluntarily by Member States across the European Region, allowing transparency and benchmarking of best practices.

Besides highlighting achievements, the latest "Status report on prison health in the WHO European Region" has identified areas for improvement for many Member States, including the Netherlands.

Amsterdam conference: creating political momentum

To bridge the health gaps in detention facilities across the European Region, the Netherlands Institute for Forensic Psychiatry and Psychology (NIFP), the Ministry of Justice and Security of the Netherlands, the Dutch Custodial Institutions Agency, and WHO/Europe have co-organized a 2-day international conference, "Mental health and well-being in detention centres: prison health is public health" in Amsterdam, on 18-19 April 2024.

"We are immensely proud to be the host country for the 2024 conference. Prison health is an important topic, not only with regard to humanity, but also from the perspective of a safe reintegration into society. The health challenges that we face are not exclusive to the Netherlands but transcend our borders. It is therefore of high importance that we share our experiences and knowledge on this topic on an international level," said Marrit de Vries, Director of the NIFP.

The conference discussions will form the basis of the Amsterdam conclusions - a report with WHO/Europe-endorsed recommendations that will help Member States to improve health policies in prisons and other detention facilities.

The event supports WHO's European Programme of Work 2020-2025, which promotes united action for better health - leaving no one behind, and the Race to the Finish campaign, which encourages countries to progress towards achieving their NCD-related commitments under the United Nations Sustainable Development Goals.

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