education in prison a literature review

Education in prison: a literature review

This publication focuses on some of the unique characteristics and challenges concerning the provision of education in prison, including: the emergence of an informal curriculum; language tuition in prison; access to higher education; the availability of library facilities; digital literacy; civic engagement and social (re)integration; and prison programmes for education. It also analyses commitments made through international and regional declarations and agreements. Furthermore, it examines penal policies, strategies and pedagogical approaches established in jurisdictions around the world. F ...  Show more

This publication focuses on some of the unique characteristics and challenges concerning the provision of education in prison, including: the emergence of an informal curriculum; language tuition in prison; access to higher education; the availability of library facilities; digital literacy; civic engagement and social (re)integration; and prison programmes for education. It also analyses commitments made through international and regional declarations and agreements. Furthermore, it examines penal policies, strategies and pedagogical approaches established in jurisdictions around the world. Finally, this review provides sets of recommendations to local administrations and national government on education in prison.

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Authors: Behan, Cormac

Published: Hamburg, Germany, UNESCO Institute for Lifelong Learning, 2021

Resource type: Report, paper or authored book

Physical description: 117 p.

ISBN: 9789282012413

Document number: TD/TNC 146.531

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Subjects: Policy Teaching and learning Literacy Language Disadvantaged

Keywords: Literature review Case study Educational policy Social policy Policy analysis Prisoners Correctional education and rehabilitation Migrant education Pedagogics Curriculum Informal learning Funding Education and training opportunity Access to education and training Digital literacy Recommendations Policy implications

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Education in prison: A basic right and an essential tool

• Introduction
• Published: 29 October 2019
• Volume 65 , pages 671–685, ( 2019 )

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• Hugo Rangel Torrijo 1 , 2 &
• Marc De Maeyer 3  

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Education for all has been a principle of social justice in Western societies for a long time. It was already formulated by French philosopher Nicolas de Condorcet in the 18th century (Condorcet 2009 [1791]). Footnote 1 An activist for human rights, universal equality and freedom. he proposed a system of free public education in order to educate citizens equally. Then as now, the principle makes a lot of sense in terms of fostering active citizenship, and the right to education should indeed be recognised as a right for all human beings regardless of their social or legal circumstances.

However, in practice, many people are still being denied access to education today. One setting where this is particularly pertinent is the prison environment: Rather than being available to all inmates, prison education is perceived by some conservative groups (both decision-making authorities and ordinary citizens) as an unjustifiable privilege which should not be provided to “criminals”. Another obstacle is that some prison authorities claim (baselessly) that running education programmes puts the security of prisons at risk.

But these reservations are more than counterbalanced by the fact that prison education has undeniable advantages. For instance, evidence has shown that offenders who have participated in education and vocational programmes during their incarceration are more likely to (re-)enter the labour market after release than inmates who did not engage in learning. It has also been found that education contributes significantly to inmates’ social reintegration. It is therefore essential to reaffirm prison education as a human right. This special issue aims to foster social recognition of this right. Several of the authors who contributed to this special issue argue that there is a strong need for advocacy for prison education.

One of the major international bodies already engaged in this important mission is the United Nations Educational, Scientific and Cultural Organization (UNESCO), not least by creating a UNESCO Chair in Applied Research for Education in Prison in 2011. Footnote 2 Its mission is to promote, stimulate and encourage applied research on various aspects of correctional education and to monitor the situation at the international level. The Chair is based at Marie-Victorin College in Montreal, Canada..

The contributions we present here highlight some of the challenges of a marginalised field in education. Indeed, if adult education is an often neglected area, prison education suffers from even less visibility. However, this field has great potential for studies in social sciences. The articles gathered in this special issue present different problems and valuable experiences; they offer some reflections and raise pertinent questions on the topic of prison education. The authors tell us about the actors in prison education, mainly inmates and volunteers. Thus, this special issue provides a view of the state of the art of prison education that takes into account inmate learners’ exceptional and difficult conditions as they participate in on-site courses.

Before we present each of the articles, it is useful to consider the exceptional circumstances of a prison environment. What does education for all – even lifelong learning – mean when time and space are completely lost to you? The organisation of prisons – and of prison education – is the responsibility of public authorities, in particular national ministries of justice. Irrespective of the prevailing political ideology, imprisonment is a universal practice all over the world. It is society’s response in the event of a citizen’s non-compliance with the agreed rules of living together peacefully.

In this context, the judicial authorities mandate prison administrators to organise inmates’ peaceful coexistence within the prison community. Means and resources (rarely sufficient) are mobilised for monitoring and peacekeeping within institutions, and education must find its place among the endeavours to punish and/or to improve. Correctional officers and education staff need to clarify their specific roles and approaches to prisoners. The teacher does not actually need to know the reason for the learner’s imprisonment, while the correctional officer must not intervene in the content and delivery of education, which is based on trust between learners and trainers.

In practice, the day-to-day reality of prison life is subject to a lack of resources, and a lack of interest on the part of the responsible national authorities in prison education. As a result, prison education has not yet attained its appropriate place within most prisons worldwide. National authorities should understand that funding prison education enables prison administrations to hire professional trainers and teachers who can facilitate second-chance education for disadvantaged citizens; provide citizenship education; promote access to literacy and thus to reading and culture; and contribute to maintaining calm in prison. Thus, inmates can learn to live together peacefully – a skill which will be of use both to themselves and to society once they are released from prison. The debate about education as a contribution to reducing recidivism has its place here.

The contributions to this special issue – inspired by the authors’ various backgrounds in terms of research and practice – provide essential elements for an understanding of the challenge of providing (and participating in) education in prison. Its organisation is especially complex, since it needs to take into account previous educational experiences, social disparities, poverty and the social exclusion of prisoners. More than anywhere else, education in prisons requires a holistic approach. Education is a right that must be accessible, without conditions, to every learner. Prison education is no exception to this requirement. Its specificity lies in the environment where it takes place and in the often-chaotic itinerary of the learner.

Upon arrival in prison, the inmate learner is confronted with an educational offer which is subject to fragile rules. These laws and regulations, often made in an emergency, can only with difficulty provide an adequate framework for the organisation of education, in a place the learner has not chosen to be in and which, very often, cannot accommodate every individual’s educational needs. Being brought into contact with prison education causes the inmate learner to revisit her/his prior learning, experienced positively or negatively, acquired formally or informally, at school, in the family, on the streets, in networks of friends. Prison education must incorporate all these elements, help the learner to understand the process that has led her/him to prison and ask her/him about these previous educational experiences. Detention is also a failure of formal or non-formal education.

Depending on its ideological stance, a prison may favour either a punishment that will isolate the offender for a certain time, without much concern for the future, or a forward-looking process of reconciliation with society as a whole. Depending on whether the judicial institution works in a perspective of punishment and re-education or integrates another way of thinking about blame, second chance, or personalised support, more or less innovative initiatives may be tested in educational activities in prison. The texts in this issue reflect this perfectly.

Nothing is ever neutral in education and certainly not with regard to prison education, which, in its complexity, embraces a whole field of social, political and individual difficulties and contradictions … Prison is organised around blame; in many cases the institution expects education programmes to reinforce this approach. Retribution, perceived as an essential function of prison, is supported by public opinion, which favours offenders’ punishment over their human right to education for all. The question is whether incarceration should be primarily about making people pay for their mistakes, punishing them and excluding them from society; or whether it should be about giving them a second chance, forgiving them their criminal deeds, building their qualities as responsible citizens and useful community members and supporting their personal development and their self-esteem. This question accompanies the evaluation of any educational and social work in prison.

The contributions gathered in this special issue demonstrate that education in prison is much more than merely adapting educational content for delivery in a prison environment.

We begin with an article entitled “The Prison Education Project”. Its author Renford Reese presents a Californian initiative in the United States which has expanded educational opportunities for inmates in 12 Californian correctional facilities. With the assistance of 800 university student and faculty volunteers, the Prison Education Project (PEP) has serviced thousands of inmates since 2011. Reese states that “By providing academic, life skills and career development programming, PEP aims to educate, empower and transform the lives of incarcerated individuals.” Volunteerism is also a central component of the programme, complemented by a “reciprocal reflex” process in which volunteers and inmates learn from and teach each other. The involvement of student volunteers is essential in the absence of sufficient public support, not only in terms of available and free “labour”, but also – and in the long term – for a broad reflection on the notion of motivation and professionalisation of educational interventions. Moreover, it fosters the understanding of a reality that volunteers/students barely know – having lived until then in a more harmonious environment. As Reese points out, the “reciprocal reflex” “ignites the passion and gratitude of both volunteers and inmates … The fact that each group shows deep gratitude to the other for the learning experience creates an exciting symbiotic loop and an esprit de corps which inspires and empowers all involved”. Indeed, this project is about human values, such as gratitude which empowers participants.

In terms of human values and benefits to the individual, it is worth mentioning at this point that one other article originally intended for inclusion in this special issue was in effect already published in an earlier general issue (Giles et al. 2016). Footnote 3 In “The role of art education in adult prisons: The Western Australian experience” Margaret Giles, Lisa Paris and Jacqui Whale provide some insights into the question whether art classes and courses (provided in Australian prisons alongside vocational training and adult basic education) produce measurable outcomes and, if not, whether there are other reasons why art classes should continue to be funded? Addressing these issues, the authors argue that (1) measurable outcomes do not reflect the complex but less quantifiable benefits to the individual and the community of studying art in prison (benefits suggested by “wider research about art making, art education and art therapy” (ibid., p. 706), and (2) better measures of all impacts of art studies in prisons are needed, including qualitative and humanitarian aspects.

In addition to the vagueness of the purpose assigned to education in prison, there are many obstacles which frustrate or ruin the efforts of education workers. These barriers are also created both by the conditions and by the potential learners themselves. The goodwill of the stakeholders is put to the test when supply exists without any link with potential demand. In some correctional institutions, the demand from prisoners for prison education is scarce. It is not enough to set up an open system, as part of a lifelong learning approach; it is also necessary for prisoners to be aware of and familiar with the education and training initiatives put in place. Why aren’t they attending classes? What barriers prevent their participation? The lack of material and human resources does not explain everything; we must work on motivation and support those for whom these initiatives are taken.

The next two articles we present tackle the causes of the absence of inmates from prison education courses in Norway and in Belgium. These studies are of particular interest, since it is important to understand inmates’ reasons for opting out before a strategy can be designed to convince more prisoners to join in. Improving participation and expanding prison education is a necessary tool in addressing problems inside prisons as well as improving ex-offenders’ reintegration into society once they are released.

Terje Manger, Ole Johan Eikeland and Arve Asbjørnsen ’s article is entitled “Why do not more prisoners participate in adult education? An analysis of barriers to education in Norwegian prisons”. The authors conducted a survey among prisoners with Norwegian citizenship who did not participate in education. The authors describe the development of their Perceived Barriers to Prison Education Scale (PBPES) and examine what deters prisoners from participating in educational opportunities. Their analysis of barriers to education in Norwegian prisons confirmed their model, which comprised institutional, situational and dispositional barriers. This typology could be useful to understand the non-involvement of inmates in education activities.

In the same vein, “Barriers to prisoner participation in educational courses: Insights from a remand prison in Belgium”, authored by Dorien Brosens, Flore Croux and Liesbeth De Donder, examines the profile of prisoners who do not take part in formal education (e.g. language or ICT courses) while being incarcerated. Aiming to identify the barriers to participation these prisoners experience, a research project conducted in a remand prison in Belgium ( n =486). found that 29 per cent of the prisoners took part in educational courses and that participation rates were lower among Belgian and non-European prisoners. Other factors impacting on participation were fluency in the Dutch language, and the length of the sentence being served. Non-participants experienced mainly situational barriers, but they also expressed having preferences for other activities such as working, and being confronted with informational, institutional or dispositional barriers.

The next article, authored by Emma Lina F. Lopez, evaluates the effectiveness of a programme launched in the Philippines in 2000. Under the National Service Training Program (NSTP), a compulsory two-semester course component for all the country’s Bachelor and technical vocational students, there is a choice of three subject areas, one of which is the Literacy Training Service (LTS) module. This is designed to train students in teaching literacy and numeracy skills to schoolchildren, out-of-school youths and other citizens in need of their services, including prison inmates. This programme is official and aims to further the role of Filipino students in social cohesion through involvement in the prison community and through volunteer activities. In her article entitled “Application of the Literacy Training Service component of the National Service Training Program in New Bilibid Prison (Philippines)”, the author interestingly considers both the students and the inmate learners. She states: “The university students were immersed in an environment entirely unknown to them and performed roles from which they obtained a different perspective and understanding of society. The inmate learners were eager to avail of this opportunity to participate in second-chance education.”

The fifth article, entitled “Cooperation and education in prison: A policy against the tide in the Latin American penitentiary crisis”, was authored by the first guest editor of this special issue, Hugo Rangel Torrijo . Prison education is a fundamental human right and contributes to democratisation processes in Latin American countries. However, due to the current penitentiary crisis (overcrowding and violence), promoting education in prison is a task against the tide. Conditions are further exacerbated by the failures of the criminal justice system and the ideology of punishment. The insights presented in this article were gathered through a series of workshops and collective studies carried out with penitentiary authorities in Latin America. Despite a number of deep-rooted problems troubling this region, the article identifies vibrant and encouraging practices of prison education. In order to reinforce these practices, the need for cooperation among different actors and institutions in prison education is underlined.

Finally, “L’éducation en prison à la périphérie de l’éducation pour tous” [Prison education on the periphery of education for all], written in French by co-guest editor Marc de Maeyer, reflects that “basic research in the prison education sector is still in its infancy internationally”. Footnote 4 In Europe, Latin America, Asia and Africa, groups and networks are emerging; the same is true at the university level, where such research that is being carried out is gaining greater visibility. The article is based on the author’s experience and meetings as a senior research specialist at the UNESCO Institute for Lifelong Learning, when he visited prisons and met officials, actors and prisoners in more than 70 countries. Indeed, it is important to develop an international debate, and this special issue aims to make a contribution. De Maeyer also points out that sometimes the educators’ and the politicians’ objectives are contradictory, and he reaffirms the right to education.

The contributions presented here refer to efforts that are complex and challenging. It is necessary to stimulate and manage the demand for education; understand the lack of support, even where learning sessions are provided; integrate volunteers and compare life experiences; question forgiveness and blame; break down the barriers that prevent the optimisation of the proposed initiatives; understand delinquency by integrating a reflection on violence in the country and the region; work on the motivations of prisoners and trainers; harness the exclusive competence of education in relation to the judicial world; consider the notion of time during imprisonment; and negotiate the places of formal and non-formal education.

This special issue is a plea for prison education and also a plea for boosting research in the field. We should point out that it was not easy to gather an international range of researchers on this subject who would be able to cover all world regions. Our difficulties demonstrate that while research is badly needed, it is not a priority even for official programmes and NGOs in prisons

Prison education itself presents a challenge for education researchers due to the complex nature of high-security confinement of human individuals and the myriad problems and aspects inherent in the prison environment. For example, courses could tackle “criminogenic” factors (Duguid 2000), Footnote 5 teaching inmate learners anger management skills, how to overcome antisocial attitudes, how to overcome drug addiction, etc. The articles gathered here illustrate several ways of conducting research and the need to imagine it differently. For instance, it is telling that, on the one hand, authors ask about the barriers to participation and deplore underfunding; on other hand, they tell us about volunteers. Subsequently, research could help to overcome barriers and build encouraging practices with volunteers.

Despite some academic and conventional disdain, education research is definitely scientific (Mayer 2000). Footnote 6 By consequence, the field of prison education is open to exploration by scientific research with multiple applications. Findings could provide evidence-based information for policymakers, prison authorities, practitioners and pedagogues and also feed public opinion. This kind of research also contributes to an adult education approach to the academic, pedagogic and social challenge of learning and teaching inside prisons. A few years ago, educational theorist Michael Apple asked: “Can education change society?” (Apple 2013). Footnote 7 This question is particularly relevant in the field of prison education. The committed provision of prison education (in both financial and practical terms) enables society to change prisons and inmates’ lives. Doubtless, the ultimate end of prison education is to humanise prisons.

The articles presented in this special issue also contribute to placing education within the broader framework of international cooperation. Prison education is an issue which would benefit from a more active role of initiative on the part of UNESCO. The potential lies in mutual support, for example by exchanging educational materials to cater for foreign inmates’ language needs, and networking to share best practices.

Éducation en prison : un droit fondamental et un outil essentiel

Longtemps, l’éducation pour tous a constitué un principe de justice sociale au sein des sociétés occidentales, un principe déjà formulé au 18 e siècle par le philosophe français Nicolas de Condorcet (Condorcet 2009 [1791]). Footnote 8 Militant pour les droits humains, l’égalité universelle et la liberté, il proposait un système d’éducation publique gratuite afin que les citoyens soient tous éduqués sur un pied d’égalité. À l’époque comme aujourd’hui, ces principes sont très utiles pour favoriser la citoyenneté active, et il conviendrait de reconnaître le droit à l’éducation comme un droit humain universel, indépendant de la situation sociale ou judiciaire des personnes.

En réalité toutefois, nombreuses sont celles qui se voient aujourd’hui encore refuser le droit à l’éducation. Cette constatation se vérifie particulièrement dans le milieu carcéral : certains groupes conservateurs (tant au sein des pouvoirs publics que chez les citoyens ordinaires) considèrent plutôt que l’éducation en prison ne devrait pas être accessible à tous et estiment qu’elle est un privilège injustifié qu’il ne faudrait pas octroyer à des « criminels ». Autre obstacle : des autorités pénitentiaires prétendent (sans fondement) que les programmes éducatifs actuellement menés mettent la sécurité des prisons en péril.

Ces réserves sont toutefois plus que tempérées par le fait que l’éducation en prison présente des avantages indéniables. Il a par exemple été prouvé que les délinquants qui ont pris part à des programmes d’éducation et de formation professionnelle durant leur incarcération ont davantage de chances de (ré)intégrer le marché du travail après leur libération que les détenus qui ne se sont livrés à aucune activité éducative. On s’est également aperçu que l’éducation contribue notablement à la réinsertion sociale des détenus. Aussi est-il essentiel de réaffirmer que l’éducation en milieu carcéral est un droit humain. Ce numéro spécial a pour objectif de promouvoir la reconnaissance sociale de ce droit. Plusieurs des auteurs ayant participé à ce numéro spécial affirment qu’il est absolument nécessaire de plaider en faveur de l’éducation en prison.

L’Organisation des Nations unies pour l’éducation, la science et la culture (UNESCO) compte parmi les grandes organisations internationales à remplir cette importante mission, notamment grâce à la Chaire de recherche appliquée pour l’éducation en prison qu’elle a créée en 2011. Footnote 9 Elle a pour mission de promouvoir, stimuler et encourager la recherche appliquée liée à différents aspects de l’éducation en prison et de procéder au suivi de la situation en la matière au plan international. La Chaire se trouve au Canada, au cégep (Collège d’enseignement général et professionnel) Marie-Victorin à Montréal.

Les articles que nous présentons ici mettent en relief quelques-uns des défis posés par ce secteur marginalisé de l’éducation. En effet, si l’éducation des adultes est un domaine souvent négligé, l’éducation en milieu carcéral est quant à elle reléguée encore plus à l’arrière-plan. Elle n’en recèle toutefois pas moins un fort potentiel pour les études en sciences sociales. Les articles réunis dans ce numéro spécial présentent des problèmes divers et de précieuses expériences; ils nous livrent quelques réflexions et soulèvent des questions pertinentes sur le thème de l’éducation en milieu carcéral. Les auteurs nous parlent des intervenants dans ce secteur, principalement des détenus et des bénévoles. Ainsi ce numéro spécial offre-t-il un point de vue de l’état actuel de l’éducation en milieu carcéral qui tient compte des conditions exceptionnelles et difficiles des détenus qui suivent des cours en prison.

Avant de présenter chacun des articles, il est utile de prendre en considération les circonstances particulières régnant dans un environnement carcéral. Que signifie l’éducation pour tous – voire l’apprentissage tout au long de la vie – quand le temps et l’espace sont abolis pour vous ? L’organisation des prisons – et de l’éducation en milieu carcéral – relève de la responsabilité des pouvoirs publics, notamment du ministère de la Justice des pays. Quelle que soit l’idéologie politique dominante, l’emprisonnement est une pratique universelle dans le monde entier. Elle est la réponse de la société quand un citoyen enfreint les règles sur lesquelles nous nous sommes mis d’accord pour cohabiter en paix.

Dans ce contexte, les autorités judiciaires chargent les directeurs de prisons d’organiser la coexistence pacifique des détenus au sein de la communauté carcérale. Des moyens et ressources (rarement suffisants) sont mobilisés pour la surveillance et le maintien de la paix à l’intérieur des établissements pénitentiaires, et l’éducation doit trouver sa place parmi les efforts mis en œuvre pour punir les détenus et/ou leur permettre de s’améliorer. Les surveillants pénitentiaires et le personnel enseignant doivent clarifier leurs rôles spécifiques et leurs approches des prisonniers. L’enseignant n’a pas vraiment besoin de connaître les raisons de l’incarcération de l’apprenant, de même que le surveillant pénitentiaire ne doit pas intervenir dans le contenu et la prestation pédagogique fournie, reposant sur la confiance entre apprenants et formateurs.

En réalité, le quotidien carcéral est en butte à un manque de ressources et à un manque d’intérêt de la part des autorités nationales compétentes en ce qui concerne l’éducation en prison. De ce fait-là, cette dernière n’a pas encore trouvé la place qui convient dans la plupart des établissements pénitentiaires du monde entier. Il faudrait que les autorités nationales comprennent que le financement de l’éducation en milieu carcéral permet à l’administration pénitentiaire d’engager des formateurs et enseignants susceptibles d’ouvrir la voie d’une éducation de la seconde chance à des citoyens défavorisés; de dispenser une éducation à la citoyenneté; de promouvoir l’accès à l’alphabétisation et, par conséquent, à la lecture et à la culture, et de contribuer au maintien du calme dans les prisons. Ainsi, les détenus peuvent apprendre à vivre ensemble pacifiquement – une compétence non seulement utile pour eux, mais aussi pour la société une fois qu’ils ont été libérés. Le débat sur l’éducation qui contribue à réduire la récidive a sa place ici.

Les articles de ce numéro spécial – nés des différents parcours des auteurs dans la recherche et la pratique – nous fournissent des éléments essentiels pour comprendre le défi que constitue l’enseignement (et l’apprentissage) en prison. L’organiser est particulièrement complexe étant donné qu’il nécessite de prendre en compte les différentes expériences éducatives antérieures, les disparités sociales, la pauvreté et l’exclusion sociale des prisonniers. Plus que nulle part ailleurs, en prison, l’éducation exige une approche holistique. Elle est un droit que tout apprenant doit pouvoir exercer, sans conditions. L’éducation en milieu carcéral ne fait pas exception à cette exigence. Sa spécificité réside dans le lieu où elle se déroule et dans le parcours souvent chaotique de l’apprenant.

En arrivant en prison, l’apprenant détenu se retrouve face à une offre éducative soumise à des règles précaires. Ces lois et réglementations, souvent élaborées dans l’urgence, peinent à offrir un cadre approprié pour organiser l’éducation dans un lieu où l’apprenant, homme ou femme, n’a pas choisi d’être et qui, très souvent, ne peut pas répondre à tous les besoins éducatifs individuels. Au contact de l’éducation en milieu carcéral, l’apprenant détenu est amené à revenir sur ce qu’il a appris auparavant, sur ce qu’il a ressenti de façon positive ou négative, sur ce qu’il a acquis de façon formelle ou informelle, à l’école, dans la famille, dans la rue ou grâce à son réseau d’amis. L’éducation en prison doit intégrer tous ces éléments, aider l’apprenant à comprendre le processus qui l’a conduit en prison et l’interroger sur ses expériences éducatives antérieures. La détention est aussi un échec de l’éducation formelle ou non formelle.

En fonction de son positionnement idéologique, une prison peut soit favoriser une peine qui isolera le délinquant pendant un certain temps, sans souci particulier de l’après, ou, dans un esprit tourné vers l’avenir, encourager un processus de réconciliation avec la société dans son ensemble. Selon que l’action de l’institution judiciaire s’inscrit dans l’esprit du châtiment ou de la rééducation, ou qu’elle intègre une autre conception de la faute, de la seconde chance ou du soutien personnalisé, des projets plus ou moins innovants peuvent être testés dans le cadre des activités éducatives en prison. Les textes de ce numéro reflètent parfaitement cela.

Rien n’est jamais neutre en matière d’éducation et certainement pas en ce qui concerne l’éducation en milieu carcéral qui, dans sa complexité, englobe tout un champ de difficultés et contradictions sociales, politiques et individuelles. La prison s’articule autour de la faute et, souvent, cette institution attend des programmes d’éducation qu’ils renforcent cette approche. La punition, perçue comme une fonction essentielle de la prison, reçoit le soutien de l’opinion publique qui privilégie le châtiment des délinquants par rapport au droit humain à l’éducation pour tous. La question est de savoir si l’incarcération devrait avant tout consister à faire payer les gens pour leurs erreurs, à les punir et à les exclure de la société, ou si elle devrait permettre de leur donner une seconde chance, de pardonner leurs actes criminels, de développer leurs qualités de citoyens responsables et de membres utiles de la communauté, et de soutenir leur développement personnel et leur estime de soi. Cette question va de pair avec l’évaluation de toute activité éducative et sociale en prison.

Les articles réunis dans ce numéro spécial démontrent que l’éducation en prison dépasse de loin la pure adaptation d’un contenu éducatif à l’enseignement en milieu carcéral.

Nous commencerons avec un article intitulé « The Prison Education Project » (Projet Éducation en prison). Son auteur Renford Reese présente un projet californien mis en œuvre aux États-Unis, qui a élargi les possibilités de s’instruire offertes aux détenus de douze établissements pénitentiaires. Avec l’aide 800 étudiants universitaires et enseignants bénévoles, le projet Éducation en prison (Prison Education Project/PEP) a accueilli des milliers de prisonniers depuis 2011. Renford Reese déclare qu’« en offrant des programmes universitaires, d’apprentissage de compétences nécessaires à la vie courante et de développement professionnel, le PEP s’est fixé pour objectif d’instruire les personnes incarcérées, de développer leur pouvoir d’agir et de transformer leur vie. » Le bénévolat est également un élément capital du programme qui s’accompagne d’un processus de « réflexe réciproque » dans lequel bénévoles et détenus apprennent les uns des autres et enseignent les uns aux autres. En l’absence de soutien public nécessaire, la participation d’étudiants bénévoles est essentielle, non seulement en ce qui concerne la disponibilité et la gratuité de la « main-d’œuvre », mais aussi, et ce à long terme, pour avoir une vaste réflexion sur la notion de motivation et la professionnalisation des interventions éducatives. De plus, elle favorise la compréhension d’une réalité que les bénévoles/étudiants connaissent très peu, eux qui, jusqu’à ce moment-là, ont vécu dans un environnement plus harmonieux. Comme Renford Reese le souligne, le « réflexe réciproque » « enflamme la passion et la gratitude tant chez les bénévoles que chez les détenus … Le fait que chaque groupe se montre profondément reconnaissant envers l’autre pour ce qu’il a appris crée un circuit symbiotique et un esprit de corps qui inspire tous les intéressés et développe leur pouvoir d’agir. » En effet, ce projet porte sur des valeurs humaines telles que la gratitude qui développe le pouvoir d’agir des participants.

Pour ce qui est des valeurs humaines et des bienfaits pour l’individu, il vaut la peine d’indiquer ici qu’un autre article qui devait paraître dans ce numéro spécial a en fait été précédemment publié dans un numéro ordinaire (Giles et coll. 2016). Footnote 10 Dans « The role of art education in adult prisons: The Western Australian experience » (Rôle de l’éducation artistique dans les prisons pour adultes : expérience de l’État d’Australie-Occidentale), Margaret Giles, Lisa Paris et Jacqui Whale fournissent des éléments pour déterminer si les cours et stages de beaux-arts (dispensés dans des prisons australiennes en même temps que des formations professionnelles et des activités d’éducation de base des adultes) produisent des résultats mesurables et si ce n’est pas le cas, s’il y a d’autres raisons de continuer à financer ce type de cours. Pour répondre à cette question, les auteurs affirment que (1) les résultats mesurables ne reflètent pas les bienfaits complexes mais moins quantifiables pour l’individu et la communauté de l’étude des beaux-arts en prison (bienfaits indiqués par la « recherche plus générale sur la création artistique, l’éducation artistique et l’art-thérapie », ibid, p. 706) et (2) qu’il serait nécessaire de mieux mesurer tous les effets, tant qualitatifs qu’humains, des études artistiques dans les prisons.

En plus du manque de clarté concernant l’objectif de l’éducation en prison, de nombreux obstacles contrecarrent ou ruinent les efforts des éducateurs. Les circonstances et les apprenants potentiels sont eux aussi à l’origine de ces barrières. La bonne volonté des parties prenantes est mise à l’épreuve quand un enseignement pourrait être proposé mais qu’il n’existe pas de demande liée à cette offre. Dans certains établissements pénitentiaires, la demande d’éducation en milieu carcéral est faible de la part des prisonniers. Ce n’est pas suffisant pour mettre en place un système ouvert s’inscrivant dans une optique d’apprentissage tout au long de la vie; il faut aussi que les prisonniers soient au courant des projets d’éducation et de formation mis en place, et que ceux-ci leurs soient familiers. Pourquoi ne suivent-ils pas de cours ? Quels obstacles les en empêchent ? Le manque de ressources matérielles et humaines n’explique pas tout; nous devons œuvrer à motiver et soutenir les personnes pour lesquelles on prend ces initiatives.

Les deux articles suivants abordent les raisons de l’ absence des détenus dans l’éducation en milieu carcéral en Norvège et en Belgique. Ces études présentent un intérêt particulier, car il est essentiel de comprendre les raisons qui poussent les prisonniers à se tenir à distance avant même qu’une stratégie puisse être conçue en vue de convaincre davantage de détenus de participer. Accroître la participation et développer l’éducation en milieu carcéral est un outil nécessaire pour répondre aux problèmes à l’intérieur des prisons et améliorer la réinsertion sociale des délinquants après leur remise en liberté.

L’article de Terje Manger, Ole Johan Eikeland et Arve Asbjørnsen est intitulé « Why do not more prisoners participate in adult education? An analysis of barriers to education in Norwegian prisons » (Pourquoi les détenus ne participent-ils pas davantage à l’éducation et à la formation des adultes ? Analyse des obstacles à l’éducation dans les prisons norvégiennes). Les auteurs ont réalisé une enquête parmi des prisonniers de citoyenneté norvégienne qui ne participaient pas à des activités éducatives. Ils décrivent comment ils ont développé une échelle des obstacles perçus concernant l’éducation en milieu carcéral et se penchent sur ce qui dissuade les prisonniers de prendre part aux offres éducatives proposées. L’analyse qu’ils font des obstacles à l’éducation dans les prisons norvégiennes a confirmé leur modèle qui englobe des barrières institutionnelles, situationnelles et dispositionnelles. Cette typologie pourrait être utile pour comprendre la non-implication des détenus dans les activités éducatives.

Dans le même esprit, l’article « Barriers to prisoner participation in educational courses: Insights from a remand prison in Belgium » (Obstacles à la participation des détenus aux programmes d’éducation et de formation : observations d’un établissement pénitentiaire en Belgique), signé Dorien Brosens, Flore Croux et Liesbeth De Donder, examine le profil des détenus qui n’intègrent aucun cours d’éducation formelle (p. ex. de langues ou d’informatique) durant leur période d’incarcération. Dans le but d’identifier les obstacles à la participation que rencontrent ces prisonniers, un projet de recherche mené dans une maison d’arrêt en Belgique ( n = 486) a révélé que 29 pour cent d’entre eux suivaient des cours et que les taux de participation étaient plus faibles parmi les Belges que parmi les non-Européens. La maîtrise du néerlandais et la durée de la peine à purger étaient aussi des facteurs qui influaient sur la participation. Les non-participants rencontraient essentiellement des obstacles situationnels mais déclaraient également qu’ils préféraient d’autres activités, par exemple des activités professionnelles, et qu’ils se trouvaient confrontés à des barrières informationnelles, institutionnelles ou dispositionnelles.

L’article suivant, signé Emma Lina F. Lopez , évalue l’efficacité d’un programme lancé aux Philippines en 2000. Le programme de préparation au service national, un cours obligatoire d’une durée de deux semestres pour tous les étudiants de premier cycle et les élèves en formation professionnelle, permet de choisir entre trois disciplines, l’une d’entre elles étant un module de formation à l’alphabétisation. Celui-ci est conçu pour former des étudiants à enseigner la lecture, l’écriture et le calcul à des écoliers, à de jeunes décrocheurs scolaires et autres citoyens nécessitant leurs services, entre autres des détenus. Le programme est officiel et vise à approfondir le rôle des étudiants philippins dans la cohésion sociale en les faisant intervenir au sein de la communauté carcérale et grâce à des activités bénévoles. Dans son article intitulé « Application of the Literacy Training Service component of the National Service Training Program in New Bilibid Prison (Philippines) » (Application du module Service de formation à l’alphabétisation du Programme national de service de formation dans la prison de New Bilibid [Philippines]), l’auteure dresse un portrait intéressant des étudiants et des apprenants détenus. Elle constate : « Les étudiants universitaires étaient plongés dans un environnement qui leur était complètement inconnu et assumaient des rôles qui leur faisaient découvrir un point de vue différent sur la société et une autre conception de celle-ci. Les apprenants détenus étaient impatients de profiter de l’occasion qui s’offrait à eux de suivre des cours de la seconde chance. »

Le cinquième article intitulé : « Cooperation and education in prison: A policy against the tide in the Latin American penitentiary crisis » (Coopération et éducation en prison : une politique à contre-courant dans la crise pénitentiaire latino-américaine) a été écrit par le premier rédacteur invité de ce numéro spécial, Hugo Rangel Torrijo . L’éducation en milieu carcéral est un droit humain fondamental et elle contribue aux processus de démocratisation dans les pays d’Amérique latine. Cependant, promouvoir l’éducation dans les prisons est une tâche qui va à contre-courant de la crise pénitentiaire actuelle (surpeuplement et violence). Ces conditions sont encore aggravées par les échecs du système de justice pénale et l’idéologie du châtiment. Les informations présentées dans cet article ont été recueillies au fil d’ateliers et d’études collectives auprès d’autorités pénitentiaires en Amérique latine. Malgré le nombre de problèmes profondément enracinés qui perturbent cette région, l’article met en lumière des pratiques dynamiques et encourageantes de l’éducation en milieu carcéral. Afin de renforcer ces pratiques, il souligne la nécessité pour les différents acteurs et établissements de coopérer dans le domaine de l’éducation en milieu carcéral.

Enfin, « L’éducation en prison à la périphérie de l’éducation pour tous », article écrit par le rédacteur co-invité Marc de Maeyer , fait remarquer que « la recherche fondamentale dans le secteur de l’éducation en prison n’en est encore qu’à ses balbutiements sur le plan international. » En Europe, en Amérique latine, en Asie et en Afrique, des groupes et réseaux font leur apparition. Il en va de même dans le domaine universitaire où ce type de recherche actuellement menée gagne en visibilité. L’article s’appuie sur l’expérience de l’auteur et des réunions auxquelles il a participé en tant que chercheur principal à l’Institut de l’UNESCO pour l’apprentissage tout au long de la vie à l’occasion de visites dans des prisons et de rencontres avec des fonctionnaires, des acteurs et des prisonniers dans plus de 70 pays. Il est effectivement important de développer un débat international, et ce numéro spécial a pour objectif d’apporter sa pierre à l’édifice. Marc de Maeyer indique aussi qu’il arrive que les objectifs des éducateurs et des politiciens soient contradictoires, et il réaffirme le droit à l’éducation.

Les articles présentés ici renvoient à des efforts complexes et ambitieux. Il est nécessaire de stimuler et de gérer la demande en matière d’éducation; de comprendre l’absence de soutien, même là où des cours sont organisés; d’intégrer les bénévoles et de comparer les expériences de vie; de remettre en question les notions de pardon et de faute; de faire tomber les obstacles qui empêchent d’optimiser les projets proposés; de comprendre la délinquance en intégrant une réflexion sur la violence dans le pays et la région; de travailler sur les motivations des prisonniers et des formateurs; d’exploiter la compétence exclusive de l’éducation en ce qui concerne l’univers judiciaire; d’examiner la notion de temps pendant l’emprisonnement et de négocier les places accordées à l’éducation formelle et à l’éducation non formelle.

Ce numéro spécial est un appel en faveur de l’éducation en prison et du développement de la recherche dans ce domaine. Nous devrions souligner qu’il n’a pas été facile de réunir un ensemble de chercheurs internationaux capables de couvrir toutes les régions du monde sur ce thème. Nos difficultés prouvent que bien qu’il existe un besoin considérable en matière de recherche, cette dernière n’est pas une priorité, même pas pour les programmes officiels ni les ONG dans les prisons.

L’éducation en prison constitue un défi pour les chercheurs en éducation du fait de la nature complexe de la réclusion dans un environnement à haute sécurité et de la myriade de problèmes et d’aspect inhérents au milieu carcéral. Par exemple, des cours pourraient aborder les facteurs « criminogènes » (Duguid 2000) Footnote 11 en enseignant aux apprenants détenus des techniques pour gérer leur colère, en leur apprenant comment contrôler des comportements antisociaux, comment vaincre la toxicomanie, etc. Les articles réunis ici illustrent plusieurs façons de diriger la recherche et la nécessité de la repenser. Il est par exemple révélateur que, d’une part, les auteurs se posent la question des obstacles à la participation et déplorent l’insuffisance des financements, et que, d’autre part, ils évoquent les bénévoles. Par conséquent, la recherche pourrait contribuer à surmonter les obstacles et à créer des pratiques encourageantes avec les bénévoles.

Malgré un certain mépris universitaire et populaire, il ne fait aucun doute que la recherche sur l’éducation est scientifique (Mayer 2000). Footnote 12 En conséquence, le secteur de l’éducation en prison est ouvert à des recherches scientifiques qui déboucheront sur des applications diverses. Non seulement les résultats pourraient fournir des informations étayées par des preuves aux politiciens, aux autorités pénitentiaires, aux praticiens et aux pédagogues, mais ils pourraient aussi nourrir l’opinion publique. Ce type de recherche apporte également une approche par l’éducation des adultes aux défis universitaires, pédagogiques et sociaux qui se posent concernant l’apprentissage et l’enseignement à l’intérieur des prisons. Il y a quelques années, le théoricien de l’éducation Michael Apple posait la question suivante : « L’éducation peut-elle changer la société ? » (Apple 2013). Footnote 13 Cette question est d’une grande pertinence dans le domaine de l’éducation en prison. Les prestations mises en œuvre pour l’éducation en milieu carcéral (tant du point de vue financier que pratique) permettent à la société de changer la vie en prison et l’existence des détenus. Sans nul doute, la fin ultime de l’éducation en milieu carcéral est d’humaniser les prisons.

Les articles présentés dans ce numéro spécial contribuent aussi à positionner l’éducation dans le cadre plus large de la coopération internationale. L’éducation en prison est un enjeu qui tirerait profit d’un rôle initiateur plus actif de l’UNESCO. Son potentiel réside dans un soutien mutuel, par exemple dans l’échange de matériels pédagogiques pour répondre aux besoins linguistiques des détenus étrangers et dans des activités de réseautage pour partager de bonnes pratiques.

Condorcet, J.-A.-N. de Caritat (2009 [1791]). Cinq mémoires sur l’instruction publique [Five briefs on public education]. Paris: Flammarion.

To maximise the impact of its work and benefit from academic expertise, UNESCO uses a system of UNESCO Chairs, one of which is the UNESCO Chair in Applied Research for Education in Prison. The current president of that Chair’s science committee is Paul Bélanger, who was involved in conceptualising this special issue. For more information, visit the Chair’s homepage at http://www.cmv-educare.com/en/ [accessed 9 August 2019].

Giles, M., Paris, L., & Whale, J. (2016). The role of art education in adult prisons: The Western Australian experience. International Review of Education, 62 (6), 689–709.

La recherche fondamentale dans le secteur de l’éducation en prison n’en est encore qu’à son balbutiement sur le plan international.

Duguid, S. (2000). Can prisons work? The prisoner as object and subject in modern corrections . Toronto: University of Toronto Press. The term criminogenic refers to being conducive to criminal behaviour.

Mayer, R. (2000). What is the place of science in educational research? Educational Researcher, 29 (6), 38–39.

Apple, M. (2013). Can education change society? New York: Routledge.

Condorcet, J.-A.-N. de Caritat (2009 [1791]). Cinq mémoires sur l’instruction publique . Paris: Flammarion.

Pour maximiser l’impact de ses activités et bénéficier des compétences de spécialistes universitaires, l’UNESCO recourt aux Chaires UNESCO, l’une d’elles étant la Chaire de recherche appliquée pour l’éducation en prison. Paul Bélanger est l’actuel président de son comité scientifique qui a participé à la conception de ce numéro spécial. Pour davantage de renseignements, veuillez consulter le site Internet de la Chaire à l’adresse http://www.cmv-educare.com/en/ [consulté le 9 août 2019].

Duguid, S. (2000). Can prisons work? The prisoner as object and subject in modern corrections. Toronto: University of Toronto Press. Le terme criminogène renvoie à ce qui favorise un comportement délictueux.

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Rangel Torrijo, H., De Maeyer, M. Education in prison: A basic right and an essential tool. Int Rev Educ 65 , 671–685 (2019). https://doi.org/10.1007/s11159-019-09809-x

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Approximately 11 million people are in prisons worldwide, a number that is constantly growing. Many prisons are overcrowded and at crisis point, unable to provide education –  a fundamental human right to which all prisoners should have access. To identify current trends, progress and challenges in prison education at a global level, the UNESCO Institute for Lifelong Learning (UIL) has published  Education in prison: A literature review . ( file:///C:/Users/belgeler/Downloads/378059eng.pdf )

The publication recognizes the variety of understandings of the concept of education in prison and aims to provide a renewed approach to the subject, as well as to build a solid knowledge base. It surveys the literature in English and focuses on some of the unique characteristics and challenges concerning the provision of education in prison. It also documents what remains an unserved domain of education and penal policy and can inform actions and reforms by governments, policy-makers, concerned organizations and other stakeholders engaged in ensuring that incarceration does not become a barrier to the right to education.

Mathematics teaching

This year I had the opportunity and privilege to teach mathematics in prison. This required an original and personalised curriculum, so as to build new skill that inmates can use once out. This required first and foremost a needs analysis, which was conducted during the first lesson.

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Education in prison: a literature review (UNESCO resource)

Approximately 11 million people are in prisons worldwide, a number that is constantly growing. Many prisons are overcrowded and at crisis point, unable to provide education – a fundamental human right to which all prisoners should have access. To identify current trends, progress and challenges in prison education at a global level, the UNESCO Institute for Lifelong Learning (UIL) has published Education in prison: A literature review .

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Promoting effective prison education policies and practices

The UNESCO Institute for Lifelong Learning (UIL) works to improve existing prison education policies and practices that are designed to support inmates’ rehabilitation and reintegration into society and thus contribute to making the right to education a reality for all.

Today, approximately 11 million people are in penal institutions worldwide, which equates to an average imprisonment rate of 144 prisoners per 100,000 of the world population.

These numbers are constantly growing. With prisons frequently overcrowded, many prison systems around the world are at crisis point, unable to provide services, such as education, in accordance with international standards. Yet education is a fundamental human right and must not be denied to prisoners.

Enshrined in the Universal Declaration of Human Rights and at the heart of UNESCO’s mission, the right to education implies a right to lifelong learning. In the prison context, this right includes ensuring that inmates are provided with continuous access to quality education, from the first day of their incarceration through to and beyond the day of their release.

In cooperation with the UNESCO Chair in Applied Research for Education in Prison and other partners, UIL is undertaking in-depth research on current policies and practice in the area of prison education. The aim of this research is threefold:

• to review how these policies and practices are progressing at the global level;
• to elaborate recommendations and guidelines for policy-makers and practitioners to improve the provision of quality adult learning and education in prisons;
• to support prison education practice through improved policies, concepts and lessons learned.

UIL’s research addresses key questions such as:

• What is known about the quality of prison education programmes in selected countries and the constraints they face, e.g. scarcity of resources?
• What factors are critical for promoting learning in prison with respect to the specific cultural and country context?
• What implications do available research findings have for policies and practices within the education system? What training, technical assistance and/or other resources are needed to further develop prison education?
• What further research is required in order to improve education in prison?

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Prison education: a review of reading education in prisons

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Published 22 March 2022

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This publication is available at https://www.gov.uk/government/publications/prison-education-a-review-of-reading-education-in-prisons/prison-education-a-review-of-reading-education-in-prisons

From Amanda Spielman, Her Majesty’s Chief Inspector, Ofsted

I am pleased to introduce our review of reading education in prisons, which we carried out jointly with Her Majesty’s Inspectorate of Prisons ( HMIP ). HMIP and Ofsted have long been concerned about the standards of education in our prisons. Education is key to success in life, and for no one is that truer than for prisoners.

We have been particularly worried about the number of prisoners who are simply unable to read. Reading is a fundamental life skill. We know from our school inspections that children who struggle to read fall behind quickly and become disillusioned with education, and that this sometimes leads to issues with behaviour and exclusions.

It is the same sad story with prisoners. Lack of access to education maintains inequality and seriously curtails a prisoner’s life chances, whereas improving reading skills can, of itself, improve employability and give access to other educational opportunities that will also improve the prisoner’s prospects after prison. Being able to read is also valuable for its own sake.

Prison leaders will recognise the difference that reading for pleasure can make to a prisoner’s quality of life. This is especially true for those on long sentences. However, prisons are not giving the right priority to improving prisoners’ reading skills. Leaders do need to ensure that prisons are safe and that prisoners’ health and welfare needs are met, but they must also find a way to improve the basic reading skills of the huge proportion of prisoners who currently lack them.

Every prison leader should want prisoners to leave having improved their reading skills significantly. The prison system should be focused on quality teaching that gives prisoners a secure reading ability that they can apply both inside and outside of prison.

This research shines some light on the reading education that prisoners are getting, or to be more precise, in most cases, the lack of it. There are some serious systemic challenges, as well as plenty of poor practice. I want Ofsted, with the prison service and wider government leaders, to be part of the solution to this enduring and enormous problem.

From Charlie Taylor, Her Majesty’s Chief Inspector, HMIP

At a cost to the taxpayer of around £45,000 each year, it is astonishing that prisoners can serve their sentence without being taught to read or to improve their reading skills. Yet this is the depressing finding of this joint thematic report between HMIP and Ofsted. We know that many prisoners have had a disrupted schooling and that high numbers cannot read at all or are functionally illiterate, so it is very disappointing that this essential skill is given such a low profile in prisons.

The way contracts for education providers are used does not incentivise the teaching of reading, because the focus is skewed towards achieving level 1 qualifications. Prisoners who cannot read are passed on to third sector organisations, such as the Shannon Trust, which train prisoner mentors to support their peers. However, this work is not prioritised in prisons and is often not possible because prisoners are locked away in their cells. While the pandemic may have compounded some of these difficulties, the lack of time prisoners spend out of their cells has been an issue that has been raised by HMIP for many years.

This report also highlights the lack of effective assessments of prisoners’ reading abilities and a routine failure to pass information between prisons. Most concerning of all is that so few teachers know how to teach prisoners to read, resources are inadequate and there are no meaningful measures of progress.

The failure to teach prisoners to read or to extend the literacy of poor readers is a huge missed opportunity. It means many prisoners do not get the benefits of reading while in prison. And it means that many will fail to learn the essential skills that will help them to resettle, get work and make a success of their lives when they are released.

It is a serious indictment of the prison system that so many prisoners are no better at reading when they leave prison than when they arrived. The prison service, governors and education providers should take urgent action to address the many concerns we have raised in this report.

Executive summary

Following concerns about the poor state of prison education, [footnote 1] Ofsted and HMIP decided to find out how prisoners are helped to improve their reading skills. Specifically, we sought to understand how prisoners’ reading is assessed, what provision is in place and how much progress prisoners make.

We jointly visited 6 prisons to carry out this research. Our findings are based on interviews with senior prison leaders, leaders in the education department, teachers, librarians, prison officers and prisoners. We reviewed curriculum plans and assessment data, visited classrooms, education departments and prison libraries, and spoke to prisoners in their residential units.

Our study highlights the systemic barriers that prevent prisoners from receiving effective support to acquire or improve their reading skills. The design and implementation of the curriculum were not focused on teaching prisoners to read or developing their reading and literacy skills. Importantly, the prisoners with the greatest need generally received the least support.

Main findings

Reading education is not given sufficient priority in the prison regime..

We found that:

• reading is not a distinct part of the core education offer
• leaders focused on qualifications that were not suitable for half of the prison population
• early reading provision in prisons relies heavily on voluntary organisations to deliver it
• assessments for identifying prisoners’ specific learning needs and gaps in reading knowledge were inappropriate
• leaders do not have effective systems to identify and address prisoners’ reading needs

Much education provision was not organised in a way that supports prisoners to improve their reading.

• prisoners had as little as an hour a day out of their cells and few were let out to take part in education
• prisoners were often paid more to work than to attend classroom education
• libraries were rarely used to give prisoners opportunities to practise reading

The curriculum was not well designed to improve reading.

• prisons offered a narrow curriculum, with a focus on teaching prisoners to pass qualifications
• many teaching staff did not know how to teach adults to read
• many resources to help prisoners practise reading were unsuitable for adults learning to read

Prisoners with the greatest need to improve their reading generally received the least support.

Introduction.

Ofsted inspects the overall effectiveness of education, skills and work in prisons and young offender institutions (YOIs) as part of HMIP ’s joint inspections of prisons. [footnote 2]

When we carried out research into prison education in 2008, we found that several aspects of it were poor. [footnote 3] For example, curriculums did not take account of what prisoners had learned before, records of prisoners’ learning were not transferred between prisons and assessments of prisoners’ educational needs on entry were often inaccurate or not used. Sadly, our new study has found that there has been little progress in the last 14 years.

We recently published a commentary which concluded that prison education is still in a poor state. [footnote 4] As a result, Ofsted and HMIP called for prison education to be given much greater attention. We committed to carrying out a year-long review of prison education, which included this research into reading in prisons.

Prisoners have much lower levels of literacy than the general population. The most recent data published by the Ministry of Justice shows that 57% of adult prisoners taking initial assessments had literacy levels below those expected of an 11-year-old. [footnote 5]

Low reading ability limits prisoners’ ability to navigate life in prison. For example, they may struggle to access written information, such as family and legal correspondence, menus or faith-based texts, and struggle to fill out forms. This makes them more vulnerable and puts them at risk of becoming isolated. It also prevents them from fully participating in the purposeful activities available in the prison such as education or work. If they cannot read proficiently, their time in prison, especially during long sentences, can become even more challenging and unproductive.

A lack of reading skills also limits prisoners’ ability to navigate life after prison. Prisoners without employment-related skills and knowledge are likely to find it more difficult to access opportunities for rehabilitation and resettlement on release. For example, completing forms to open a bank account and applying for jobs, education or training become difficult or impossible tasks. This may make it less likely that they will get into work and more likely that they will reoffend.

In prisons, reading education is currently delivered through wider English classes. These include functional skills classes, which teach the core skills required for employment and independent living. These classes include speaking and listening, reading and writing. Reading skills are also included as part of English for speakers of other languages ( ESOL ) classes, which teach those whose first language is not English to read in English. When prisoners cannot read at all, a voluntary programme to teach reading is sometimes available, at the discretion of the governor.

Since 2018, functional skills qualification content has included a greater focus on the theory behind how you learn to read. Prisoners need to have learned, securely, the underpinning knowledge in reading in order to read well. For example, to read menus, letters from family or legal correspondence, prisoners need to have knowledge of the fundamental blocks that make up learning to read.

Part of the purpose of entry level functional skills is to teach reading. [footnote 6] The Department for Education’s guidance explains that this should be done through the use of phonics. [footnote 7] Prisoners need to be systematically taught the relationship between letters and sounds.

When functional skills English programmes are not taught well or do not use the best methods for teaching adults to read, prisoners are less likely to develop expertise or enjoyment in reading in its own right.

We expect to see that learners are being taught the fundamental building blocks of English, including how to read. In functional skills classes, as in any English curriculum, we want teachers to encourage learners to enjoy learning to read. They should have the opportunity to apply their reading skills across their life, including through reading whole books.

This report sets out the current barriers to improving prisoners’ reading skills and challenges the government and the prison service urgently to find solutions.

Prisons are complex organisations and prison leaders, especially governors, have multiple and competing priorities. The safety of prisoners and staff is understandably of uppermost importance, as are maintaining standards of cleanliness and ensuring that prisoners are treated decently and humanely. These standards were especially relevant during the COVID-19 pandemic in order to reduce the spread of infection. Governors were obliged to respond to the pandemic by minimising the movement of people around the prison, reducing the time prisoners were allowed out of their cells and confining social ‘bubbles’ to the residential units.

Governors have limited resources and have to make difficult choices. Allocating the time, space and staff needed for widespread education to take place in prisons is not easy. However, we visited one prison that had overcome these difficulties, where all prisoners were expected to take part in out-of-cell education. Where taking part in education is the norm, it is because senior leaders within individual prisons have made a conscious decision to prioritise it.

In most prisons, face-to-face education was only available for a very small number of prisoners. We also heard of long delays in prisoners being able to enrol on education courses. This was despite the easing of the government’s COVID-19 restrictions.

Reading education is not given sufficient priority in the prison regime

Reading is not a distinct part of the core education offer.

The core education offer is commissioned by Her Majesty’s Prison and Probation Service ( HMPPS ) centrally and is set up for prisoners to gain qualifications. [footnote 8] This includes those in English, mathematics and information and communication technology. These qualifications were designed to equip post-16 learners with the English and mathematics skills they need to progress into employment.

The core education offer does not include a distinct reading curriculum for its own sake. Yet there are many prisoners who would benefit from gaining and developing their reading skills. Staff told us that much of the prison population can read a bit, but not well.

Governors, too, had largely overlooked the need to help prisoners become functionally literate in their prisons. However, they acknowledged that improving prisoners’ reading skills gives them better access to education, and that this has been shown to reduce reoffending. [footnote 9]

Education leaders did not have a strategy for developing teaching staff. Training in using phonics to teach reading was extremely limited, where it happened at all. Although some trained teachers had some idea how to teach reading, they had not been given appropriate training.

Although English courses could have been made available, education leaders had not made this happen. In most prisons, fewer than 30 prisoners were enrolled in any form of English education, [footnote 10] which represented a very small proportion of the prisoners who would have benefited from this. We found that very little reading education was taking place during our visits or had happened in the recent past.

Similarly, most of the prisons we visited did not prioritise beginner-level courses that could have taught early reading. [footnote 11] One prisoner, who was very motivated to improve his reading so that he could apply for jobs, told us he had waited months for reading support.

Where prisons did teach early reading, leaders had not ensured that teaching took account of best practice in teaching adults to read. They also did not put in place a reputable structured phonics programme to develop prisoners’ reading skills. This was despite phonics programmes being recommended in the functional skills syllabus to provide a systematic approach that teaches learners how to recognise letters and blend sounds to read words. [footnote 12]

Leaders focused on qualifications that were not suitable for half of the prison population

Prison leaders and education managers focus most of their efforts on helping prisoners to gain English qualifications rather than making sure they can read well.

Each prison sets a target number of prisoners to enrol on these courses as part of contractual obligations. Education leaders told us that these targets were based on an analysis of prisoners’ needs. Yet sometimes, there did not appear to be a clear reason for enrolment. It appeared that prisons focused on contractual obligations more than reading needs. For example, a teacher told us that she had been told to register 8 prisoners and had to go to the residential units and find prisoners willing to enrol.

I don’t [prioritise which prisoners enrol on courses]; administration do that. I don’t get the data. Over COVID, I got told my targets and then I’d go out to the wings.

    (Teacher)

Leaders focused on the level 1 qualification in functional skills in particular. This qualification enables prisoners to access work-based opportunities in prison, and leaders are set a target number of prisoners to achieve it. Most prisoners who were taking part in education were undertaking a level 1 qualification.

Gaining an English language qualification, such as functional skills at level 1, is appropriate and useful for some prisoners. However, it is only suitable for those who can already read. The level 1 course focuses on understanding texts. Prisoners who cannot read or who struggle with reading will not be able to access this curriculum, and so will not gain the qualification.

There is not enough effort on the lower levels of reading. When prisoners are transferred here they are given an assessment. Once you know their assessed levels, you can place them on the relevant course. The governor wants everyone to be at least level 1. Some workshops require you to have a level 2, such as engineering or industrial cleaning.

    (Learning and skills manager)

The level 1 course was, in fact, unsuitable for many prisoners. Prison staff told us that up to 50% of the prison population could not read well enough to take part in functional skills courses at level 1 or above. [footnote 13] Prisoners with lower levels of reading ability, who were unlikely to achieve this qualification, were largely ignored. Evidence submitted to Ofsted by the University and College Union concluded similarly that contractual obligations detract from providing good education. [footnote 14] Education contracts appear to incentivise enrolment on certain qualifications over learning.

Early reading provision in prisons relies heavily on voluntary organisations to deliver it

Teaching of prisoners who could not read was usually left to the Shannon Trust, a voluntary organisation that trains prisoners to mentor fellow prisoners who are learning to read.

The Shannon Trust uses an appropriately structured and sequenced programme designed specifically for teaching prisoners. It uses age-appropriate books and texts and is overseen by an external regional Shannon Trust coordinator. The programme is available in many prisons, and mentors have been trained using the training manuals and DVDs provided.

The Shannon Trust’s programme is intended for prisoners who cannot read. Indeed, education leaders told us that the Shannon Trust was the main vehicle for teaching those who cannot read in their prisons.

We have the Shannon Trust and entry level for the weakest learners. Initial assessment identifies who goes to the Shannon Trust and who goes to entry level.

There are several benefits of using the Shannon Trust, which were explained to us during our visits. For example:

• prisoners who train as mentors can build supportive relationships with prisoners who cannot read
• prisoners felt at ease with the Shannon Trust mentors because they receive one-to-one support in their residential units instead of in classes
• prisoners felt a certain amount of stigma about learning to read and felt that learning with the mentors offered more confidentiality

But importantly, the Shannon Trust is not contracted by HMPPS to provide reading education as part of the core education offer. It has only recently been possible for prison leaders to use their limited funding to commission the programme.

Although leaders said that the Shannon Trust programme is the main way that prisoners learn to read, the programme was not integrated with the English curriculum at any level. Prison leaders and managers did not communicate or liaise with mentors or the charity’s coordinators. There was little, if any, coordination between teaching staff and Shannon Trust mentors on the assessment or progress of those being mentored.

Shannon Trust mentoring, as with all of the core education offer, stopped for a time during the first national COVID-19 lockdown. Once the restrictions were eased, prisoners were able to leave their cells for work such as wing cleaning, inducting new arrivals and acting as orderlies on segregation units. However, at the time of our visits there had been little or no attempt to restart Shannon Trust mentoring. It was simply not a priority for wing staff or leaders, and there was very little evidence of mentors being able to deliver the programme. In all the prisons we visited, the Shannon Trust programme was much slower to be reintroduced than functional skills courses.

Where the programme could take place, it was only possible in the very limited association time (which could be as little as an hour) that prisoners had out of their cells. This led to prisoners and staff expressing frustration that, despite having trained mentors in place, it was not possible for them to teach fellow prisoners to read.

I’ve spoken to a few too; the thing is that they’re willing to learn, just not on association [time]… I’m happy giving up my association, as long as I get my shower, but my learners don’t want to.

    (Shannon Trust mentor)

A common complaint we heard from mentors was that they did not have a suitable space to work with prisoners. Some delivered the programme in their cells, which was not conducive to learning:

Also, my cell’s tiny; you can only just about fit two people in there let alone lay things out and start writing.

We also saw examples of resources, provided by charities, that aimed to help develop reading skills and encourage reading. These included:

• the Diffusion scheme, which provides texts that help adult learners to develop their reading skills, with content that is relevant to adults in prison
• the Reading Agency’s ‘Reading Ahead Challenge’, which encourages prisoners to read 6 books and rewards them with a dictionary
• the Storybook Mums and Storybook Dads scheme, which encourages prisoners to record themselves reading a story for their children to hear

Prisoners and teachers spoke of the positive impact of initiatives such as these. However, the frequency with which these took place varied considerably between prisons. They were usually driven by the enthusiasm of one member of staff rather than encouraged by leaders, managers and prison staff as part of a whole-prison approach.

This means that many prisoners did not have the opportunity to learn to read or improve their reading skills. When they did, this relied on charitable or voluntary organisations. Prisoners’ reading skills were not developed as a matter of routine because early reading was not implemented systematically as part of a core offer.

Assessments for identifying prisoners’ specific learning needs and gaps in reading knowledge were inappropriate

The English assessment that all prisoners take when they first enter a prison is intended to make sure that they are offered the right English functional skills course. It is not intended to assess whether or how well the prisoner can read. The assessment does not give leaders or teachers information on which prisoners struggle with reading or on the precise knowledge and skills gaps that might limit their reading ability.

In the prisons we visited, there was no routine phonics screening assessment to identify whether a prisoner could read or how the curriculum needed to be planned to fill specific gaps in knowledge and skills. Only one teaching staff member, who had previously worked as a primary school teacher, carried out her own phonics screening assessment. This was not replicated across the prison education department, which meant that only a very few prisoners benefited.

Instead, the assessment tests the skills that learners need to access functional skills courses, such as how to identify bias, skim read text and fill in missing letters of words. Concerningly, this test asks prisoners to state whether they have a certain skill rather than actually testing how well they can use it. For example, one question on the form asks if the prisoner finds filling in forms difficult. This question is then followed by many more pages to complete. These approaches are, at best, substitutes for assessments of knowledge and skills. They often measure prisoners’ confidence rather than their actual knowledge and skills. Teachers and education managers told us that prisoners who struggled with reading found these tests hard to complete, but they had been unable to come up with an alternative.

This type of assessment does not help leaders or teachers to identify whether learners have difficulty with reading. Many prisoners have poor reading skills, and the gaps in knowledge and skills could be very different from one person to another. The assessments failed to unpick these differences. For example, the different reasons a learner may struggle to skim read text could include poor fluency or a limited vocabulary. Understanding these differences is fundamental to supporting older readers, who will have different needs. [footnote 15]

Jake was in care before arriving in prison. He told us that he couldn’t write and could only read very basic books, because he skipped school when he was younger. After completing an initial assessment, he was placed on an entry level 2 course. Initially, he found the course difficult and struggled with anxiety in group classes: ‘I was very shy, but I thought “only me got me into this and only me can get myself out.”’ So, he signed up to the Shannon Trust programme to be mentored one-to-one. With this extra support, he was able to gain entry level 2 and 3 qualifications and was studying for his level 1 when we spoke to him. Jake’s goal is to get a job cutting hair, which he described as his passion. Once he has gained a level 1 qualification in English, he will be able to enrol on a barbering course and get the qualification he needs to pursue this goal on release. When we asked him why he decided to learn to read, he told us: ‘You’ve got to better yourself. I don’t want to be back in a dead-end situation.’

Leaders do not have effective systems to identify and address prisoners’ reading needs

In all the prisons we visited, systems to assess prisoners’ reading ability, identify their reading needs, implement solutions and monitor progress were largely absent.

Despite the existence of a central database, we were told of examples where information about prisoners’ education was not kept in a consistent way, was missing or was not accessible when they moved prisons. This included information as basic as whether a prisoner:

• had taken an education assessment previously
• was enrolled in education
• was receiving education
• had achieved an English language qualification

In order to build on previous learning, teachers must have information about what education a prisoner has received in previous prisons, as well as any qualifications they have attained. But we were told that this information is not routinely shared. The database that is intended to share information about prisoners’ education was not widely used. [footnote 16]

Additionally, we were told that information on a prisoner’s qualifications can only be sent to another prison if the prisoner ticks the relevant boxes for sharing personal information. One curriculum manager told us this rule is not made clear to prisoners and many do not understand the implications of this decision. As prisoners can move prison at very short notice, it can be difficult to have useful and timely information for a new prisoner.

Every prisoner should complete an initial English skills assessment, which is the same across all prisons. However, if information is not shared when prisoners are transferred, it’s possible that the prisoner will complete the same assessments several times. Leaders also told us that many prisoners had yet to complete this assessment.

Interviewer: When you arrived at this prison, did you have an initial assessment?

Learner 2 (prisoner): Well no, I don’t think so. To be honest I was a bit confused. I did that test in the other prison and they lost it and then I did it again. When I got here I told them I already filled in that form. I told the officers, tried to let them know. But they said they didn’t have it. About two months after I arrived I did the exact same one in English and maths. I think I’ve done the same one three times. But they don’t know what I have; they say they haven’t got it.

Prisoners who have recently arrived in a jail are often anxious or distracted. They may not be in the right state of mind to carry out an assessment. This means that the data that prisons do collect on reading and literacy is unlikely to be accurate; although, positively, one prison was aware that some prisoners would be rehabilitating from drug misuse and arranged for their initial assessment to take place at a time when their medication was most effective.

As a result of COVID-19 restrictions, in many prisons assessment materials were posted to prisoners in their cells. We were told that, because prisoners usually need to attain level 1 to be able to get a job, some of those who could not read were getting cellmates to complete the form.

All of the teachers and education leaders we spoke to had serious concerns about the accuracy of the initial assessment. This was largely due to the way it was administered.

Leaders did not appear to have an accurate measure of how many prisoners were receiving English or reading education. For example, one prison counted the number of learners who had received a letter saying they had a place on a course, even though they were not due to start the course until several months later. Another measured enrolment by simply sending a pack to a prisoner, without following up to find out if the course had been started or completed. These measures did not tell leaders whether prisoners had actually received education or learned anything.

We also saw very few examples of leaders and education managers monitoring how well prisoners were learning to read on their courses. Instead, they mostly focused on basic tracking of the number of prisoners achieving each qualification in English functional skills.

Importantly, any information on the progress that learners were making while learning to read was extremely limited. This was one of the key areas that we aimed to carry out research on, yet the lack of information recorded about it meant that we could not find out how much progress a prisoner was making.

Consequently, leaders and education managers did not have the necessary information to even begin to address prisoners’ reading needs.

Much education provision was not organised in a way that supports prisoners to improve their reading

Prisoners had as little as an hour a day out of their cells and few were let out to take part in education.

At the time of our visits, prisoners had as little as an hour a day out of their cells. [footnote 17] During this time, prisoners had to fit in daily tasks such as exercising, having a shower, collecting meals, submitting written applications, making phone calls and doing laundry.

On association you’re grabbing lunch, you’ve got to clean your cell, do laundry, shower, have a little walk around, any paperwork. In an hour and 45 minutes.

    (Prisoner)

Prisoners commented that they were not keen to use the limited time out of their cells to take part in education.

In most prisons, teachers, mentors and tutors could not move around the different residential units. In these prisons, the only face-to-face education available was a small number of English classes, or vocational training and industrial workshops. We were told of education classes that took place outside of association time, although we saw very few of these happening.

Lessons had to fit around the rest of the prison day. This led to some lessons being much too long. For example, some lessons consisted of two 3-hour sessions across the day. In one of the prisons we visited, teachers were running 20-minute sessions on English and mathematics during industry workshops. Sometimes, the length of lessons depended on the availability of prison staff to escort prisoners around the jail.

However, in one prison it was clear that the deployment of teachers was based more on prisoners’ learning needs than on other factors in the prison regime. For example, during lockdown, when classes could not take place, each teacher taught prisoners in their cells. They also reduced lesson time of an individual lesson from 3 hours to 75 minutes. They found this to be a positive approach, as it was more conducive to learning and enabled education to take place outside of association time.

Some prisons were so short-staffed they could not facilitate education at all. For example, one prison only let prisoners who were employed in cleaning out of their cell beyond their limited association time. In addition, contact with teachers doing outreach on the residential units could only be facilitated during the short time prisoners were allowed out of their cells. Prisoners therefore had limited access to education, and it was difficult for prisoners to be allocated an allotted time when they could learn.

Prisoners told us that association time was the only opportunity for Shannon Trust mentors to work with their fellow prisoners. This meant that they often missed out on other opportunities, such as gym visits. We saw only one prison that gave mentors time and space to work with prisoners on the Shannon Trust programme out of their cells.

Prisoners were often paid more to work than to attend classroom education

Prisoners are paid for each work and education session they complete. They were generally not able to attend a combination of work and education, so had to choose between the two. Work opportunities included cleaning, cooking, recycling, waste processing and laundry. Some of the prisoners we spoke to were able to earn more by working because the rate of pay was higher or because the work sessions were longer than those in education. Even those prisoners who wanted to be peer mentors for the Shannon Trust could earn more money by working in the kitchen.

Jane had been in prison for 2 and a half years. After completing an initial assessment, she was placed on an entry-level functional skills course. She gained her entry level 3 qualification, which sparked her desire to learn. In addition to starting level 1 English, she also signed up for mathematics and IT courses. This meant Jane was now classed as being in full-time education and deemed unable to work according to the prison’s rules. She had to choose between education and work. As work was better paid, she dropped two of her courses and continued only with English. She told us she would like to do a level 2 mathematics qualification, but that she’d probably stick at level 1 so that she could work.

Although all the prisons we visited had reopened commercial workshops, where prisoners make products that can be sold, they had not made education classes more widely available for prisoners.

Our textiles workshops, for example, have targets to produce a certain amount; those targets will always come first.

    (Governor)

Governors have a devolved responsibility for setting the prisoner pay for taking part in education. Although the Coates Review recommended that governors should be free to encourage education through increased pay, this was not always happening in practice. [footnote 18]

Libraries were rarely used to give prisoners opportunities to practise reading

Since the COVID-19 pandemic began, leaders have been slow to reopen libraries, and opening hours have been much reduced. At the time of our visits, most were closed due to the pandemic, or only open for short periods of time during the day. Libraries were rarely open in the evening or at weekends.

Sometimes library opening times clashed with education sessions. Opportunities to use the libraries were extremely limited for prisoners who were working. If a prisoner’s scheduled library visit clashed with their working hours, it would be missed.

Teachers told us that staffing shortages caused by the pandemic made escorting prisoners to the library even more difficult. In one prison, prisoners had to fill out a form to order a book, restricting access for those who could not write.

Despite staff shortages and limited library opening times, some prisons ensured that libraries facilitated reading. For example, one prison moved a selection of books to the residential units so that prisoners could access these while still in their ‘bubbles’. In one prison, teachers escorted their learners to the library during lessons so that they could pick appropriate books. In another, a teacher picked up and returned books for her learners in her own time. Two libraries were used for the Shannon Trust programme.

Libraries are important for supporting those with some reading skills to improve their reading. The most requested book in prison was the dictionary. Needing a dictionary shows a willingness to learn and a recognition of the importance of literacy.

Where libraries were accessible, they were used in a range of positive ways to encourage prisoners to read for pleasure. We saw reading initiatives such as a challenge where, if prisoners read 6 books, they received a dictionary. The Storybook Dads scheme was also held in some libraries. This initiative helps prisoners to record bedtime stories or messages for their children. Libraries were also used for book clubs. In one prison, prisoners earned money for taking part in a book club run by the librarian. Over 10 prisoners took part each month, but it was available to any prisoner who wanted to join.

We met librarians who were passionate about their work and encouraged reading for both pleasure and purpose. In one, individuals worked hard to make sure they stocked resources that were appropriate for different levels of reading ability. In another, the librarian was able to provide a wider range of books through partnering with a local authority library. We also heard about author visits, book clubs and creative writing opportunities.

However, we saw limited communication between prison education departments and libraries to align what the library could offer with the education programmes available.

Although there were occasions when prison libraries were used well, the practical constraints around opening libraries meant that many did not help or encourage prisoners to practise their reading.

The curriculum was not well designed to improve reading

Prisons offered a narrow curriculum, with a focus on teaching prisoners to pass qualifications.

The strong focus on achieving English functional skills qualifications rather than learning to read was evident in the narrow curriculum we saw in the prisons we visited. Across all the functional skills courses, the curriculum was designed to enable prisoners to practise for the exams. It did not focus on acquiring the skills to become a fluent reader.

When we asked teachers and leaders in the education department what goals they had for reading, almost all of them gave a similar answer:

To get them through their exam. That’s the main goal.

    (Education manager)

Teachers made frequent use of text extracts rather than whole books to replicate exams. Lessons focused on comprehension and neglected the basic building blocks necessary for learning to read. This meant there were not enough opportunities to practise or improve reading.

‘Teaching to the test’ means that prisoners may not be able to apply their reading skills to unfamiliar situations, outside of an exam. Prisoners may not learn to read texts that would help them in their daily lives, while inside prison or after release. In most prisons, teaching and curriculum were only planned to achieve the end goal of passing a qualification at level 1.

Many teaching staff did not know how to teach adults to read

As part of the English curriculum in prisons, learners can take a number of functional skills qualifications at different levels: level 1 or level 2 and entry levels 1, 2 and 3. Entry levels are for beginner learners who are not yet ready for level 1. Entry-level courses would be the most appropriate for teaching early reading.

However, the teaching we saw did not focus on reading. Teaching at entry levels did not make sure that prisoners had a secure understanding of the basics of reading. It did not focus on identifying and addressing gaps in prisoners’ reading knowledge or skills.

Few teaching staff had the subject knowledge and training to know how to teach reading. Some we spoke to did not have a teaching qualification or even any previous experience of teaching. Course materials did not demonstrate their understanding of how to use phonics to teach prisoners to read.

Teaching focused on repeating short tasks, with an assumption that this would improve learners’ ability to read words and sentences and understand short pieces of text. Other tasks involved the use of phonics without teachers understanding the need to teach it in a systematic order.

Teachers did not know which resources would be appropriate to teach phonics and early reading. This was especially evident when they provided written resources for prisoners who could not read well enough to use them.

Teachers did not have an accurate picture of prisoners’ initial reading ability nor the progress they had made. This, combined with teachers’ lack of subject knowledge, time, space and a suitable curriculum, meant that many prisoners did not get the opportunities to learn to read or to develop their reading skills.

Many resources to help prisoners practise reading were unsuitable for adults learning to read

Prisoners who were learning to read or improving their reading were frequently given resources that were of little help to them.

Prisons often provided education packs that could be completed in the prisoner’s cell. All of these packs demanded some reading ability. They were far too difficult for some prisoners to be able to read or understand. For most prisoners during lockdowns, this was the only education available. Teaching staff told us that many prisoners who struggled to read well found the packs hard to complete.

As one teacher told us, learning to read requires face-to-face teaching. Staff told us:

You can’t teach phonics through a cell door.

Some books and worksheets were those that would be used to teach young children and so had limited appeal for adult prisoners. Where appropriate books were provided (for example, by the charity Diffusion), there were rarely enough to go round. Tutors commented that they did not always read books aloud in classes because there were ‘no materials short enough’.

Prisoners told us that sometimes when they requested books from the library, they were sent something completely different. One prison provided ‘reading pens’, which read out text as they pass over it. However, prison leaders did not always ensure they were useful for prisoners; for example, the font in the menus in this prison was not compatible with the pens.

Some teachers spoke of the benefits of using in-cell education packs in addition to teaching, which had been introduced during the pandemic. They said they planned to continue to use them when restrictions were lifted. This meant that those prisoners who could read and learn independently could carry on their education in their own time in their cells, rather than relying on just face-to-face classes.

In one prison, a teacher told us that they were discouraged from reading from a book to prisoners during workshops. This meant that teachers resorted to worksheets for prisoners to complete, and the opportunity to demonstrate how reading a book could be enjoyable as well as instructional was missed.

Where we did hear of times when prisoners were supported to learn to read, this was largely because of the actions of a single enthusiastic member of staff.

Anne had never been to school when she arrived in prison at 53 years old. She could not read or write but was too embarrassed to seek help: ‘You don’t want everyone else to know your demons’. When she received an initial assessment to complete remotely, she paid her cellmate with vapes to do it for her. This meant she could apply for work, and she got a job in industrial cleaning. Her supervisor was the first to notice she couldn’t read. Her supervisor referred her to an additional learning support officer, who had previously been a primary school teacher. The learning support officer did a phonics screening assessment and gave Anne a DVD that had a phonics course on it. She told us how valuable she found this intervention: ‘I can’t say enough good things about what they’ve done. It’s all about pushing what you can do. When I had the DVDs, I could do the practise myself. I don’t have to rush anything. I can make mistakes and check them in my room – I can talk to myself in my room, take it slowly, write it down. Then you can help yourself, you don’t get the demons… I couldn’t read, now I can read.’ Since learning to read, Anne has gained all the entry-level English qualifications and was studying for level 1 when we spoke to her. She had also been able to get a job in textiles and had started a course in digital skills. She told us about the difference that reading had made in her life: ‘I can write to my son now; he says “Mum, I’m so proud of you.” … When you’re in the travelling community, it’s all about the children, and the cleaning. You look after everyone else, that’s the way, you don’t go to school, you keep the house, you keep everyone clean and fed. This is about me; this is my time and now I know I’ll go out of here better. It shows you the bigger picture, I’m more confident now.’

Overall, little thought has been given to providing resources for prisoners to use to help them learn to read or improve their reading skills. This meant very limited chances for prisoners to develop their reading skills.

Prisoners with the greatest need to improve their reading generally received the least support

Fundamentally, the lack of distinct reading education as part of prisons’ core education offer means there is limited provision for those prisoners with the greatest need.

The education system in prisons encourages leaders to focus on qualifications in functional skills rather than on improving reading. This qualification-driven approach has meant that the prison system has overlooked providing education for those prisoners who cannot read. Instead, a voluntary organisation, the Shannon Trust, is often the only way prisoners who cannot read are taught.

Our evidence suggests that the prison regime lacks the systems to identify and address prisoners’ reading needs. In particular, without an appropriate screening assessment, prisoners who cannot read or who cannot read well will not receive the support they need. If reading is not given due priority, prisoners with the greatest need to improve their reading will be left behind.

Very few prisoners have had opportunities to learn to read or improve their reading skills, and the lack of face-to-face education has hit those who cannot read at all the hardest. We know from our previous research, before COVID-19, that limited provision for reading was the norm. [footnote 19] The pandemic appears to have exacerbated an existing problem. Prisoners who cannot read at all need face-to-face teaching; they are unable to make improvements on their own or by practising reading. Through the pandemic and beyond, there has often been no-one available in residential units to offer help and support for prisoners with their education courses. With limited time out of cells and a lack of help when trying to complete in-cell education packs, very little learning has been possible for those prisoners who need help with learning to read fluently.

Where prisons have focused on practise for exams and teaching to the test, prisoners who can read a little but not fluently have been disadvantaged. They may not be able to apply their reading skills to unfamiliar situations outside of an exam, or to read texts in their daily lives, while inside prison or after release.

It is essential that reading is better understood as an essential part of English qualifications in prison. Where the curriculum was not focused on reading or delivered by expert staff, those prisoners who need to improve their reading did not receive the teaching they needed. Those with the greatest need to improve their reading need appropriate books and texts to learn from, but we saw a lack of suitable resources. The curriculum and teaching need to help prisoners to enjoy reading for its own sake and become more confident in being able to read in their daily lives.

Recommendations arising from the research

The education, skills and work offer should include:

• initial and ongoing assessments that pinpoint the specific knowledge and skills in reading that prisoners are missing or need to improve
• a distinct part of the curriculum offer dedicated to teaching reading
• specialist training and development on teaching adults to read

For prison governors

Governors should lead a whole-prison approach to reading that facilitates reading for pleasure, purpose and rehabilitation. This would include:

• having an ambitious strategy to improve prisoners’ reading skills
• making sure the library promotes reading for pleasure and purpose effectively and provides appropriate texts for adults who are learning to read
• using appropriate interventions that support reading as well as systems to assess, monitor and share information on prisoners’ reading ability and the progress they make

How Ofsted and HMIP will respond

During inspections, Ofsted will include a focus on the quality of reading education and support for those who are learning to read. We will do so regardless of whether this is commissioned as part of the core education offer.

HMIP will continue to inspect library provision and will consider its focus on how effectively libraries promote reading and how they support the prison’s wider reading strategy.

Methodology

This review sought to understand how prisoners’ reading ability is assessed, what provision is made to improve their reading and how much progress they make.  

We carried out 6 research visits to prisons. For an in-depth, qualitative study of this kind, our visits enabled us to describe in detail the situation in these prisons and highlight themes from across them.

Research visits were carried out by an Ofsted schools Her Majesty’s Inspector (HMI) with a specialism in reading, an HMIP consultant reading specialist, and an Ofsted further education and skills HMI with experience of inspecting prisons.

Participation in the research visits was voluntary. For convenience, we used a sample of prisons that were scheduled for inspection. We visited 4 adult male prisons and 2 female prisons. The male prisons had all been graded requires improvement for education, work and skills at their last full inspection, whereas the 2 female prisons we visited had been graded good. We visited prisons with a mix of security categorisations. Two prisons were privately managed.

We carried out deep dives into reading, which included observations of English classes where these were happening. [footnote 20] We interviewed leaders, those involved in delivering reading education [footnote 21] and prisoners engaged in education. We also visited the prison library and reviewed curriculum plans and assessment data. See Annex A for a list of the job roles of those we spoke to.

Following each visit, the anonymous notes of each interview were typed up into a structured template. In addition to evidence gathered on our research visits, we drew on the combined expertise of Ofsted and HMIP ’s inspectors, who provided feedback on our findings. Interview responses were then coded thematically using coding software. At the final stage of analysis, the coded responses were compared across all 6 visits. We changed the names of individuals described in case examples.

Limitations

The findings from such a small sample are not generalisable across the whole prison estate. There may be prisons that have prioritised reading education and, in particular, the needs of those who cannot read at all, outside of our sample.

Although we had aimed for observations of education to be a significant part of our deep dives, we could not observe much education at all. We were able to observe teaching of functional skills (from entry level 3 to levels 1 and 2) in 2 out of the 6 prisons we visited.

The visits took place while many prisons were subject to pandemic-related restrictions on the range of education, skills and work activities that could take place. The restrictions that each prison was under at the time of our visit were taken into account. We relied on what participants told us about reading education at their prison before the pandemic. These interviews suggest that, as a result of the pandemic, education has a lower priority than it has previously.

Finally, we were not able to audio-record our conversations with participants for security reasons. Instead, a dedicated researcher took notes of the discussion in real time. A 15-minute period following each interview was scheduled to ensure that the notes taken were as verbatim as possible. However, this means that the participant quotations given in this report may not be the exact wording, verbatim, that the participant used.

On these visits, we carried out deep dives into reading. These included:

• interviews with senior leaders in the prison and education department, including the governor, the prison-appointed education manager and the education manager from the organisation contracted to provide the core curriculum
• interviews with teachers of English functional skills courses, as well as one interview with an ESOL teacher and one with an additional learning support officer
• an interview with the librarian and visit to the library
• interviews with prisoners enrolled on entry-level and level 1 English courses
• interviews with all those involved in delivering the Shannon Trust peer-to-peer mentoring programme for early readers, including the responsible prison officer, peer mentors and mentees
• scrutiny of curriculum plans and assessment data on reading

At the start of the pandemic, prisons were placed under a system of restrictions known as ‘regime stages’ mandated by HMPPS . [footnote 22] The table below sets out the stage of restrictions that each of the prisons we visited were under at the time of our visit. All the prisons we visited were under stage 3 or stage 2 restrictions.

In stage 3, HMPPS guidance is that in-cell learning should be in place, priority workshops should be reopened and one-to-one learning should be delivered in a COVID-secure way. At stage 2, classroom education and greater workshop activity should be reintroduced.

Table 1: Level of COVID-19 restrictions in place during our visits

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Over the last 5 years, around 60% of prisons have been graded inadequate or requires improvement for education, skills and work. This compares with just 20% of provision in other parts of the further education sector that we inspect, as we reported in our 2019/20 Annual Report: ‘Ofsted Annual Report 2019/20: education, children’s services and skills’ , Ofsted, December 2020.  ↩

Ofsted makes judgements and awards grades to the aspects that contribute to the overall effectiveness of the education provision delivered in prisons. Our judgements contribute to HMIP ’s ‘purposeful activity’ part of its 4 tests of healthy prisons. HMIP grades purposeful activity based on Ofsted’s findings and grades and other factors such as prisoners’ time out of cell, library use and access to the gym.  ↩

‘Learning and skills for the longer-serving offender’ , Ofsted, January 2009 (now accessed through the National Archives); ‘Learning and skills for offenders serving short custodial sentences’ , Ofsted, January 2009 (now accessed through the National Archives).  ↩

‘Launching our prison education review’ , Ofsted, September 2021.  ↩

‘Prison education statistics 2019–2020’ , Ministry of Justice, August 2021.  ↩

Functional skills English qualifications can be taken at a range of levels from entry level 1 to level 2. The latter is broadly equivalent to a GCSE pass at grades 4 to 9.  ↩

‘Functional skills subject content: English’ , Department for Education, February 2018.  ↩

HMPPS contracts with 4 education providers to supply the Prison Education Framework for prisons. See ‘Procurement for prison education dynamic purchasing system’ , Ministry of Justice, January 2019.  ↩

‘Evaluating the effectiveness of correctional education: a meta-analysis of programs that provide education to incarcerated adults’ , RAND Corporation, 2013.  ↩

Including English functional skills and ESOL courses.  ↩

The functional skills curriculum at entry levels 1 and 2 should be used to teach prisoners to read or improve very basic reading skills.  ↩

‘Subject content functional skills: English’ , Department of Education, February 2018.  ↩

These prisoners were identified as working at entry level 3 or below in functional skills.  ↩

‘Prison education evidence to Ofsted’ , University and College Union, March 2022.  ↩

P Cirino, M Romaine, A Barth and others, ‘Reading skills components and impairments in middle school struggling readers’ , August 2013.  ↩

In 2019, ‘Curious’ was created as a centralised database to share information about prisoners’ education between prisons. The Curious database covers prisoners’ initial assessments, participation and achievement in courses.  ↩

Before COVID-19, prisoners would have anything between 8 and 11 hours out of their cell.  ↩

‘Unlocking potential: a review of education in prison’ , Ministry of Justice, May 2016.  ↩

‘Learning and skills for the longer-serving offender’ , Ofsted, January 2009 (now accessed through the National Archives).  ↩

Including English functional skills courses and English for speakers of other languages.  ↩

Including Shannon Trust, English for speakers of other languages and functional skills courses.  ↩

‘COVID-19: national framework for prison regimes and services’ , Ministry of Justice and Her Majesty’s Prison and Probation Service, June 2020.  ↩

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Open Access

Peer-reviewed

Research Article

Equity considerations in clinical practice guidelines for traumatic brain injury and the criminal justice system: A systematic review

Roles Formal analysis, Investigation, Validation, Visualization, Writing – original draft, Writing – review & editing

Affiliation Department of Forensic Science, University of Toronto, Mississauga, Canada

Roles Formal analysis, Investigation, Methodology, Project administration, Validation, Visualization, Writing – original draft, Writing – review & editing

Affiliation Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada

Roles Formal analysis, Investigation, Writing – review & editing

Affiliations Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada, KITE Research Institute-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada

Roles Methodology, Writing – review & editing

Affiliations Library and Information Services, University Health Network, Toronto, Canada, The Institute for Education Research, University Health Network, Toronto, Canada

Roles Conceptualization, Funding acquisition, Writing – review & editing

Affiliations Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada, KITE Research Institute-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

Roles Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliations Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada, KITE Research Institute-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada

• Zoe Colclough, 
• Maria Jennifer Estrella, 
• Julie Michele Joyce, 
• Sara Hanafy, 
• Jessica Babineau, 
• Angela Colantonio, 

• Published: August 12, 2024
• https://doi.org/10.1371/journal.pmed.1004418
• Reader Comments

Traumatic brain injury (TBI) is disproportionately prevalent among individuals who intersect or are involved with the criminal justice system (CJS). In the absence of appropriate care, TBI-related impairments, intersecting social determinants of health, and the lack of TBI awareness in CJS settings can lead to lengthened sentences, serious disciplinary charges, and recidivism. However, evidence suggests that most clinical practice guidelines (CPGs) overlook equity and consequently, the needs of disadvantaged groups. As such, this review addressed the research question “To what extent are (1) intersections with the CJS considered in CPGs for TBI, (2) TBI considered in CPGs for CJS, and (3) equity considered in CPGs for CJS?”.

Methods and findings

CPGs were identified from electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), targeted websites, Google Search, and reference lists of identified CPGs on November 2021 and March 2023 (CPGs for TBI) and May 2022 and March 2023 (CPGs for CJS). Only CPGs for TBI or CPGs for CJS were included. We calculated the proportion of CPGs that included TBI- or CJS-specific content, conducted a qualitative content analysis to understand how evidence regarding TBI and the CJS was integrated in the CPGs, and utilised equity assessment tools to understand if and how equity was considered. Fifty-seven CPGs for TBI and 6 CPGs for CJS were included in this review. Fourteen CPGs for TBI included information relevant to the CJS, but only 1 made a concrete recommendation to consider legal implications during vocational evaluation in the forensic context. Two CPGs for CJS acknowledged the prevalence of TBI among individuals in prison and one specifically recommended considering TBI during health assessments. Both CPGs for TBI and CPGs for CJS provided evidence specific to a single facet of the CJS, predominantly in policing and corrections. The use of equity best practices and the involvement of disadvantaged groups in the development process were lacking among CPGs for CJS. We acknowledge limitations of the review, including that our searches were conducted in English language and thus, we may have missed other non-English language CPGs in this review. We further recognise that we are unable to comment on evidence that is not integrated in the CPGs, as we did not systematically search for research on individuals with TBI who intersect with the CJS, outside of CPGs.

Conclusions

Findings from this review provide the foundation to consider CJS involvement in CPGs for TBI and to advance equity in CPGs for CJS. Conducting research, including investigating the process of screening for TBI with individuals who intersect with all facets of the CJS, and utilizing equity assessment tools in guideline development are critical steps to enhance equity in healthcare for this disadvantaged group.

Author summary

Why was this study done.

• Traumatic brain injury (TBI) is more common among individuals involved with the criminal justice system (CJS) than the general population, often resulting in longer prison sentences, serious disciplinary charges, and repeated future conflicts with the CJS.
• Although individuals with TBI who are involved with the CJS must receive care that meets their needs, studies show that most clinical practice guidelines (CPGs)—designed to guide care—tend to overlook equity and disadvantaged groups, instead focussing on the effectiveness or cost-effectiveness of care.
• As a first step to improving equitable care, this study assessed existing CPGs for TBI and CPGs for CJS to see if and how (1) evidence regarding individuals who intersect with the CJS is included in CPGs for TBI and evidence regarding TBI is integrated in CPGs for CJS; and (2) equity is considered in CPGs for CJS.

What did the researchers do and find?

• We used available electronic databases (MEDLINE, Embase, CINAHL, PsycINFO), targeted websites, Google search, and reference lists for CPGs for TBI and CPGs for CJS.
• We documented their characteristics, reviewed their content, and assessed whether equity was considered using checklists focused on equity and disadvantaged groups.
• We found that 14 out of 57 CPGs for TBI referenced individuals who are involved with the CJS and 2 out of 6 CPGs for CJS referenced TBI.
• Practices to ensure that equity is considered, such as the involvement of disadvantaged groups when developing CPGs were lacking in CPGs for CJS.

What do these findings mean?

• Findings from this review suggest that consideration of equity is lacking in the development of CPGs for TBI for those within the CJS and provide the foundation to consider CJS involvement in CPGs for TBI and to advance equity in CPGs for CJS.
• There is a critical need for further research into screening processes for TBI with individuals who intersect with all facets of the CJS, and into the benefits of equity assessment tools in guideline development to enhance equity in healthcare for this disadvantaged group
• Unfortunately, we cannot comment on how much of the existing evidence regarding TBI or individuals who are involved with the CJS remains unintegrated in existing CPGs, as our search did not include research papers on TBI and the CJS, outside of CPGs.

Citation: Colclough Z, Estrella MJ, Joyce JM, Hanafy S, Babineau J, Colantonio A, et al. (2024) Equity considerations in clinical practice guidelines for traumatic brain injury and the criminal justice system: A systematic review. PLoS Med 21(8): e1004418. https://doi.org/10.1371/journal.pmed.1004418

Received: October 31, 2023; Accepted: May 22, 2024; Published: August 12, 2024

Copyright: © 2024 Colclough et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: AC Canada Research Chairs Program Grant #2019-00019 https://www.chairs-chaires.gc.ca/home-accueil-eng.aspx The funder did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. VC Ontario Ministry of Health Grant # 725A https://www.health.gov.on.ca/en/ The funder did not play any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Abbreviations: CJS, criminal justice system; CPG, clinical practice guideline; GRADE, Grading of Recommendations Assessment, Development, and Evaluation; LOC, loss of consciousness; NICE, National Institute for Health and Care Excellence; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta Analyses; SDoH, social determinants of health; TBI, traumatic brain injury

Introduction

Traumatic brain injury (TBI) affects 69 million people every year [ 1 ] and may cause long-term challenges in behaviour, cognition, and communication [ 2 ] with functional limitations in various areas of life [ 2 , 3 ]. TBI is particularly prevalent among disadvantaged populations, such as individuals who intersect with the criminal justice system (CJS) [ 4 – 8 ]. Prevalence rates of TBI among individuals who intersect with the CJS far exceed the rates found in the general population [ 5 ], with rates ranging from 25% to 86% among individuals who are incarcerated [ 7 ], 47% among those on probation [ 9 ], and 17% to 72% among youth [ 6 ]. Most recently, a meta-analysis published in 2023 found that the prevalence of TBI among individuals within the CJS was 46% [ 10 ].

Research has identified a relationship between having a history of TBI and experiencing adverse outcomes within the CJS. For example, a longitudinal study found that individuals completing sentences in federal correctional facilities who have a history of TBI were 39% more likely to incur serious disciplinary charges than those without a history of TBI [ 11 ]. Research has also demonstrated that a history of TBI is associated with an increased risk of reoffending upon release [ 12 – 15 ]. Unfortunately, health inequities experienced by individuals with TBI who intersect with the CJS also contribute to higher rates of chronic and infectious diseases, mental health challenges, substance use disorders, and serious psychological distress compared to the general population [ 16 ]. These health inequities are exacerbated by social determinants of health (SDoH), such as structural racism, that can limit healthcare access for groups that are disadvantaged, and lead to worse health outcomes for the high proportion of black, Indigenous, and people of colour who intersect with the CJS [ 17 ].

Clinical practice guidelines (CPGs) are “statements that include recommendations intended to optimise patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options” [ 18 ]. However, despite their potential to enhance care, CPGs have been critiqued for dictating a one-size-fits-all approach to care [ 19 ] and lacking consideration for equity [ 20 ] or health inequities [ 21 – 23 ]. As such, existing CPGs may not be serving disadvantaged populations if they include recommendations that may not be applicable or beneficial to their needs. To the best of our knowledge, there has been no systematic review conducted to date that has examined the extent to which CPGs for TBI consider intersections with the CJS and the extent to which equity is considered in CPGs for CJS. This systematic review assesses the extent to which (1) intersections with the CJS is considered in CPGs for TBI; (2) TBI is considered in CPGs for CJS; and (3) equity is considered in CPGs for CJS.

The protocol for this systematic review was registered on PROSPERO [CRD42022331499] and is an extension of our published systematic review assessing equity in CPGs for TBI and CPGs for individuals experiencing homelessness [ 24 , 25 ]. The reporting of the systematic review search strategy follows the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) extension for searching (PRISMA-S) [ 26 , 27 ] and the reporting of the systematic review followed the PRISMA Equity Extension [ 28 ] (please see Fig 1 ). A meta-analysis was not conducted, as the aim of the review was to specifically assess if and to what extent equity was considered; as such, combining and getting an overall effect estimate of the varying outcomes reported by CPGs was not necessary.

• PPT PowerPoint slide
• PNG larger image
• TIFF original image

CJS, criminal justice system; CPG, clinical practice guideline; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta Analyses; TBI, traumatic brain injury.

https://doi.org/10.1371/journal.pmed.1004418.g001

Search strategy

CPGs were identified from (a) databases for peer-reviewed literature; (b) grey literature (i.e., targeted websites and Google Search); and (c) reference lists of eligible CPGs. Searches for CPGs for TBI and CPGs for CJS were conducted separately, as the process for identifying CPGs for TBI was completed as part of our published systematic review assessing CPGs for TBI and homelessness [ 24 ].

The CJS, in this review, encompasses 4 distinct facets in which direct involvement frequently occurs: policing (i.e., police interactions and arrests), courts (i.e., trials, including prosecution, adjudication, and sentencing), corrections (i.e., detention), and parole and probation [ 29 – 31 ]. Disadvantaged is a term used throughout this review to convey the lack of opportunities that ultimately place individuals in a disadvantaged position. While it is recognised that this term can be stigmatising, along with other terms such as marginalised or underserved, it was used to remain consistent with the language used by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guideline series [ 32 ] that informed equity assessment for this review. Additionally, we recognise that the term “criminal legal system” is used more recently to refer to the criminal justice system; however, we decided to use “criminal justice system” in this paper to be consistent with the language currently used in CPGs.

Peer-reviewed literature.

The search strategy was informed by a validated search for retrieving CPGs [ 33 ] and search strategies of scoping or systematic reviews of CPGs, TBI, and/or the CJS [ 24 , 25 , 34 – 36 ]. This search strategy was developed with an Information Specialist (JB) and team members with research and subject-matter expertise relevant to TBI and the CJS (VC, ZC, MJE). Additional details of the search strategy associated with each database for CPGs for CJS are outlined in S1 Text .

The overarching search strategy involved the search structure (a+b) OR (a+c) for text words and subject headings related to (a) CPG; (b) TBI; and (c) CJS. This search was conducted in 2 stages. The first stage was to identify CPGs for TBI (i.e., a+b), reported in a systematic review assessing equity in CPGs for TBI and CPGs for individuals experiencing homelessness [ 24 ]. The second stage was to identify CPGs related to CJS (i.e., a+c). For this stage, the following databases were searched: MEDLINE ALL (in Ovid, including Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily), EMBASE and EMBASE Classic (Ovid), CINAHL (EBSCO), and APA PsycInfo (Ovid).

For both stages, no date or language limits were placed on the search strategies; however, where possible, we excluded animal studies and conference abstracts. Peer-reviewed literature searches for CPGs for TBI (stage 1) were conducted in November 2021 and in March 2023. Searches for CPGs for CJS (stage 2) were conducted in May 2022 and in March 2023.

Grey literature.

The grey literature search strategy was informed by Goldin and colleagues’ methodology on applying systematic review search methods to grey literature [ 37 ] and used the same search structure of (a+b) or (a+c). Grey literature, defined as CPGs outside of the peer-reviewed literature, were identified from Google Search and targeted websites from Grey Matters: A Practical Tool for Searching Health-Related Grey Literature (hereafter referred to as “Grey Matters”) [ 38 ].

Reference list.

Reference lists of scoping and systematic reviews and CPGs identified from the databases and the grey literature search were manually reviewed for CPGs that met inclusion criteria.

Study selection

Eligibility criteria..

CPGs for TBI and CPGs for CJS were screened separately. Only CPGs that met the eligibility criteria outlined in the PICAR statement [ 39 ] presented in Table 1 were included in this review.

https://doi.org/10.1371/journal.pmed.1004418.t001

EndNote X8 [ 40 ] was used for reference management and de-duplication, and Covidence [ 41 ] was used for de-duplication and study selection. Two independent reviewers (ZC, MJE, JMJ, or SH) screened all articles. Prior to formal title and abstract screening and full-text screening, a pilot screen of 20 articles and 10% of full-text articles, respectively, was conducted until a minimum 80% agreement was achieved between 2 independent reviewers. At the title and abstract screen, articles that focused on (a) the broader brain-injured population without specific mention of TBI or (b) non-criminal aspects of the legal system were included for the full-text screen to confirm whether they focused on the populations with TBI or those involved with the CJS. Scoping and systematic reviews of CPGs for TBI or CJS-involved individuals were also included and their reference lists were manually reviewed to identify additional CPGs not retrieved from the search. All non-English language CPGs were translated and assessed for eligibility using the English full-text translation, DeepL Translate, Google Translate, DocTranslate, or reviewers with knowledge of the language. CPGs that could not be translated were excluded and documented in the PRISMA flow chart. Discrepancies were resolved through consensus or by consulting a third reviewer (VC). The PRISMA flow chart [ 42 ] ( Fig 1 ) illustrates the study selection process for peer-reviewed literature.

Two independent reviewers (ZC, MJE, JMJ, or SH) assessed all items on the Grey Matters checklist and the first 10 pages of Google Search to identify potentially relevant websites using the title and/or short text underneath the title. At the title and abstract screen, the executive summaries and/or table of contents were reviewed if an abstract was not available. Similar to the study selection of peer-reviewed literature, CPGs that focused on (a) the broader brain-injured population without specific mention of TBI; or (b) non-criminal aspects of the legal system were also considered for full-text review to confirm that they focused on populations with TBI or those involved with the CJS. Abstracts or executive summaries not in the English language were translated and assessed using identical procedures to the peer-reviewed literature screening. CPGs were then screened using the eligibility criteria outlined in Table 1 for the full-text screen. The PRISMA flow chart [ 42 ] ( Fig 1 ) illustrates the study selection process for grey literature.

Similar to the grey literature screening, items identified from the reference list searches were added to an Excel file to generate a list of additional articles for review. Duplicates previously identified from the peer-reviewed and grey literature searches were removed prior to screening. The PRISMA flow chart [ 42 ] ( Fig 1 ) illustrates the study selection process for the reference list search.

Data extraction and synthesis

The method for data extraction and synthesis was adapted from Tannenbaum and colleagues’ review of CPGs for sex and gender considerations [ 43 ], which involved grouping or categorising CPGs into (1) text-positive and text-negative CPGs (see S1 Data ); and (2) specific characteristics.

First, the content and reference lists of CPGs were assessed for (a) keywords for TBI and CJS involvement; and (b) content related to the definitions displayed in Table 2 . CPGs were then categorised into text-positive and text-negative CPGs. Text-positive CPGs for TBI and CPGs for CJS were guidelines that contained at least one of the keywords for and content consistent with the definition of CJS involvement and TBI, respectively. Text-negative CPGs for TBI and CPGs for CJS were guidelines that, within the body of their text, did not contain keywords or content related to the definition of CJS involvement or TBI, respectively.

https://doi.org/10.1371/journal.pmed.1004418.t002

Text-positive and text-negative CPGs were then further categorised by 2 independent reviewers (ZC, MJE, JMJ, or SH) using the categories and definitions outlined in Table 3 . Data (i.e., quotes) that were used to categorise the guidelines were extracted. S1 Data presents the data extraction and synthesis for this systematic review.

https://doi.org/10.1371/journal.pmed.1004418.t003

Narrative synthesis, informed by the Guidance on the Conduct of Narrative Synthesis in Systematic Reviews [ 45 ], was conducted. CPGs were grouped based on their characteristics (e.g., country, type of guideline, target audience), in addition to text-positive and text-negative categories. Tabulation (defined in Table 3 ), qualitative content analysis of text-positive CPGs, and quality appraisal were used to address the objectives of the review. Qualitative content analysis [ 46 ] were used to evaluate how evidence regarding TBI and CJS was integrated in CPGs for CJS and CPGs for TBI, respectively.

Quality appraisal

Two independent reviewers (JMJ, MJE, or SH) completed quality appraisal using the equity lens from Dans and colleagues [ 21 ] and the equity extension from the GRADE working group [ 32 , 47 – 49 ] to assess equity considerations in included CPGs. Any technical, methodological, or supporting documents associated with the CPGs included in the review were retrieved to inform the quality appraisal process [ 39 ].

Sixty-three unique CPGs (4 of which were non-English language) met the eligibility criteria. Of these 63 CPGs, 6 were CPGs for CJS [ 50 – 55 ] and 57 were CPGs for TBI [ 56 – 120 ]. Table 4 presents the characteristics of included CPGs.

https://doi.org/10.1371/journal.pmed.1004418.t004

Inclusion of CJS information in CPGs for TBI

Fourteen CPGs for TBI (24.6%) were text-positive for CJS-related keywords or content [ 57 , 75 , 76 , 81 , 82 , 84 , 86 , 90 , 97 , 102 , 106 , 112 – 120 ]; one CPG provided an evidence-based recommendation for individuals with CJS involvement (i.e., category 1) [ 97 ], 7 acknowledged or made reference to data regarding individuals with CJS involvement without recommendations (i.e., category 2) [ 57 , 81 , 84 , 86 , 90 , 112 – 117 , 119 , 120 ], and 6 mentioned individuals with CJS involvement without providing context related to the literature or recommendations (i.e., category 3) [ 75 , 76 , 82 , 102 , 106 , 118 ].

Three CPGs mentioned CJS-related keywords in the context of TBI evaluation in the CJS [ 86 , 97 , 102 ], one of which provided a concrete recommendation regarding vocational evaluation in the forensic context, noting that evaluators must consider medical-legal contexts during vocational evaluation, as they can influence the validity, completion, and reporting of evaluation findings [ 97 ]. One incorporated history of arrests in a checklist for behavioural affective symptoms associated with TBI [ 102 ] while the other identified prison inmates as a group who may not have received an initial assessment despite sustaining a TBI [ 86 ] but did not provide further recommendations.

Three CPGs reported on the role of CJS staff in increasing awareness about TBI, but did not provide recommendations for individuals with TBI who intersect with the CJS [ 81 , 82 , 84 ]. These CPGs highlighted the role of police officers in encouraging patients to immediately seek medical advice regarding TBI that they or others have sustained, regardless of injury severity [ 82 ], and ensuring that patients with TBI understand the risks of not being transported to the hospital following a head injury [ 81 ]. One CPG highlighted the need for TBI rehabilitation programs to increase awareness regarding TBI through information and education activities regarding the challenges and needs of individuals with TBI. This CPG listed police and parole officers under groups most likely to encounter individuals with TBI [ 84 ].

Three CPGs mentioned CJS keywords when associating TBI with criminal behaviour [ 86 , 112 – 117 , 119 , 120 ]. One CPG noted that symptoms of TBI (e.g., cognitive impairments, functional disability, and difficulties regulating emotions) can hinder return-to-work and lead to impairments in interpreting social situations, thereby increasing individuals’ susceptibility to criminal behaviour [ 112 – 114 , 116 , 117 , 119 , 120 ]. Another CPG acknowledged the positive correlation between TBI and incarceration among Māori people [ 86 ]. The same CPG also noted the presence of sexually aberrant behaviours following TBI that can lead to sexual offences against medical staff, patients, and their families [ 86 ].

Two CPGs integrated CJS keywords in return-to-work considerations [ 81 , 86 ], specifically police, criminal record, litigation, and legal requirements when helping an individual return to work [ 81 ]. For example, the CPG noted the need for the person with TBI and their caregivers to be informed regarding legal requirements for driving (e.g., log books, licencing procedures, and license revocation procedures) and fitness-to-drive post-injury [ 81 , 86 ].

Five CPGs integrated CJS-related information when reporting on guideline development [ 75 , 76 , 86 , 106 , 118 ]. One CPG listed police associations as a target user of the CPG [ 118 ], while 2 mentioned lawyers and physicians working in prison in the groups that contributed to the development recommendations [ 75 , 76 ]. One CPG included an explanation of the guideline development process and listed “effective identification of TBI in prisons” as part of the agreed-upon list of topics to be covered by the guideline [ 86 ]. One reported not including literature on aggression among prison populations, as it was too difficult to generalise to the larger population of individuals with brain injury [ 106 ].

Some CPGs included CJS-specific keywords in contexts not relevant to individuals with TBI who intersect with the CJS. Such contexts include child abuse reporting [ 57 ], concussions and physical therapy for police officers [ 90 ], medico-legal implications or ramifications of appropriate TBI evaluations [ 85 ], and the utilisation of pharmacologic treatments [ 76 ]. The proportion of text-positive and text-negative CPGs for TBI for each category is summarised in Fig 2 .

CJS, criminal justice system; CPG, clinical practice guideline; TBI, traumatic brain injury.

https://doi.org/10.1371/journal.pmed.1004418.g002

Inclusion of TBI information in CPGs for CJS

Two CPGs for CJS (33.3%) were text-positive for TBI keywords [ 50 , 51 ]. The National Institute for Health and Care Excellence (NICE) 2017 guideline for mental health in the criminal justice system referenced epidemiological data regarding individuals with TBI without recommendations (category 2) [ 50 ], specifically noting the prevalence of TBI among individuals in prison compared to the general population. The NICE 2016 guideline for physical health of people in prison provided evidence-based recommendations for individuals with TBI (i.e., category 1), [ 51 ] to consider head injury in health assessments for all individuals in prison. Specifically, at first reception into prison, healthcare professionals should assess physical injuries (including head injuries) and document any treatments received. Further questions concerning the frequency of head injuries and/or loss of consciousness (LOC), the duration of the LOC, and difficulties with memory or concentration should then be asked during the second-stage health assessments [ 51 ]. The remaining 4 CPGs for CJS were text-negative and included no keywords or content specific to TBI within the body of the guidelines or their reference lists. The proportion of text-positive and text-negative CPGs for CJS for each category is summarised in Fig 2 .

CPGs for CJS were often cognizant of equity issues as these guidelines were developed specifically for individuals intersecting with the CJS, a disadvantaged population. All CPGs for CJS offered distinct recommendations for those who are disadvantaged [ 50 – 55 ]; 4 (66.7%) noted differences in disease epidemiology between privileged versus disadvantaged populations [ 50 , 52 , 54 , 55 ], and 5 (83.3%) addressed the burden of disease on disadvantaged groups [ 50 , 52 – 55 ], provided solutions to barriers that hinder the implementation of recommendations in these populations [ 50 – 52 , 54 , 55 ], and evaluated data on cost, resource use, impact on equity, acceptability, and viability of interventions for populations that were disadvantaged [ 50 – 54 ].

A minority of CPGs for CJS reported involving disadvantaged groups in the development of the guideline. Two CPGs (33.3%) involved disadvantaged groups in their guideline development group and consulted them in determining the value of interventions and their outcomes [ 50 , 51 ]. None reported considering representatives from pertinent groups that were disadvantaged when ascertaining target audiences of the guidelines or recruiting methodologists or voting panel chairs who were familiar with equity issues.

Equity considerations in searching, synthesising, and reporting evidence on disadvantaged groups were often present in CPGs for CJS. Five CPGs (83.3%) reported searching for evidence specific to populations that were disadvantaged [ 50 – 54 ], and 2 (33.3%) explored databases for intervention outcomes that were critical to disadvantaged populations, addressed evidence from non-health-related disciplines that consider disadvantaged populations, and made considerations for equity when specifying the evidence eligibility criteria [ 50 , 51 ]. Three CPGs were published after the development of the PRISMA-equity statement [ 50 , 51 , 55 ]; however, none reported following the PRISMA-equity statement when reporting findings of systematic reviews and including good practice statements that address equity issues.

The majority of CPGs for CJS provided recommendations related to the implementation of the guidelines. Two offered specific tools for implementing the guidelines [ 50 , 51 ]; 5 provided clarifications for recommendations to ensure that the guideline is properly implemented [ 50 – 54 ], and offered strategies to monitor groups according to PROGRESS-plus elements [ 50 – 52 , 54 , 55 ]. One had recommendations related to monitoring the use of the guideline among disadvantaged groups [ 50 ].

Four CPGs for CJS were devoted entirely to singular health issues (hepatitis viruses [ 53 – 55 ] and mental health [ 50 ]). CPGs for CJS included considerations for culture [ 50 , 52 , 54 , 55 ], race and/or ethnicity [ 50 – 52 , 54 , 55 ], geographic location and proximity to medical care [ 50 , 51 ], financial status [ 51 , 52 ], disability [ 50 , 51 , 54 ], as well as sexual identity, sex, and gender [ 50 – 52 , 54 ]. However, these considerations were often only present in the reporting or synthesis of evidence and rarely in the guidelines’ list of recommendations. Specifically, only 2 of the 6 CPGs for CJS included evidence-based recommendations that highlighted disability [ 50 , 51 ] and only 4 highlighted gender or sex [ 50 – 52 , 54 ] and race or ethnicity [ 50 , 52 , 54 , 55 ].

Quality appraisal results of CPGs for CJS are presented in S2 Data and Fig 3 . Please refer to a separate systematic review on assessing equity for CPGs for TBI and homelessness for the equity assessment of CPGs for TBI [ 24 ].

CJS, criminal justice system; CPG, clinical practice guideline.

https://doi.org/10.1371/journal.pmed.1004418.g003

To the best of our knowledge, this is the first systematic review to explore the extent to which CPGs for TBI consider CJS intersection or involvement and, likewise, the degree to which CPGs for CJS consider TBI. This review also evaluated equity considerations in CPGs for CJS. Findings show that evidence-based recommendations for individuals with TBI who intersect with the CJS and equity considerations are lacking in CPGs for TBI and CPGs for CJS. We identified the following opportunities to advance equity in healthcare for individuals with TBI who intersect with the CJS: (1) conduct research with disadvantaged groups; (2) investigate TBI screening in all parts of the CJS, and (3) utilise equity assessment tools in guideline development.

First, there is an urgent need to conduct research with disadvantaged groups to build the evidence base on the intersections of TBI, CJS, health equity, and SDoH. Our findings showed the lack of specific evidence-based guidance regarding TBI care for individuals who intersect with the CJS. While a quarter of CPGs for TBI included CJS keywords, only one provided a concrete evidence-based recommendation regarding vocational evaluation for individuals who intersect with the CJS [ 97 ]. In contrast, only two of the CPGs for CJS included were text-positive for TBI, and only one of the two provided a specific recommendation to consider TBI when assessing the health of individuals in prison [ 51 ]. Specifically, individuals should be asked if they ever suffered a head injury or lost consciousness. Follow-up questions should include the number of times they suffered a head injury or lost consciousness, how long they were unconscious, and whether or not they have challenges with memory or concentration [ 51 ]. However, no specific instruments or tools to screen for a TBI were recommended. Policing and corrections were the predominant focus in CPGs for TBI and CPGs for CJS, with the courts, parole, and probation systems being largely neglected. It is also worth noting that 4 out of 7 CPGs that focused on policing were focused on police officers as patients themselves and not necessarily police interactions with individuals with TBI. The largely singular focus of the CPGs is likely due to the overwhelming focus of research on the CJS on persons who experience incarceration [ 122 ]. However, other parts of the CJS, such as parole, probation and courts, require equal attention, given the overrepresentation of TBI among persons on probation [ 9 ], the lower rates of successful probation completion among those with TBI, and the difficulties experienced by individuals with TBI in comprehending legal language [ 123 ]. More research focusing on, and with individuals who intersect with all parts of the CJS, is needed to build the evidence base and advance care for this population.

Second, this review identified an opportunity to investigate TBI screening in all parts of the CJS. For decades, public health organisations such as the Centers for Disease Control and Prevention have recognised the high prevalence of TBI in individuals intersecting with the CJS as a public health problem [ 124 ]. However, to date, TBI screening is inconsistently implemented in the CJS [ 125 – 127 ] due to a lack of funding and staff, poor awareness of TBI, and high rates of turnover among individuals in prison [ 126 ]. The findings of this systematic review echo this contrast. While a significant portion of TBI guidelines recognised intersections with the CJS as an important consideration, screening for TBI was not mentioned; only 1 out of 6 CJS CPGs recommended inquiring about head injuries when assessing the physical health of individuals in prison [ 51 ]. Importantly, several studies have reported on the potential benefits of screening for TBI in the CJS. A scoping review on rehabilitation programs for individuals with TBI who intersect with the CJS found that TBI screening is a crucial first step in the identification of unmet needs and the development of individualised intervention plans for this group [ 127 ]. Another study found that the aggressive and violent behaviours often exhibited by individuals with TBI are correlated with recidivism, and TBI screening in correctional facilities can be used to identify individuals at risk for reoffending, advise inmate behavioural management, and improve their safety [ 128 ]. These findings acknowledge the potential of TBI screening in supporting individuals with TBI. However, despite these potential benefits, we also recognise that screening for TBI may come with the risk of being identified as someone with a potential cognitive disability, which could put persons in the CJS at further risk of victimisation. As such, there is a clear need to further explore and understand the best way to incorporate screening for TBI in all parts of the CJS. Considerations for screening, including duration of screening, recommended tools and resources, procedures and supports following screening, and communication of screening results between different levels of the CJS and the community need to be explored through future research. Such information will also inform the feasibility, processes, and implications of screening for TBI in all parts of the CJS [ 127 ].

Lastly, through our assessment of equity, we identified a need to utilise equity assessment tools in guideline development and to incorporate considerations for disadvantaged groups into the evidence-based recommendations. CPGs for CJS lacked good practice statements and did not report using the PRISMA equity statement even though half were published after the statement’s publication in 2012. Considerations for race or ethnicity, financial status, and disability were largely absent from the recommendations. These considerations are important to include, as SDoH such as sex, gender, race, disability, and financial status can implicate the relevance and efficacy of the recommended interventions. Incorporating these equity best practices in the formulation of recommendations and using equity assessment tools in the development of CPGs are necessary first steps to reduce healthcare disparities between privileged and disadvantaged populations. Ultimately, the findings from this review provide a foundation to address equitable healthcare for individuals with TBI who intersect with the CJS.

While our review addressed an important gap in the literature regarding TBI, CJS, and equity considerations in CPGs, we recognise the following limitations. First, we did not systematically search for research on individuals with TBI who intersect with the CJS, outside of CPGs. As such, we are unable to comment on evidence that is not integrated into existing CPGs. Second, while we did not place restrictions on language or country in our search, our searches were conducted in English language. As such, we may have missed other non-English language CPGs in this review. Finally, although our eligibility criteria were selected in accordance with guideline development best practices [ 129 ], selecting only CPGs that rated the strength of their recommendations may have resulted in the exclusion of CPGs from certain lower-income countries, where rating the level of evidence or recommendations is a less prevalent or not commonly reported practice [ 130 , 131 ].

Despite these limitations, our systematic review is strengthened by its application of the externally peer-reviewed and published protocol of a systematic review that was conducted in tandem with this review [ 25 ], as well as the rigorous search strategy. Validated search filters for CPGs [ 33 ] and methodological guides to searching grey literature [ 37 , 39 ] were used to increase transparency and replicability. Additionally, our search strategy for searching grey literature was a core strength, particularly given the enhanced precision that has been shown to be associated with searches beyond bibliographic databases [ 33 ]. Furthermore, this systematic review assessed numerous key facets of the CJS, thus providing a comprehensive overview of CJS intersection. This was important because although research on individuals in correctional facilities is ample, the remaining facets of the CJS are largely neglected. As such, our systematic review highlights the gaps in the literature regarding the court, sentencing, and parole systems [ 132 ]. Lastly, through the identification of text-positive CPGs, we have established a collection of CPGs for TBI that address the needs of those within the CJS and CPGs for CJS that address individuals with TBI, which serve as a foundation for individuals providing TBI care in forensic settings.

Collectively, this systematic review highlights a lack of published guidance for the care of individuals with TBI who intersect with the CJS and an overwhelming need to recognise healthcare inequities for individuals intersecting with the CJS and take meaningful action to address current gaps in guidance for care delivery. Critical next steps in advancing equity and healthcare for this disadvantaged group include continuing to grow an evidence base for the intersection of TBI and CJS care, addressing the vulnerabilities stemming from brain injury that are unique to those who intersect with the CJS within our approaches to care, exploring opportunities to screen for TBI across all facets of the CJS to understand the impacts of brain injury among those who intersect with the CJS, and utilizing equity assessment tools in the development and implementation of CPGs. Furthermore, it is important that CPGs make considerations for the differing needs of distinct populations and address relevant SDoH, such as sex, gender, and race, as the healthcare needs, effectiveness of clinical recommendations, and structural barriers for different groups can vary substantially. Achieving these goals will be a step forward in delivering high-quality care for disadvantaged populations experiencing TBI.

Supporting information

S1 table. prisma checklists..

https://doi.org/10.1371/journal.pmed.1004418.s001

S1 Text. Search strategy.

https://doi.org/10.1371/journal.pmed.1004418.s002

S1 Data. Data extraction and synthesis.

https://doi.org/10.1371/journal.pmed.1004418.s003

S2 Data. Quality appraisal tables.

https://doi.org/10.1371/journal.pmed.1004418.s004

Acknowledgments

We would like to acknowledge Adam Mohammad for editorial review of the data extracted and the PAC of the Traumatic Brain Injury in Underserved Populations Research Program for their feedback on this systematic review.

The views expressed in this publication are those of the authors and do not necessarily reflect those of the Ministry of Health.

• View Article
• PubMed/NCBI
• Google Scholar
• 18. American Academy of Family Physicians. Clinical Practice Guideline Manual. 2022 [cited 2022 Aug 3]. Available from: https://www.aafp.org/family-physician/patient-care/clinical-recommendations/cpg-manual.html .
• 20. World Health Organization. Health Equity. Available from: https://www.who.int/health-topics/health-equity#tab=tab_1 [cited 2022 Aug 3].
• 27. Rethlefsen MLKS, Waffenschmidt S, Ayala AP, Moher D, Page MJ, Koffel JB. PRISMA-S Group. PRISMA for Searching. 2021 [cited 2021 Oct 20]. Available from: http://www.prisma-statement.org/Extensions/Searching .
• 29. Bureau of Justice Statistics. The Justice System. 2021 [cited 2022 May 27]. Available from: https://bjs.ojp.gov/justice-system .
• 30. Correctional Service Canada. Section 3 ‐ Federal Corrections and the Criminal Justice System. 2007 [updated 2008 Apr 17; cited 2022 May 27]. Available from: https://www.csc-scc.gc.ca/text/pblct/sb-go/03-eng.shtml .
• 31. Crown Prosecution Service. The Criminal Justice System | The Crown Prosecution Service. 2017 [cited 2022 May 27]. Available from: https://www.cps.gov.uk/about-cps/criminal-justice-system .
• 38. The Canadian Agency for Drugs and Technologies in Health (CADTH). Grey matters: A practical tool for searching health-related grey literature Ottawa: CADTH; 2018 [cited 2021 October 20]. Available from: https://www.cadth.ca/grey-matters-practical-tool-searching-health-related-grey-literature-0 [accessed 2024 May 14].
• 40. The EndNote Team. EndNote. EndNote X8 ed. Philadelphia, PA: Clarivate; 2013.
• 41. Veritas Health Innovation. Covidence Systematic Review Software. Melbourne, Australia; 2021.
• 50. National Guideline Alliance. National Institute for Health and Care Excellence: Guidelines. Mental health of adults in contact with the criminal justice system: Identification and management of mental health problems and integration of care for adults in contact with the criminal justice system. London: National Institute for Health and Care Excellence (NICE) Copyright © National Institute for Health and Care Excellence, 2017; 2017.
• 51. National Guideline Centre. Physical Health of People in Prison: Assessment, Diagnosis and Management of Physical Health Problems. London: National Institute for Health and Care Excellence (NICE). 2016 [accessed May 24].
• 53. Saiz de la Hoya-Zamácola P, Marco-Mouriño A, Clemente-Ricote G, Portilla-Sogorb J, Boix-Martínez V, Núñez-Martínez O, et al. Expert recommendations for the diagnosis and treatment of chronic hepatitis C infection in the prison setting. Enferm Infecc Microbiol Clin. 2006;24(9):568–575. doi: https://doi.org/10.1157/13093878
• 65. French Language Neuroanesthesia and Resuscitation Association SAfF, French Society of Neurosurgery, French Society of Neuroradiology, French Language Resuscitation Society, French Society of Anesthesia and Resuscitation, French Pediatric Society, Francophone Society of Medical Emergencies. Management of cranial injuries early-phase. 2000;81:643–8.
• 81. Motor Accidents Authority New South Wales. Guidelines for mild traumatic brain injury following closed head injury. 2008 [accessed 2022 Aug 18].
• 82. National Institute for Health and Care Excellence. Head injury: assessment and early management. 2014 [accessed 2022 Aug 18].
• 83. National Institute of Excellence in Health and Social Services (INESSS). Assessment and management of the risk of serious neurological complications following mild traumatic brain injury. 2021 [accessed 2022 Aug 18].
• 84. National Institute of Excellence in Health and Social Services (INESSS) ONF. CLINICAL PRACTICE GUIDELINE FOR THE REHABILITATION OF ADULTS WITH MODERATE TO SEVERE TBI. 2016 [accessed 2022 Aug 18].
• 85. New South Wales Ministry of Health. Initial management of closed head injury in adults. 2011 [accessed 2022 Aug 18].
• 86. New Zealand Guidelines Group. Traumatic brain injury: Diagnosis, acute management and rehabilitation. The Terrace, Wellington, New Zealand; 2006 [accessed 2022 Aug 18].
• 87. Ontario Neurotrauma Foundation. Guideline for Concussion/Mild Traumatic Brain Injury & Prolonged Symptoms. 2018 [accessed 2022 Aug 18].
• 88. Ontario Neurotrauma Foundation. Living Guideline for Pediatric Concussion Care. 2021 [accessed 2022 Aug 18].
• 89. Pediatric mTBI Guideline Workgroup. Systematic Review and Clinical Recommendations for Healthcare Providers on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children. 2016 [accessed 2022 Aug 18].
• 94. Scottish Intercollegiate Guidelines Network. Early management of patients with a head injury: A national clinical guideline. Hillside Crescent, Edinburgh; 2009 [accessed 2022 Aug 18].
• 100. The Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury Work Group. VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT AND REHABILITATION OF POST-ACUTE MILD TRAUMATIC BRAIN INJURY. 2021 [accessed 2022 Aug 18].
• 101. The Management of Concussion-mild Traumatic Brain Injury Working Group. VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF CONCUSSION-MILD TRAUMATIC BRAIN INJURY. Department of Veterans Affairs, Department of Defense. 2016 [accessed 2022 Aug 18].
• 111. Workplace Safety and Insurance Board. MILD TRAUMATIC BRAIN INjURYPROGRAM OF CARE. 2012 [accessed 2022 Aug 18].
• 115. Physicians ACoE. Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department with Mild Traumatic Brain Injury. 2023.
• 121. National Clinical Guideline C. National Institute for Health and Clinical Excellence: Guidance. Head Injury: Triage, Assessment, Investigation and Early Management of Head Injury in Children, Young People and Adults. London: National Institute for Health and Care Excellence (UK) Copyright National Clinical Guideline Centre; 2014.
• 124. Centers for Disease Control and Prevention. Health Disparities and TBI. 2021 [updated 2021 May 12]. Available from: https://www.cdc.gov/traumaticbraininjury/health-disparities-tbi.html#print [accessed 2022 Dec 14].
• 128. Coid J. Correctional populations: Criminal careers and recidivism. Washington, DC: American Psychiatric Publishing; 2005.
• 129. Medicine Io. Clinical Practice Guidelines We Can Trust. Graham R, Mancher M, Wolman DM, Greenfield S, Steinberg E, editors. Washington, DC: The National Academies Press; 2011. p. 290.
• 131. American Academy of Family Physicians. Grading Evidence and Strength of Recommendation (CMSS-P 6; IOM Standards 5 and 6). 2017. Available from: https://www.aafp.org/family-physician/patient-care/clinical-recommendations/cpg-manual.html#ix .