Queen's University Belfast

Academic Institute

Michael Donnelly

E072

The exponential rise in drug related deaths (DRD) is a significant United Kingdom public health issue, with a 5-fold increase in Northern Ireland (NI) in the last decade, especially in males aged 25-44 years, and with most DRD involving two or more substances. Prisoners often have a mix of health and care needs, and substance use disorders are common. Preventing DRD amongst the prison population is a major concern for the criminal justice system and public health. The project aims are: (i) to examine health and mental health in prison; (ii) to quantify all-cause and DRD mortality risk post-release from prison; (iii) to characterise those most at risk and (iv) to determine if this is moderated by or specific to those with mental health problems. We anticipate that prisoners’ risk of death is highest shortly after release and will be greatest for those with drug dependencies and who have started replacement therapy, or have mental health issues, and will be most pronounced within the first two weeks of release. Data/methods: This is a joint project between QUB and the NI Healthcare in Prisons SE Trust (Director Dr. R Kirk). It will analyse the linked health records of prisoners and health data held in Business Services Organisation (BSO). This will include date and cause of death, mental health indicators in the Honest Broker Service (HBS) including prescribed psychotropic medication from Enhanced Prescribing Database (Enhanced Prescribing Database) and admissions to psychiatric units. The analysis dataset that the researchers will access will be entirely anonymous; all researchers will have undergone approved safe researcher training and will only analyse the data via the safe setting at BSO.

Background: The exponential rise in drug related deaths (DRD) is a significant UK public health concern, with a 5-fold increase in NI in the last decade, especially in males aged 25-44 years, and with most DRD involving two or more substances. A recent ADR NI report, using linked mortality and 2011 Census records, showed strong socio-economic gradients, though the high proportion of unlinked DRD records was a noted limitation with underrepresentation of homeless or people in communal establishments such as prisons. This is a particular concern, as preventing DRD amongst the prison population is of major concern to the criminal justice system and public health organisations. In utilising existing data held by publicly funded databases, the study is a cost-effective way of using data from key public health resources and answering our research questions using a large and representative population sample. Because this is a joint enterprise with the NI Prisons Healthcare services the study findings should directly impact on the care of prisoners both in prison and post-release.

08/12/2021

TRE