Involving families in prison healthcare would save lives and relieve pressure on the NHS – new report –

Pact, the national Catholic prison charity, has today (Friday 3rd February) published Nobody’s Listening, a new report which amplifies the voices of families supporting unwell loved ones in prison. The reports key findings include:

  • Prisoners’ mental and physical health at historically low levels following Covid
  • Families too often ‘locked out’ of the system, unable to support their loved-ones who are unwell
  • A more proactive role for families would save lives, as well as relieving pressure on the NHS and reducing reoffending

The reports says that involving families more proactively in prisoners’ healthcare would reduce deaths in custody, relieve pressure on the NHS and the criminal justice system, and cut crime.

Pact (Prison Advice and Care Trust) spoke to families caught up in the criminal justice system, inviting them to share their experience of trying to support loved ones in prison.

The report finds that when families are involved in the process everyone benefits –prisoners, families, the criminal justice system and the NHS. When the system works well it can have a positive impact on people’s health, allowing prisoners to access previously unavailable support.

However, the report concludes that families and significant others are too often locked out of a system that doesn’t value their role as carers. This stores up a range of problems, the ripple effects of which are felt well beyond the prison gates.

The Rt Rev. Richard Moth, Liaison Bishop for Prisons, said he hoped that the report would bring about a “real change” in the prison system.

‘I welcome this report and am very pleased to commend it to you,” said Bishop Moth.

“Particular thanks go to all those who who shared their experiences as family members struggling to support a loved one with health difficulties within the criminal justice system.

“The findings reaffirm a Christian understanding of our connectedness as human beings and especially of the importance of family relationships. It is to be hoped that the report’s recommendations are recognised and inspire real change in a system which so often leaves families feeling unheard and isolated.”

Andy Keen-Downs, Pact CEO, said: “All the research and guidance stress the crucial role that families have in caring for loved-ones who are ill. Families bring with them a wealth of experience and knowledge – they know what ‘well’ looks like and understand the subtle signs that someone is struggling.

“We found examples where the system works well and people’s health had improved while they were in prison. But all too often guidance about family involvement is simply not put into practice, leaving family members locked out, prisoners struggling and a healthcare system under pressure.

“Ensuring that prisoners get access to the right healthcare isn’t just about doing the right thing – it creates safer prison regimes, reduces reoffending and relieves pressure on the NHS.”

In the report, Pact makes a series of recommendations to improve the way that healthcare providers and prisons can involve families more proactively, such as

  • Diverting more appropriately risk-assessed people with mental health problems to community treatment and secure treatment settings
  • Training for staff to ensure that they understand how to involve family members
  • A single point of contact in every prison to champion the role of families in the healthcare process

The report also sets out some of the statistics that illustrate the extent of the health problems facing the prison population:

  • Half of prisoners, and three in five female prisoners, have a mental health problem.
  • Rates of self-harm are near record levels – 684 incidents per 1,000 prisoners.
  • One in three prisoners has a serious drug addiction.
  • Prisoners have a life expectancy 20 years younger than the general population.

‘I was in prison and you visited me.’ If you would like to get involved in the work we do at Pact, please get in touch:


Link to full report


About the Prison Advice & Care Trust (Pact)

Pact is a pioneering national Catholic charity that supports prisoners, people with convictions, and their children and families. We provide caring and life changing services to all, at every stage of the criminal justice process: in court, in prison, on release, and in the community.

Pact’s vision is of a society that understands justice as a process of restoration and healing, uses prisons sparingly and as places of learning and rehabilitation, and values the innate dignity and worth of every human being. We work for the common good of Society, taking a public health-based approach. We work at the intersection of criminal justice, child and family welfare, mental health, wellbeing provision and health and social care.

Our volunteers and staff can be found in courts, prisons, probation services, and in communities across England & Wales.  Building on our Catholic roots, we are a diverse, inclusive, modern, and collaborative charity.  We build effective partnerships and sustainable solutions based on our well-established understanding of the systems in which we work, and on our historic values and ethos developed through our 120+ years of service delivery.

What we do:

  • Build stronger families and safer communities.
  • Reduce risk of harm to prisoners and their children.
  • Remove barriers and increase awareness in public services.
  • Influence commissioning, policy and legislation.



Twitter: @prisonadvice


Instagram: @prisonadvice


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Pact is a charity registered in England & Wales, number 219278.

Company registration number: 356443.

Registered office: 29 Peckham Road, London, SE5 8UA.


Theresa Alessandro, Catholic Community Engagement Manager


T: 07860 720011