Table 3.

Study characteristics

Author, year and Country	Ethical approval	Study aim and methodology	Data collection methods	Recruitment methods	Data collection process	Data analysis	Findings/key themes
Plugge et al. (2008) Southern England	South East Multicentre Research Ethics Committee (04/MRE01/14)	To explore women prisoners’ experiences of health care provision as part of a wider project examining the health impact of imprisonment on women. Qualitative descriptive (inferred)	Focus groups ×6: Participants (n = 37) Audio recorded Semi-structured, individual interviews: Participants (n = 12) Audio recorded	Focus groups –purposive sampling using local inmate directory Interviews – convenience sampling from women participating in a longitudinal questionnaire over a 3-month period	Location: focus groups – held in a private room in the prison health centre Interviews – held in private room in the prison health centre	Thematic analysis (framework not reported) N-vivo (v7)	Application process to access health care is a protracted process. Nurses perceived as “gatekeepers” and “bodyguards” Health-care staff competence questioned by participants “rejects”, “unprofessional”, unqualified” Lack of privacy when discussing health care issues
Bowen et al. (2009) England & Wales	South East Multi-Centre Research Ethics Committee	Drawing on narrative accounts of prisoners and the staff they must negotiate, this paper considers the prescribing and taking of medication related to the management of mental health problems in a prison context. Qualitative – narrative synthesis	Semi-structured, individual interviews: Participants (n = 39) Audio recorded Non-participative observation	Purposive sample of: Those known to have a recent history of mental disorder Were currently withdrawing from drug/alcohol misuse Had experience of processes for the management of suicide/self-harm Had been in prison for at least two weeks and less than approximately 8 months	Interview location: not stated Interview privacy: Not stated Non-participative observation location: Reception, induction, residential, in-patient and detoxification units. Participant observation duration: between 2 and 7 h in each location.	Thematic analysis closely following Miles and Huberman (1984) “Drawing Valid Meaning from Qualitative Data: Toward a Shared Craft”	Autonomy – lack of autonomy impacted the women’s ability to self-manage Lack of personal control over medication taking Changes to medication regimes disruptive to routines and cause anxieties, confusion and distress Anti-therapeutic relationships between participants and staff
Kenning et al. (2010) North West England Ealing and West London Mental Health Trust Ethics Committee	Central and Eastern Cheshire Primary Care Trust.	To compare attitudes of women prisoners who self-harm with the attitudes and perspectives of different prison staff and to examine the possible impact on the delivery and development of prison services. Qualitative descriptive (inferred)	Semi-structured, individual interviews Participants (n = 15) Audio recorded	Purposive sample according to where the women prisoners were housed within the prison.	Interview location: not stated	Grounded Theory	Health care staff were positively perceived. Prison officer staff perceived as “cold” Imported factors (modifiers brought in to prison by women) relating to self-harm behaviours such as past histories of abuse Situational factors (modifiers existing as a result of the women’s current situations) such as being on basic regime The purpose of self-harming behaviours was to control feelings of anger, frustration or a form of self-punishment
Marzano et al. (2011) England and Wales	Central Office for Research Ethics Committee (06/MRE12/83) Prison Service (PG 2006 063)	To identify socio-demographic, criminological and psychological variables associated with near-lethal self-harm. To provide further understanding of this behaviour and inform preventative initiatives. Mixed-methods (qualitative methods were descriptive, inferred)	Semi-structured, individual interviews Participants (n = 120) (60 with a history of self-harm, 60 with no history of self-harm) Audio recorded	Purposive sample of women who engaged in potentially lethal methods of self-harm	Interview location: Private room	Thematic analysis (no framework reported) N-Vivo (v8)	Negative relationships with staff were reported as antecedents to near-lethal self-harm. Being treated better by prison staff reported as a way to prevent self-harm behaviours in addition to not being in prison, having more distractions and time out of cell, more help with mental health problems, reduced access to means to self-harm, being in a shared cell and receiving counselling
Caulfield (2016) England	Associated University	To explore the suggestion that the prison environment exacerbates the incidence and severity of mental health issues. Qualitative descriptive (inferred)	Semi-structured, individual interviews Participants (n = 43) Audio recorded	Convenience sample using letters, posters, peer recruiters, prison officer recruiters, a prison television interview	Interview location: Not stated Privacy: only researcher and research participant present	Thematic analysis (no framework reported) N-Vivo	Positive experiences about prison-based health care included having access to therapy/prescriptions on a regular basis Being employed helped to reduce symptoms of depression Doctors advising that medication would suffice when counselling requested
Ahmed et al. (2016) Canada	University of Alberta Health Ethics Research Board	To report on female inmates’ perceptions of the barriers they face when accessing health care during incarceration, the impact this has on health during incarceration and in the community and implications for correctional health care practice. To show how these were used to inform the development of a resource aimed at improving functional health literacy regarding accessing correctional health care services Qualitative descriptive (inferred)	Focus groups Participants (n-12) Audio recorded	Purposeful sample from general correctional facility population meeting eligibility criteria for participation	Focus group location: Not stated	Thematic analysis (no framework reported). N-Vivo 10	Participants reported being unaware of services available to them because they did not see care being provided or because of poor health literacy Not being able to take a taxi to a medi-centre and manage self Being afraid of asking for help or further information when required Feeling “sloughed off” by staff Health care applications being sent back Having information provided that’s too simplistic and not reflective of the seriousness of the subject matter Reading other prisoners health care application forms
Jacobs and Giordano (2018) USA	All procedures in accordance with ethical standards of the national and/or institutional research committee and 1964 Helsinki Declaration	To illuminate service recipient’s perspectives on jail mental health care. To identify the elements of care most salient to participants while obtaining a unique perspective on service potential and limits. Qualitative inductive utilising techniques from Interpretative Phenomenology and Constructivist Grounded Theory	Semi-structured, individual interviews Participants (n = 19) Audio recorded	Purposeful sample of those who have a psychiatric diagnosis, had at least two experiences of jail detainment in the county, one of which occurring within two years of the interview	Interview location: Not stated	Techniques used in Constructivist Grounded Theory Techniques used in Interpretive Phenomenology	When medication regimes were adjusted this was mentally and physically harmful as well as discriminatory Assessment of mental health was overlooked on committal to prison No availability of “out of hours” crisis intervention services for prisoners