Improving primary care services for imprisoned women with severe mental illness (IP-SIS) Protocol Paper

A gap exists in the provision of care for imprisoned women with Severe Mental Illness (SMI), both in prison and on release to mainstream primary care. Women in such settings tend to have complex mental health problems, often with comorbid long-term physical health conditions (LTCs). These problems are compounded in women who are racially minoritised. The prison regime can be a barrier to addressing health needs of women: limited time out of cell and depletion of staff resources. Little is known about how imprisoned women with SMI use prison primary care services, to what extent services meet health care needs, and how services are experienced by different ethnic groups.

1. To explore the range of primary care services delivered to imprisoned women with severe mental illness (SMI) in England and describe what is working well and the barriers to accessing care.2. To develop a framework for use in women's prison services to support the primary care of racially minoritised women with SMI.

The proposed study comprises of three phases across female prisons in England. Purposive sampling will be used to capture different prison groupings.Phase 1: Semi-structured telephone/online interviews with prison primary care practitioners.Phase 2: Focus groups / one to one dicussions with imprisoned women with SMI, including women from a range of ethnic groups.Phase 3: Consensus groups with prison healthcare and non-clinical staff.

Co-applicant PH will be the PPIE lead, as a lived experience researcher, who supports engagement with imprisoned communities and PPIE in research. She will recruit and facilitate meetings with an ethnically diverse Lived Experience Advisory Group (LEAG), supporting members to participate in the Research Steering Group (RSG) that monitors study progress. She will be supported by Co-applicant HK who has expertise in supporting PPIE in engagement and participation in research.

ISRCTN10216673.