Improving care for women in prison living with severe mental illness

Research led by Fuse Associate, Professor Tammi Walker at Durham University, is helping to improve understanding of how healthcare can better support women in prison living with severe mental illness.

Women in the prison system often experience complex mental and physical health difficulties. These challenges can be particularly acute for women from racial minority backgrounds. Professor Walker’s research highlights how aspects of the prison environment can make it difficult to meet these needs effectively.

Professor Walker co-led the IP-SIS (Improving Services for Imprisoned Women with Severe Mental Illness) study funded by the National Institute for Health and Care Research (NIHR) with Professor Carolyn Chew-Graham at Keele University, which examined how primary care services for imprisoned women could be improved. She also led a second study funded by NIHR Three Schools Mental Health Programme focusing on how women with lived experience of imprisonment can play a central role in shaping research and services.

Professor Walker was able to access this funding through Durham University’s membership of Fuse, which in turn is part of the NIHR School for Public Health Research, one of the three NIHR schools in the NIHR Three Schools collaboration.

The IP-SIS study found that the prison regime itself can create barriers to accessing healthcare. Limited time out of cells, pressures on staff resources, and periods of restricted movement can all mean that healthcare appointments are disrupted or missed. These insights point to opportunities to strengthen how care is delivered within existing systems.

“What’s been most important in this work is doing it alongside women with lived experience.”

Professor Walker, Fuse Associate from Durham University

A key feature of the work has been its strong emphasis on lived experience. The research team worked closely with a Lived Experience Advisory Group (LEAG), made up of women who have experienced imprisonment, to ensure their perspectives shaped both the research and its outputs. This was convened by Co-investigator Paula Harriot, CEO of Unlock, a charity which supports and advocates for people with criminal records in England and Wales to be able to move on positively in their lives.

Additional funding from the NIHR Three Schools Mental Health Programme supported this aspect of the work, enabling the team to co-produce practical resources with members of the group. These include materials for women entering prison, a video on involving lived experience in research, and a toolkit for researchers working with women who have experience of imprisonment.

Reflecting on the work, Professor Walker, Professor of Forensic Psychology at Durham University, said: “What’s been most important in this work is doing it alongside women with lived experience. Through meaningful PPIE, and with Paula Harriot’s leadership of the LEAG, we’ve been able to make sure those voices genuinely shape the research. We’re also very grateful to the NIHR for supporting this work. For us, that’s a feminist commitment not just listening to women but taking their knowledge seriously and building it into change.”

The findings were recently presented at a House of Lords event hosted by Baroness Sara Hyde, bringing together policymakers, researchers, and senior stakeholders from across the prison and health systems. The event highlighted the importance of co-produced research in informing more effective and inclusive healthcare provision.

The next phase of the work will focus on developing more person-centred and ethnically sensitive approaches to care, ensuring that services better meet the needs of women in prison with severe mental illness.

Free Resource:

The free NIHR-funded Lived Experience Research Toolkit (Health and Justice) is now available via the ‘Resources’ section of Professor Walker’s website. You are asked to complete a very short form beforehand, as this helps us understand how it is being used and how we can continue to improve it.

You can access it here: https://healthjusticeforensicresearch.webspace.durham.ac.uk/

Publication:

Roden-Lui G, Chew-Graham CA, Hard J, et al. Improving primary care services for imprisoned women with severe mental illness (IP-SIS) Protocol Paper. https://openresearch.nihr.ac.uk/articles/5-14

Photo by Ye Jinghan on Unsplash

Last modified: Wed, 17 Jun 2026 10:06:31 BST