MERCADO DE LA MERCED

Initial code Organising code

Thematic category: knowledge, attitude and behavior

Increased knowledge (pd) Increased knowledge

Increased knowledge (r)

Attitudinal change (pd) Attitudinal change

Attitudinal change (r)

Raised self-awareness and understanding Raised self-awareness and understanding

The role helps peers to accept their own issues/problems

Behavioural change (pd) Behaviour change

Behavioural change (r)

Changes in offending behaviour (pd) Changes in offending behaviour (r) Impact on parole (r)

Thematic category: improved mental health

Increased self-esteem and self-worth (pd) Increased self-esteem and self-worth

Increased self-esteem and self-worth (r) Regarded as a positive role model

Empowerment (pd) Sense of empowerment

Empowerment (r)

Increased confidence (pd) Increased confidence

Increased confidence (r)

Life enrichment Life enrichment

Personal growth (pd)

Being able to‘give something back’

Improving prisoners’mood, reducing depression and anxiety

and preventing suicide (r)

Improving prisoners’mood

Reduced depression and anxiety Reduction in suicide and parasuicide

Thematic category: social relationships

Relationship or friendship with the peer worker Improved social network

Empathy Empathy and compassion

Initial code Organising code Thematic category: stress and coping

Multi-role peers and burnout Burnout

Manage boredom Peer role enables individuals to cope

with adverse institutional stressors Sense of normality/given a role/purpose

Professional identity

Increased stress and emotional burden Emotional burden and coping mechanisms

Coping mechanisms to manage stress and emotional burden

Peer relationships–support or friendship from other peer workers

The role diverts attention away from the peers’own issues

Who provides peer support for the peer deliverers

Thematic category: skills and employment

Improved skills (pd) Skill development

Improved skills (r)

Increased teamworking skills (pd) Improved communication skills (pd)

Future employment post prison Employment prospects

Setting prisoners up to fail

Codes mapped to review question 2

Initial code Organising code

Thematic category: references for health service delivery

Less likely to judge Peer communication

More comfortable talking to peers than staff Value of lived experience

Accessibility Accessibility of peers

Waiting times to access peers

Confidentiality arrangements Confidentiality

Thematic category: peer recruitment, training and support

Training Training and support mechanisms

Accredited training

Training the (non-prison-based) trainers The danger of medicalising the role Support systems for pd

Recruitment and selection process Recruitment and selection

Diversity and lack of representation

Retention and managing prisoner turnover Retaining peer deliverers

Payment/privileges Payment and privileges

Motivation for the role of pd Motivation for the role

Thematic category: prisoners relationships

Providing practical support to prisoners Providing practical support to prisoners

Prisoner dependency on peer deliverers Dependency

Role boundaries Role tensions

Stigma

Ambiguity of peer role

Awareness of peer-based intervention Awareness and utilisation

Reasons for prisoners not using the peer-based intervention

Thematic category: organisational support

Peers and partnerships with staff Partnerships

Role of voluntary sector organisations (e.g. Samaritans)

Managerial support (from governor, NOMS, NHS, etc.) Institutional_‘buy-in_’

Prison staff support

Importance of dedicated members of staff overseeing the scheme

Funding and resource implications Funding and resources

Lack of prison staff to support scheme

Initial code Organising code Thematic category: prison life

Abuse of position (including drugs, mobile phones) Power and risk

Power imbalance Security issues

Access within prison (i.e. keys) Risk management

Peers diverting demand from paid staff Contribution of peers to the wider prison

workforce and service delivery Extra support to staff

Mediators between prisoners and staff Peers filling a gap in service provision Number of contacts with prisoners Lack of progression within the role

Peers increasing prisoners’access to services

Improved ethos of prison/less violence Impact on prison ethos and culture

Offering prisoners an alternative role of employment in the prison

Interventions contributing to prison performance targets Peer interventions contributing to prison

performance targets Evidencing impact

Integrating the scheme as the_‘norm_’within the prison Integration of peer interventions into the prison

Vulnerable prisoner tensions Staff resistance

Hierarchy of peer-led schemes

Location of intervention Location of intervention

Reception YOI

Working arrangements including monitoring Intervention arrangements and monitoring

Intervention

mode Definition Application to prison setting

Peer education Peer education involves the teaching and communication

of health information, values and behaviours between individuals who are of equal social status, or who share similar characteristics, or who have common

experiences.94,95

There are various rationales advanced for

peer education including accessing‘hard-to-reach’or

socially excluded populations;165

the influence of social networks and opportunities for positive social modelling

and reinforcement of social norms;95

and personal

development and empowerment of peer educators166

Peer education has been widely applied in the prison setting, particularly in relation to the prevention of HIV infection and risk reduction. Peer educators typically undertake formal training to equip them with the knowledge and skills to undertake the role. They then deliver (a) formal educational/behaviour change interventions, e.g. risk reduction

planning,27

and/or (b) engage in informal education and awareness raising through social interactions with

fellow prisoners within the prison.106

The case for peer education in the prison setting is broadly based on the same understandings of the powerful effect of social influences as for other peer education approaches. Although prisoners have good functional access to health care, the nature of the prison population (marginalised groups often

with low levels of literacy)27

and the boundaries between professional staff and prisoners can result in resistance to

a health agenda.101

In this context, peer education can be seen as a means to engage prisoners when there might be barriers to professional advice, etc. A further benefit may be the transmission of health information in the prison, between prisons as prisoners move and

outside to partners and families131

Peer support Peer support is the support provided and received by

those who share similar attributes or types of experience. Peer support can be an informal process between individuals and/or can be provided through formalised interventions in which peer supporters seek to

promote health and/or build people’s resilience to

different stressors94

There is a range of different peer support interventions reported in the prison literature. As an overview, peer support in a prison setting involves peer support workers providing practical help and/or social support to other prisoners

in a paid or voluntary capacity.25

Peer support roles can include befriending, carrying out domestic duties for other prisoners (e.g. fetching meals), liaison with prison staff, translation, providing basic information and signposting to

other services.25,149

Some peer support interventions, such as the PST programme in Canada, involve peers providing emotional support to alleviate

stress.153

In the UK, the Listener scheme is a specific peer support intervention focused on the prevention of suicide and self-harm (see below). Some peer support interventions involve group work, such as self-help groups on

Intervention

mode Definition Application to prison setting

PST programme The PST programme trains women prisoners to provide

emotional support on a one-to-one basis to other prisoners who request their support. Delveaux and

Blanchette153

describe the peer support workers as

‘pseudo-counselors’(p. iii)

The PST programme is a Canadian model that has been developed and delivered across a number of Canadian prisons. It is specifically targeted at women prisoners and is based on a holistic, women-centred approach to health care that aims to be culturally

sensitive and to develop the women’s

autonomy and self-esteem153,156

Insiders Insiders are volunteer peer support workers who provide

reassurance, information and practical assistance to new prisoners on arrival in prison. Insiders are also referred

to as buddies38

The Insiders scheme is a UK-based intervention that aims to alleviate the stress of arrival in prison and is delivered in settings such as reception and the

first night suite.140_{Insiders are volunteer}

prisoners and receive some training but, unlike listeners, the role is not designed to offer emotional support and insiders are not bound by the same strict rules

of confidentiality22,38

Listeners Listeners are volunteers who provide confidential

emotional support to fellow prisoners who are experiencing distress. They are selected, trained and supported by the Samaritans and use the same principles of confidential, sympathetic listening to alleviate distress

and reduce self-harm and suicide22,31

The Listener scheme is a UK-based prison suicide prevention intervention. The first Listener scheme was

established in 1991 at HMP Swansea.31

The scheme has grown rapidly and in 2006 there were an estimated 1400

listeners.22

Listener schemes now operate across almost all prisons in England and Wales and all prisoners should have access to a listener at any time of day or night and in any setting,

including segregation units.25

The exception to this is young prisoners as listeners are not recruited under the age of 18 years

Prison

hospice volunteers

Prison hospice volunteers provide companionship, practical assistance and social support to terminally ill patients. They may be involved in a range of activities as requested by patients including letter writing, reading, accompanying patients to religious services and other parts of the prison and sometimes maintaining a bedside

vigil with dying patients40

Prison hospices aim to meet the physical, emotional, social, and spiritual needs of terminally ill prisoners who are not able to get compassionate

release.40,127_{Hospices were initially}

introduced in the USA to deal with the high incidence of HIV/AIDS-related deaths and are based on the concept of

a_‘decent prison_’.40_{Prison hospice}

volunteers are considered to form part of the multidisciplinary hospice team and often work alongside nursing staff

Peer mentoring Mentoring describes the development of a relationship

between two individuals in which the mentee is able to learn from the mentor, model positive behaviour and

gain experience, knowledge or skills.167,168

Peer mentors,

as defined by Finneganet al.,168

have a similar background as or experiences to their mentee (p. 6)

Peer mentoring has been proposed as an approach to engage disadvantaged and excluded young people by offering role models to encourage and inspire

them.169

There are a number of peer mentoring schemes in UK prisons focused on education and training, such

as the Learning Ladder,142

and on resettlement and prevention of reoffending

Health trainers Health trainers are lay public health workers who use a client-centred approach to support individuals around health behaviour change and/or to signpost them to other services (Health Trainers England). Health trainers work with disadvantaged communities and are often recruited from those communities. They receive training to reach standardised competencies and are usually

employed by the NHS170

The health trainer role was introduced

in the 2004 public health White Paper2

as a means of tackling inequalities by providing peer support around lifestyle change, and in 2006 a health trainer initiative was piloted across three adult prisons, one YOI and one probation

service.28

The service has since expanded and there are now health trainer services in a number of prisons across England and Wales. Prison health trainers receive standardised training on health promotion, healthy lifestyles and mental health, which is adapted for the prison setting and client group

Peer advisors Peer advisors provide housing advice to fellow prisoners

within prisons, particularly new prisoners and those planning for resettlement. Some peer advisors support

prisoners_‘through the gate_’

In response to the issues around resettlement, employment and reoffending, the St Giles Trust established the Peer Advice Project in a number of prisons in London and the

south-east of England.135_{Peer advisors}

receive training and complete an NVQ Level 3 in Advice and Guidance. The role involves assessing housing needs, finding accommodation, support with welfare benefits and signposting/referral to other sources of help. The Peer Advice Project also offers employment experience to peer advisors who volunteer/work with the project

following release.135,139_{Peer advisors}

can be seen as offering both peer

support25_{and acting in a bridging role,}97

assisting prisoners to access services/ accommodation outside the prison setting

Life coaches Life coaches are peer support workers who provide

low-intensity support to prisoners during the transition between prison and the community. The role is a bridging role that aims to connect prisoners to other community services and sources of support

Life coaches are part of the Routes out of Prison initiative based in Scotland. Life coaches are usually ex-prisoners but some are recruited from similar disadvantaged groups (these individuals are described as peer mentors). Life coaches see prisoners in the prison setting and also outside the gate, to allow some continuity of support. The

aim is to‘provide a‘bridge’between

the prison and the community’.147

Life coaches can be seen as offering both peer support and a bridging role,

Intervention

mode Definition Application to prison setting

Other intervention modes

Peer observers (suicide prevention)

Peer observers were identified in one study as part of a

suicide prevention initiative.124_{Peer observers observed}

prisoners who were on suicide watch, i.e. at risk of suicide. They undertook active listening but the role did not involve counselling

Peer training (violence)

The AVP involves prisoners training and then facilitating training on conflict resolution techniques with young offenders. The project involves a formal five-step programme moving from basic training to train the trainers, to facilitation and involvement in the

management council.132

Although it involves peer education in terms of using a cascade training model, it reflects a high degree of involvement and is described

as‘inmate run’

Peer outreach (harm reduction)

A harm reduction programme in Moldovan prisons involved peer volunteers in distributing condoms, supplies for needle exchange and information booklets to

fellow prisoners163

Peer counsellors (substance misuse)

The peer counsellor role was found in one study,145

with peer counsellors assisting in the delivery of a formal substance abuse treatment programme

In document UNIVERSIDAD COMPLUTENSE DE MADRID (página 159-162)