Improving drug treatment in prison: Policy recommendations by key stakeholders

Drug use in European, and more specifically Belgian prisons remains high, while drug treatment in detention is often insufficiently organized and fragmented. In 2017, the Belgian Federal Department of Public Health launched a pilot project on drug treatment for detained persons, consisting of a psychosocial intervention, as a first step towards qualitative care for this group.

In this study, the policy documents stating the goals for the pilot project are critically examined. The aim is to understand whether this policy is adequately adapted to the needs of drug using persons in detention and how this policy could be further improved. In total, 23 semi structured interviews were conducted with professional key stakeholders to the pilot project in the prison of Hasselt. Professional key stakeholders were identified as policy makers, prison management, project staff and prison staff related to the drug treatment project (e.g. medical service staff, psychosocial prison staff, prison officers, religious counselors). This study is funded by federal Science Policy BELSPO [DR/00/83], a Belgian public funding agency for scientific studies. The results illustrate the need for an integrated and integral vision on penitentiary health care, including drug treatment. This implies a continuous cooperation between welfare-, health- and judicial actors. Finally, the participants request more attention towards a differentiated health care delivery adapted to the needs of detained persons, the accessibility and (evaluation of) quality of this delivery.

These results are in line with recommendations from international health organizations, such as the World Health Organization and the European Monitoring Centre for Drugs and Drug Addiction. The Belgian pilot project is overall considered by the stakeholders as a promising first step in providing qualitative drug treatment in detention, yet the results clearly indicate several policy issues (i.e. integrated and integral vision, cooperation, needs-based care delivery) still need to be addressed.