Voices of Prisoners: Experiences Shared with Let’s Be Heard – A Case Study

Prisoners across Scotland shared a multitude of insights into the challenges they faced during the pandemic. Respondents shared their experiences across several aspects of prison life, including how they felt authorities managed the pandemic, prison staff measures and behaviours, barriers to healthcare, mental health impacts, and life under pandemic restrictions. Their experiences, as highlighted in this report, will help inform the Inquiry's investigations. It is important to note that the views shared below represent the personal experiences and perspectives of prisoners and are not reflective of the views held by the inquiry.

This section focuses on the experiences shared by prisoners about how the Scottish authorities and prison staff managed the pandemic. While some respondents felt the pandemic was handled well, many expressed frustrations around poor planning and limited communication about what was happening. When safety measures were introduced, prisoners highlighted further barriers to infection-control, including limited access to COVID-19 testing, a shortage of adequate Personal Protective Equipment (PPE), and instances where staff did not follow the necessary safety precautions. Those in need of justice services from within prison reported limited access and delays in receiving essential support.

As a result, many prisoners shared that they felt anxious and unsafe during the pandemic, with some describing a loss of trust in the system that was meant to protect them.

3.1.1 Lack of pandemic planning and preparation

While a few prisoners felt that the Scottish Government and the SPS managed certain aspects of the pandemic well, a large proportion reported that authorities need to be better prepared in the future. Many prisoners perceived that there was no plan in place to address the pandemic. 

Some prisoners acknowledged the difficulty of responding to the pandemic for governing bodies, as one prisoner noted: “The SPS and NHS government did their best they could as no one had experienced this. A lot of people are still alive. There are good and bad in every new pandemic.”  Another prisoner reported that the prison they were in “did well under the circumstances,” while another expressed: “In a close-knit community, the regime they adopted worked well.”

Prisoners also expressed negative views around perceptions of preparedness. As one respondent simply noted, “there was no preparation put in place for the pandemic,” while another commented, “the SPS/Government need to look at places like prisons and set up plans for infectious viruses in the future instead of doing nothing.” This sentiment was echoed by others who called for “a crisis plan [to be put] in place in case of a similar incident, a plan prisoners could be aware of.” Such a plan would prevent the sudden lockdowns from feeling like “a slap in the face,” as one respondent noted, as prisoners would be informed in advance about what was happening.

One respondent expressed that “the lack of preparation meant that at first no one took the pandemic seriously,” a view shared by others who felt the response was “too slow” as a result. Several prisoners highlighted that authorities did not proactively address the potential risks as the pandemic started to emerge. When actions were finally implemented, some prisoners viewed these measures as reactive rather than being part of a pre-planned strategy. A few prisoners noted that this perceived lack of planning resulted in poor decision making, of which they reported bearing the consequences, calling the response “haphazard”. As another prisoner explained:

Many other respondents were critical about measures being implemented too late, such as delayed lockdowns, which allowed the virus to spread before any significant steps were taken. For instance, one person noted that a full wing lockdown was imposed after six people had tested positive, while another mentioned that a lockdown was triggered when 10 people had been infected. Some prisoners expressed the view that better management could have reduced the risk of infection in the first place, as one person expressed, “if things had been dealt with differently, I probably wouldn't have caught COVID-19.”

Overall, a large proportion of respondents thought that better planning and proactive strategies might help address the delayed responses in the future. Reflecting on COVID-19, one prisoner noted that “better operational planning and decisions need to be made not only to deal with what happened but what could happen in the future.” Others felt that “COVID-19 could have been handled better,” and that “we can use this to create a future crisis plan.” One person specifically called for “a review of prisons” to better prepare for similar challenges. 

3.1.2 Communication failures between prisoners and authorities

Communication has emerged as a key theme in understanding the prison experience during the pandemic in Scotland, underscoring its critical role in shaping relationships between authorities and prisoners.^[8] In this Let’s Be Heard case study, many respondents described their experiences in prisons during the pandemic as “hell” and “mayhem,” largely due to communication breakdowns in information delivery. Many respondents also acknowledged the unprecedented nature of the situation but still felt the Scottish Government and the SPS failed to provide timely and adequate information. Several respondents called for better communication between the government, NHS, SPS, and prisoners, stating that this would “alleviate anxiety and dispel rumours.” 

While one prisoner acknowledged that staff “did their best” to keep them updated adding that “it was hard,” many other prisoners reported contrasting experiences. Respondents expressed frustration with the lack of information from the SPS, stating that as prisoners they were “restricted to what we are told by staff.”  Lack of information about the spread of COVID-19 and what was happening in the wider world during the pandemic proved to be a prominent cause of mental distress among prisoners. As one person stated, “Only hearing about it from a form and then on the news 24/7 really made me anxious.”

Getting information was challenging as “staff weren’t allowed to talk to you in case it spread the virus.” As one person explained, “the only information I could find out is from what was on the news and what we could ask families over the phone.” This view aligns with broader findings from the Armstrong et al. study that highlights how support from families became essential for prisoners by providing information.^[9] Without clear and consistent information, a few respondents explained that misinformation quickly became an issue, with rumours spreading unchecked in the absence of reliable updates. This was especially evident early in the pandemic, as described by one respondent:

Many also expressed a strong desire to have been better informed about COVID-19 and vaccines but faced significant barriers. As one respondent put it:

Respondents noted that they wanted more information about isolation periods and which prisoners or prison staff had tested positive for COVID-19. This perceived lack of transparency created confusion and uncertainty among both prisoners and staff. Prisoners called for “open and honest” communication, emphasising the need for clearer guidance about the status of COVID-19 cases within the prison. Prisoners expressed that better communication could have helped to reduce anxiety and avoid confusion and emphasised the need for clearer dissemination from the Scottish Government to prison staff and prisoners. 

These responses suggest that the lack of information left some prisoners feeling that “no one cares” about them. Another stated that better communication would “alleviate anxiety,” and that, “when all parties are on the same page, there is better compliance.” These experiences highlight how communication serves two functions in prisons: reducing stress by keeping prisoners informed and improving institutional operations through better understanding of rules and expectations. When prisoners understand why certain procedures exist and feel informed about changes, they are more likely to comply willingly, creating a safer environment for everyone. 

3.1.3 Lack of staff training and compliance with infection control procedures

Previous literature highlights prisoners’ concerns about staff failing to follow the procedures they are tasked with enforcing.^[10] Prisoner responses to Let’s Be Heard align with these views, with prisoners reporting that staff did not comply with infection control procedures. It further reveals that prisoners attributed this to a lack of staff training. These factors were key in shaping how prisoners viewed the overall handling of the pandemic within the facility. 

Many respondents felt that staff were not trained to handle the virus, describing them as “overwhelmed,” and “ill-equipped.” One person noted that “staff did not seem to understand how to manage day to day.” Another person described:

The importance of consistent direction was highlighted by one prisoner, who said, “in an environment as volatile and unpredictable as prison, we need clear instructions and direction,” underscoring how stability and guidance minimise tensions during a challenging time. Tensions were also heightened by staffing changes, which prisoners described as “confusing and conflicting,” further undermining any sense of predictability.  

Many prisoners voiced significant concerns about staff bringing COVID-19 into the prison due to poor infection control procedures and training. They explained that once visits were stopped, it appeared that staff became the main source of COVID-19 infection in the prison. Several prisoners suggested that while safety measures were focused on stopping prisoner interactions, the risk posed by staff was largely overlooked. According to one prisoner, “SPS's emphasis was on prisoner-to-prisoner transmission which neglected that it was staff who were the group who were taking the virus into the jail.” Another person explained:

Another explained the perceived issue in more detail:

If these beliefs are correct staffing shortages caused by sickness or quarantine during the pandemic might be a contributing factor. Prison staff who responded to Let’s Be Heard reported that these shortages were not adequately addressed, noting that this worsened the spread of the virus, as understaffing led to more pressure on staff members to work despite being sick.

Several prisoners blamed the absence of infection control procedures for staff that would have prevented them from entering the facility with COVID-19. As two separate respondents explained:

In some cases, prisoners perceived these experiences as unfair and unequal, especially as they were required to isolate and restricted from seeing family, while staff were allowed to interact both within and outside of the facility. This added to the emotional strain on prisoners at an already difficult time. As one person stated, “The hall bubble couldn’t mix, but staff from all over the city could mix from day to day.” These descriptions demonstrate the feelings of injustice and frustration among respondents, who felt staff were not following the same COVID-19 restrictions they were subject to.

Respondents said they often observed staff failing to comply with PPE guidelines, and they criticised staff for the perceived inconsistent and careless approach to PPE. Others reported that some staff members wore PPE sporadically, while other members of staff ignored the guidelines entirely. Prisoners viewed this behaviour as irresponsible, as it increased the risk of infection and reduced their sense of safety. As one person stated:

Prisoners reported they had limited access to PPE compared to staff members, which meant that staff therefore had “more protection” from the virus. Prisoners felt that “what should happen is that PPE is available to everyone, not just staff,” highlighting concerns about fairness and needing more equal safety measures for both staff and prisoners during a pandemic. These descriptions suggest prisoners would welcome greater accountability and oversight to ensure protocols are consistently followed in the future.

3.1.4 Staff attitudes and treatment towards prisoners

The treatment of prisoners by staff members is a key theme that emerged from the broader studies on the prisoner experience in Scotland, with care and compassion playing an important role.^[11] Similarly, the prisoner responses align with these findings, with respondents offering both positive and negative feedback around these behaviours. 

On the one hand, respondents recognised the efforts made by staff to support them in difficult circumstances and took the opportunity to “thank the staff for doing everything they could with COVID-19”. One person stated that it was helpful to be given extra TV channels, phone money, and entertainment. Another prisoner, who was in isolation for over a year, shared that, “staff went out of their way to help me cope.” Multiple respondents acknowledged concern for officers who had to balance their work and family life during the pandemic with no formal support. Some prisoners felt that many members of staff did their best under the conditions and expressed empathy for the broader challenges faced by frontline workers during the pandemic. One prisoner praised the response, stating “NHS, SPS and Scottish ambulance were all amazing and are heroes.”

Inversely, some respondents described difficulties with an embedded culture of poor staff attitudes towards prisoners. They described carelessness among staff towards prisoners, which some prisoners attributed to a lack of training. Dismissive and disrespectful behaviour from staff was shared, particularly when prisoners were expressing concerns about their safety or a risk of infection. Respondents reported that staff often reacted with indifference or even mockery, with one person explaining, “the staff just laughed when you told them you were worried.”

Similarly, another respondent recalled staff telling prisoners, “Don’t worry we have received lots of plastic coffins so you will be sent back to your family,” showing a lack of empathy for prisoners’ fears and anxieties. Multiple prisoners reported that staff members “never helped to ease any issues,” suggesting a level of indifference and highlighting the psychological toll of an environment where concerns were dismissed. As a result of their experiences, one prisoner called for the creation of a “whistleblowing process” to hold staff accountable for their actions and ensure transparency in addressing misconduct in the future.

3.1.5 Insufficient protective equipment and cleaning measures

Previous studies have reported a failure of the SPS to provide PPE in time to protect prisoners from infection.^[12] In this Let’s Be Heard case study, almost a third of the respondents also expressed significant concerns about the quality and quantity of protective equipment and cleaning. They described the impact of COVID-19 as “dramatic” as they were unable to avoid interactions in a small, enclosed environment that did not allow them to socially distance effectively. They reported the significant lack of PPE, such as masks and cleaning measures, with the spread of infection likened to a “wildfire,” putting lives at serious risk. 

Respondents shared that, in their view, prisons were slow to distribute PPE, if it was provided at all. One prisoner described PPE as “gold dust,” with some only receiving face masks, while others were told to make their own from recycling old T-shirts. As one respondent commented:

On a similar note, another person shared:

Other prisoners described their struggle with basic hygiene and protection. One person reported that they had “no hand wipes for the first lockdown,” and “no hot water for 3 weeks during it.” 

Some respondents also raised issues over the protection of prisoners who were performing essential tasks within the prison, such as those involved in food preparation and cleaning cells. They highlighted that these workers were not provided with adequate PPE. This was considered especially concerning as they needed proper chemicals and protective gear to prevent contamination between cells. One prisoner explained that they were only given masks and gloves to clean showers for around 50 prisoners, highlighting their concern that the protective measures were insufficient. These accounts suggest prisoners felt there were significant gaps in safety protocols, contributing to the rapid spread of the virus and placing both staff and prisoners at risk. 

Overall, many prisoners felt that they were not properly protected from COVID-19. One person stated that in a small environment, “all we had were face masks and social distancing, which was not sufficient.” Another prisoner stated, “make sure we’re prepared with the right PPE.” These accounts suggest that prisoners felt PPE supply and quality may have fallen short of what was needed to protect both prisoners and staff.

3.1.6 Disruptions to justice processes and court proceedings

Several prisoners reported disruptions to justice processes and court proceedings in Scotland during the pandemic, with some describing the situation as “shocking.” Trials were frequently postponed due to COVID-19 exposure.^[13] A few respondents were unhappy with these delays, with one person sharing that their trial was delayed by three months simply because they had been in close contact with someone who had tested positive. This increased time spent going through the justice system caused significant stress. Another individual explained that delays to the justice system caused them “prolonged anxiety.”

The impact of court delays on remand period was first documented in the literature on the early pandemic.^[14] One respondent reported that she pleaded guilty simply because she would have spent more time waiting on remand than her actual sentence would have been. She explained that she was on remand awaiting trial when the pandemic hit Scotland. She had originally intended to plead not guilty, but the restrictions imposed on her receiving visitors led her to decide to plead guilty “to get it done with, because I might still be there now.” 

This respondent also explained that due to COVID-19 restrictions, she was unable to review evidence properly while on remand. This was because her solicitor could not bring video evidence into the prison for her to watch. She also added that, “everything slowed down as well, and trials just weren’t happening.” She went on to explain “remand was probably half my sentence anyway, so if I stayed on that I may have done more than my sentence, waiting to go to court.” This suggests there may be a need for more efficient systems to prevent undue delays and ensure fairness in the justice process, even during crises like a pandemic.

3.1.7 Delays in prison progression and rehabilitation

The pandemic in Scotland disrupted the transition of prisoners to lower security facilities or release, resulting in extended stays in higher-security settings.^[15] The lack of opportunities to demonstrate progress or good behaviour during lockdown periods meant that many were left in more restrictive environments for extended periods. One respondent remarked, “The pandemic resulted in a longer period of imprisonment because it was impossible to progress to less severe conditions (being a life prisoner).” Without progression programmes, one prisoner expressed that they felt they were left to “languish”.

One respondent explained that while they understood their punishment was a loss of freedom, they felt “marginalised” by the delays in progressing to less secure conditions. These delays added to their sense of unfair treatment, as they felt their chances for progression were unjustly stopped during the pandemic. Angered at the lack of progression during the pandemic period, one respondent noted the unequal impact on prisoners, stating:

Similarly, rehabilitation programmes were suspended in some instances, leaving prisoners without access to vital services intended to prepare them for reintegration into society. Respondents stated that this left them with no meaningful opportunities for skills development and added years to their incarceration. According to respondents, preparation for release was effectively paused, further adding to their frustration. To address these challenges, one respondent suggested virtual and distance modules could be available for offender behaviour programme delivery, stating that:

These experiences suggest that prisoners believe the pandemic caused significant setbacks in progression, rehabilitation, and release processes, underscoring the importance of adopting solutions to maintain these pathways, even in challenging circumstances.

3.1.8 Ongoing issues after the easing of restrictions

Several respondents reported that in some cases restrictions remained in place into 2023, despite the reduced risk of COVID-19 in Scotland and the lifting of restrictions outside of prisons. They provided examples, such as being locked in their cells early in the evening, the failure to restore pre-pandemic routines, and experiencing long periods of isolation. Some respondents noted that they were initially told the restrictions would be temporary, but these measures stayed in place, making prisoners feel they were living in harsher conditions than necessary. The absence of a clear timeline for the return of pre-pandemic routines left prisoners stressed and dissatisfied. Another prisoner stated that:

Cancelled activities and disrupted routines were reported by many respondents as resulting in them experiencing poor mental health. Many of these respondents also said that the “lockdown regime” or disruption continued in the prisons despite the pandemic being officially declared as ‘over’. As one person stated: “Mental health was really bad with lock-up and the routine never reverted back [after the pandemic].” Another asked:

More detail on how the reported continued change of routine has affected mental wellbeing in the prison, was provided by another respondent who stated:

These experiences highlight the ongoing challenges of prisoners and suggest that more effort may be needed to restore pre-pandemic routines. 

This suggests that re-establishing routines could help improve the wellbeing of prisoners and provide a sense of stability and fairness after the disruptions caused by the pandemic.

[8] Armstrong, Left out and Locked Down, 57; Maycock, “Dramatic Change to Prison Life,” 227-8.

[9] Sarah Armstrong, Betsy Barkas, Ryan Casey, Neil Cornish et al. Prisoner experiences of COVID-19 restrictions in Scotland during 2020 (University of Glasgow, 2022), 3.

[10] Armstrong, Left out and Locked Down, 9.

[11] Armstrong, Prisoner experiences of COVID-19, 4.

[12] Armstrong, Left out and Locked Down, 57.

[13] Armstrong, Left out and Locked Down, 63.

[14] Armstrong, Left out and Locked Down, 63. 

[15] Armstrong, Left out and Locked Down, 62.

Prisoners described compounded impacts from strict pandemic restrictions being added to an already demanding environment in the prisons. This section explores how these stricter measures, as described by prisoners, disrupted daily routines, limited access to education, reduced opportunities for exercise, and affected food quality and hygiene. It sheds light on how these additional restrictions shaped the overall experience of prison life during the pandemic and resulted in the perceived compounded impacts on the prisoner’s experiences.

3.2.1 Increased isolation

The prison lockdowns resulted in prolonged periods of isolation, which many respondents described as being extremely difficult. One respondent stated, “The isolation […] was a very dark and excruciating experience for prisoners like me.”

Prisoners described how some of the lockdown measures in Scotland resulted in almost solitary confinement-like conditions. Several prisoners stated that due to social and physical distancing, they were kept in their cells for over 23 hours a day. Some respondents even reported being locked up alone for 24 hours in their cells.

Being confined to their cell all day without breaks was described in detail by one respondent:

Prisoners described being confined to their cells with little-to-no family contact, and they shared that staff were often the only other human beings that they had any contact with during the lockdown conditions. As one prisoner stated:

These thoughts indicate how important human contact can be for prisoners, as contact with others was something that was missed by many respondents during the lockdown conditions. A report by Edinburgh Napier University on the impact of COVID-19 on voluntary sector work in the justice sector confirms the importance of providing human contact and reducing the isolation of prisoners.^[16]

3.2.2 Suspension of work, exercise and education programmes

In response to the pandemic, prison governors in Scotland were granted new powers to suspend work, education, and recreation activities.^[17] Previous research revealed that these measures had a detrimental impact on the wellbeing and mental health of prisoners, as they rely on such activities to maintain a sense of purpose.^[18] Respondents reported that this suspension significantly disrupted their daily routines. They shared that education, work and exercise programmes were reduced or stopped altogether, significantly affecting the mental health and wellbeing of prisoners. As one respondent explained:

A large proportion of respondents emphasised that their access to exercise was severely restricted. For example, one respondent shared that gym access was reduced to just 20 spaces, three times a week, for 75 prisoners. Another described the experience:

Many prisoners shared that they felt bored, isolated and depressed by these restrictions, suggesting that having nothing to do and less interaction made the impact of confinement even harder to endure. Impacts on the mental health of prisoners will be expanded on later in this case study.

Many respondents also expressed that education programmes in prisons were largely shut down, leaving many without access to learning opportunities. Armstrong et al.’s study noted that this loss was particularly challenging as education often provides a sense of purpose in prison.^[19]. As one respondent described:

Work programmes were another critical part of prisoners’ routines that changed during the pandemic in Scotland. While key work, such as cleaning and food preparation continued, all other work came to a halt.

Prisoners shared that some prisons attempted to improve prisoner wellbeing in the absence of activities by increasing “rations”, wages and providing mobile phones with credit so they could maintain contact with people outside. However, some respondents made it clear that these measures were not enough to offset the increased mental health challenges that many prisoners faced. Respondents shared that the programme closures left them feeling isolated and unproductive, further adding to the challenges of confinement. One prisoner explained, “education was stopped [and] restrictions were hard to cope with.” Another shared, “It was hard for prisoners, we were just locked up with nothing to do,” suggesting that work, exercise and education programmes are considered by prisoners to play an essential role in maintaining prisoner wellbeing. 

3.2.3 Challenges with personal hygiene and cleanliness

Previous studies indicate that limited access to proper personal hygiene was a significant concern for prisoners during the pandemic.^[20] Prisoners also expressed that showers became a limited privilege, with time out of cells described as “sparse, even for a shower.” Many prisoners reported being allowed to shower only every two to three days, while some said they were permitted just once a week. In addition to infrequent access, respondents explained that there were challenges with hot water in some prisons, making hygiene more difficult to maintain. As one respondent stated:

Several prisoners also emphasised the need for more regular opportunities to clean themselves and their cells in addition to showering, as the conditions left the environment feeling “overrun with dirty prisoners.” They noted that “although staff did everything they could”, hygiene measures were not sufficient. 

Overall, prisoners felt that a lack of clarity, combined with infrequent access to hygiene facilities, added to the frustration and discomfort of an already difficult situation. As one prisoner explained, “showers could have been every day and give time to clean your cell when sick as cleaning all the stuff away could help speed up getting better.” These responses imply that ensuring regular access to basic hygiene facilities was seen as essential for maintaining good health and wellbeing under the restrictive conditions.

3.2.4 Decline in food quality and meal conditions

Many respondents described a decline in food quality and meal conditions during the pandemic, expressing concerns about what they felt was a drop in overall standards. Several prisoners noted that the unpredictability of the meals made it even more difficult to maintain a sense of normalcy during the lockdown period. As one respondent described, “lockdown and meal conditions were sporadic and ill managed. Staff seemed to be operating on a 'try it and see' system.” Others reported that the food was often cold, stale, and served late, which left them feeling unsatisfied and demoralised. As one person stated:

During times of isolation, some prisoners reported that they were also required to eat meals in their cells. This lack of communal dining, they reported, not only made meals feel even more isolated but also had a negative impact on their mental and physical health. One respondent described that, “both myself and rest of hall lost easy 1 stone each over the 10 days as no access to cooking facilities and jail food was undercooked and cold.” Another shared:

Respondents reported that the poor quality of the food, combined with isolating conditions, left prisoners feeling ignored and disregarded, especially when meals were one of the few things that they had left to enjoy during the height of lockdown restrictions. These experiences indicate that prisoners felt that ensuring adequate portions, nutritional value and proper meal preparation could help support their physical and mental wellbeing. Prioritising meal standards might reduce frustration and foster a sense of care and dignity among prisoners in times of crisis. 

3.2.5 Lack of family contact

Being unable to see or contact family was expressed as a significant cause of mental distress for many respondents and, in some cases, family members too. When in-person visits were stopped during lockdown in Scotland, respondents reported “lengthy delays” to when the SPS provided alternative communication sources. These sources included approved mobile phones and iPads, so that prisoners could have family contact. 

Many respondents reported negative mental health impacts as a result of having no contact with their families. One respondent spoke of the metaphorical distance between them and their family as a result of the ceasing of in-person visits:

Another response explained that the lack of family contact compounded their punishment, stating: “I didn't see my family for months and that was extra punishment and stress added.” Similarly, the the University of Glasgow's study, ‘Prisoner experiences of COVID-19 restrictions in Scotland during 2020’ noted that many participants indicated significant stress due to loss of family contact.^[21]

It was noted that having no family contact during periods of the pandemic had lasting consequences, with one respondent explaining:

Use of, and access to, communication devices also affected the ability of prisoners to communicate with family and loved ones. The SPS gave out devices to prisoners, but prisoners expressed that this was only after a significant period of lockdown had passed. In the ‘Criminal Justice-Involved’ chapter of the ‘Left Out and Locked Down’ study by the University of Glasgow, it was found that although rollout of mobile phones for Scottish prisoners was announced for May 2020, this was “significantly delayed” leading to frustration for prisoners.^[22] Prisoners noted that having the devices made a profound difference to their experience, emphasising the need for access to loved ones. Similarly, an SPS study noted that the majority of their participants indicated that the introduction of “mobile phones had improved contact with the family and friends” and many in the study also felt that the phones helped “reduce feelings of isolation, anxiety and depression.” ^[23]

The SPS response was praised by one respondent, who noted “They [the SPS] responded positively by […] distributing mobile phones and providing telephone credit.” However, another respondent expressed frustration at the length of time it took for mobile phones to be issued, as well as noting the effect the non-contact had on their mental health: “[I] couldn't contact family until mobiles were eventually given, this caused depression and anxiety not knowing if they were okay.” Another respondent stated:

Many respondents detailed the impact of pandemic restrictions on their families, as well as themselves. One person stated, “Not being able to see my wife and kids for over a year messed up my mental health and the mental health of my wife and kids”, noting the mental toll on their loved ones. One respondent also identified the possible knock-on effect of prisoners’ mental health issues transferring to their families:

In this instance the prisoner has highlighted the wide-ranging effects of their intensified isolation, notably on the wider community, with a reminder to policy makers that mental health problems within the prison population does not stop and start at the prison gate. Rather, the above respondent noted, the effects spill out beyond the prison walls and can have a ripple effect on others.

[16] Faye Skelton, Christine Haddow. The Impact of COVID-19 on the Justice Voluntary Sector (Edinburgh Napier University, N.d), 11.

[17] Maycock, “Impacts of COVID-19,” 8. 

[18] Armstrong, Left out and Locked Down, 57, 59; Sarah Armstrong, “Things are the same: Complicating OK narratives of prisoners during lockdown,” Scotland in Lockdown, December 3, 2020; Armstrong, Prisoner Experiences of COVID-19, 4, 13; Maycock, “Dramatic Change to Prison Life,”219, 224-5; Maycock, “Impacts of COVID-19,” 7-9, 11.

[19] Armstrong, Left out and Locked Down, 57.

[20] Armstrong, Left out and Locked Down, 57, 59; Armstrong, “Things are the same,” 57.

[21] Armstrong, Prisoner Experiences of COVID-19, 12.

[22] Armstrong, Left out and Locked Down, 64.

[23] Dickson, Mobile Phones and Virtual Visits, 9.

Many prisoners shared their experiences of the significant barriers to healthcare services during the pandemic. These challenges can be grouped into four main categories: 

• access to routine medical care; 
• poor mental health support; 
• delays in accessing COVID-19 tests; and,
• issues getting COVID-19 vaccinations. 

Respondents shared that the quality of healthcare delivery deteriorated as prisoners struggled to secure appointments, faced inconsistent testing protocols, and experienced slow vaccine rollout. They reported that these issues were compounded by strict pandemic restrictions in Scotland, which increased mental health needs, meaning that support services remained largely inaccessible and unable to effectively address the increase in poor mental health.

3.3.1 Access to healthcare

In Scottish prisons, healthcare is managed in partnership between the SPS and the NHS. This collaboration is intended to ensure prisoners receive efficient medical care. NHS professionals provide treatment and support within the prison setting, while the SPS oversees the administration and logistics of healthcare services. Many respondents highlighted that this partnership faced many challenges during the pandemic, reporting that this impacted both access to, and the quality of, healthcare. Some respondents also noted other healthcare access issues, including a perceived unfairness in receiving vaccinations and the poor access they had to mental healthcare treatments.

Eleven of the respondents expressed concerns about how well the partnership between the NHS and SPS was functioning. As one person explained:

This perceived division of duty left individuals stressing the importance of shared responsibility and clearer communication between the SPS and NHS to ensure better healthcare delivery. As one individual explained:

Some respondents praised the hard work and dedication of NHS staff in tackling the challenges of the pandemic, noting that they were “looked after first class with medic staff.” Others criticised the significant delays in accessing healthcare. Some described it as “blatant dysfunction” and a “farce”. One prisoner stated that seeing a doctor was “almost non-existent”, sharing that despite numerous requests for an appointment to address a hearing impairment caused by COVID-19, they never received one. Others highlighted excessively long waiting times, often lasting months, to see specialists or receive necessary treatment. 

The delays in accessing healthcare were made worse by the perception that healthcare providers were indifferent to the needs of prisoners, with respondents calling for greater care and empathy. One person noted, “the NHS should care more and do more,” while another emphasised the need for “a bit of compassion from nurses.” Several felt that healthcare management needed significant improvement to address these issues effectively. 

3.3.2 Access to testing

Many prisoners identified access to COVID-19 tests as another critical issue, with respondents sharing that there were significant delays, limited availability, and poor management. Many respondents attributed the rapid spread of COVID-19 within the prison, and in some cases the development of long COVID, to the inability to access tests in time. They shared that the absence of reliable testing made it difficult to determine who was positive, allowing the virus to spread unchecked. As one prisoner stated, “COVID test kits were for the most part limited and not everyone could test themselves.” Many respondents also noted that test kits often took days to arrive, with one individual stating that it took 10 days to receive a test, by which time it was too late. Another person reported:

“The testing which took place when a prisoner tested positive, and lack of isolation and distancing led to a lot of prisoners contracting COVID-19 and then either getting seriously ill or continuing to suffer from long COVID symptoms.”

Further concerns were raised by prisoners about the use of tests in Scottish prisons. Several respondents reported that testing was self-administered and not checked by staff, leaving individuals responsible for ensuring they followed proper procedures alone. One person remarked, “they left us to make sure we did our best to stop the spread of COVID-19.” Some prisoners were reportedly told by staff to keep positive test results quiet, and prisoners expressed that this undermined efforts to contain the virus and increased risk to others. As one person stated: 

“I am currently in prison and the care I got when I was tested positive for COVID was BAD. On testing positive, I told the hall staff, and they told me to keep it quiet, do not inform of having tested positive, so what was the use I thought. I am now left with COPD and chronic asthma and suffer every day. I feel let down as this would not have happened on the outside.”

Respondents shared that it was only after widespread testing was finally conducted that the numbers of those infected were then revealed. As another respondent explained:

Prisoners expressed the view that improving access to COVID-19 tests through prison healthcare could have played a crucial role in the early identification of the virus, helping to prevent its spread. Respondents indicated that quicker access to testing might have allowed for more effective isolation measures, reducing the overall impact of the virus within the prison.

3.3.3 Vaccine access

Vaccine inequality for prisoners was also highlighted as a healthcare access issue, with numerous respondents expressing frustration at the rollout of vaccines to prisoners. As one prisoner noted, “vaccination for prisoners was lax. [Prisoners were] treated like fourth class citizen[s].” Several other respondents noted that staff were prioritised to receive vaccinations first, emphasising the inequality of having to wait so long to get the vaccine. One respondent noted: “the vaccine rollout was troublesome, as staff for some reason being vaccinated [first].”

Other respondents observed the consequences of not having the vaccine, sharing that there were outbreaks of COVID-19 spreading fast due to crowded prison conditions. One respondent reported: “We faced a delay in receiving COVID vaccinations when they were first introduced, leading to no protection when we had an outbreak in our landing.” Another prisoner stressed that there were not enough vaccines available for all prisoners to receive one, noting “there was simply not enough to deal with [the prison] population.” The lack of sufficient numbers of vaccines for all prisoners was also identified by another respondent. They noted how it appeared that the available vaccines were prioritised to prisoners based on their age and health status, explaining: “Vaccines were based on age/health status even though all of us in this environment should all be top priority as we have a wing of 70. Some of those share cells.” 

A respondent noted that some fellow prisoners had expressed their concern to prison authorities. They recounted:

In this instance it appeared to be the initial rollout that had challenges, with subsequent vaccine timetables being followed by prison and health authorities.

3.3.4 Poor mental health support and services

The majority of respondents highlighted the significant impacts on mental health experienced in prisons during the pandemic. They shared that these impacts were compounded by a lack of access to sufficient mental health support and services. Prisoners noted that increased mental health issues, combined with physical healthcare issues suffered by those who had contracted COVID-19, together put much greater stress on the prison healthcare system.

Many prisoners expressed that there was no treatment or help available in prison for their mental health issues, which had deteriorated due to the day-to-day reality of living in restrictions brought about during the pandemic in Scotland. One person noted that there was:

Another respondent indicated they “never received help or support for mental health during COVID which was a big thing” while another respondent noted that “mental health was through the roof and [there was] no support inside prison.”

Several respondents reported that the amount and level of care available was insufficient, even when available. As one person recalled: “No mental health nurses were on the hall when everyone’s mental health was adversely affected by the lock up.” Another respondent similarly shared: “A lot of mental health problems arose through the prison lockdown without much healthcare available for prisoners.” This situation prompted one respondent to ask for more help with mental health treatment: “There should be more mental health help for guys locked up.” Staff may also need help with mental health issues, as noted by one prisoner: “More help with mental health follow up two years after [COVID-19 started] and now [more help is needed] for prisoners and staff.”

Respondents identified long wait times for treatment as another factor in the provision of mental healthcare in prisons during the pandemic. One prisoner described there being “a year waiting time to speak to a mental health nurse.”  Another person noted that poor outcomes were often the result of long waiting times for treatment:

Respondents reported barriers to accessing healthcare and felt there was a lack of preparedness for the demands put on the existing healthcare provisions for prisoners. Increased physical healthcare demands, due to the virus itself, were exacerbated by the increased demand for mental healthcare support and services. Respondents are seeking efforts to address and help treat the scale of mental health issues facing prisoners of Scottish prisons.

There were several key factors related to prison lockdowns during the pandemic, which proved detrimental to the mental health of prisoners, as some respondents noted. These included: lack of family contact, isolation, cancellation of activities and usual routines, as well as a lack of information about the virus reaching prisoners. Respondents noted that these significant disruptions led, in many cases, to severe behavioural and other mental health issues for prisoners. These issues included: a general deterioration in mental health (including increased depression and anxiety), increased substance abuse, an increase in self-harm and suicide (including suicidal thoughts, suicide attempts and witnessing others completing suicide). In turn, as discussed in the previous section, the increase in mental health issues led to increased demands on an already pressured and overburdened prison healthcare system.

3.4.1 Mental health – negative consequences and behavioural outcomes

The reported lack of family contact, isolation, absence of information and disruption to activities and usual routines have been identified by respondents as the main drivers of poor mental health during lockdown. This section details the consequences of those drivers. Respondents also reported several behavioural consequences, either experienced by respondents themselves, or observed in others. These included a general increase in depression, anxiety and an overall rise in poor mental health, an increase in illicit substance use, an increase in self-harming behaviour, and behavioural themes around suicide. 

3.4.2 Expressions of anxiety, depression and general negative mental health outcomes 

Respondents described in detail the effects of being in prison during the pandemic. Most specifically, respondents pointed to their own struggles with mental health during the prison lockdowns (for additional details of lockdown conditions and events, see Section 3.2 that highlights the compounded impacts on prisoners). 
 

One respondent simply stated: “My mental health got bad and my mood changed.” Several prisoners referenced lockdown-induced depression and anxiety. As one person recalled: “I felt depressed, lonely, alone”, while another stated: “During the pandemic my mental health suffered badly, and my depression became much worse.”

Increased anxiety was reported to be another common occurrence, with a respondent revealing: “The impact to my mental health was quite significant. I ended up with severe depression and an increase in my anxiety levels.”

Feeling unsafe was a pointed concern for another person who noted: “During lockdown at [the prison] it was relentless […] a brutal experience like no other, pretty alien land, no-one felt safe.”

Other respondents observed mental health deterioration in others, with one prisoner observing: “Lots of prisoners suffered serious mental health issues due to lockdown”, with another noting “many prisoners developed fears and depression.” The new reality of how the strict lockdown conditions affected the mental health of prisoners was noted by prisoners, with one respondent stating, “COVID and its related lockdowns and changes in prison conditions meant that many prisoners struggled with their mental health.” These general thoughts and feelings from respondents were also found to be the case with a report conducted by the SPS, where participants described frustration with the restrictions as boredom, anger and general poor mental health were all reported by participants.^[24]

3.4.3 Increase in drugs/substance use

Respondents also observed an increase in illicit drug use by other prisoners. This substance use was strongly linked to coping with the new restrictions brought about by COVID-19 guidelines. This was noted by one respondent, who observed: “Drugs use soared as a means of coping.” Fellow prisoners coping through drug use was also observed by another person: “Even though I do not use drugs, many people around me increasingly turned to drugs to cope, which again brings more problems than solutions in prison.” 

Boredom was reported as a factor in the increase of substance abuse by one prisoner, “In prison the lockdown had a lot of people misbehaving and trying drugs […] out of boredom.”  The Scottish Centre for Crime and Justice Research in 2022 similarly noted that coping with isolation, lock-ups and boredom was also identified as directly contributing to increased demand for drugs by prisoners.^[25]

One respondent reported that since many activities were cancelled, having nothing to do was a big factor in increased substance abuse, and sometimes had deadly consequences:

Another prisoner suggested that the abuse of illicit substances was a factor in the deaths of several fellow prisoners: “I was a prisoner in [prison name] [and witnessed] drug use to the point 6 people died.”

Substance use was detailed by another respondent as being a refuge for prisoners affected by the changes to their routine: 

The Scottish Centre for Crime and Justice Research also noted lack of activities or routine from “frequent lockup” and “limited regimes” led to new and increased demand for drugs by prisoners due to boredom and isolation.^[26] Similarly, respondents detailed that during the pandemic lockdowns, the lack of activities and routines, which can help keep them in a positive mindset as well as keeping prisoners connected to others, led to increased substance use by prisoners as a way to cope with the situation.

3.4.4 Self-harm

A trend observed in the responses shared with Let’s Be Heard was an increase in self-harming behaviour. This trend was identified by prisoners as another factor directly related to lockdown restrictions on prison life. Some respondents detailed their own experiences on this theme, while others observed it in fellow prisoners.

One prisoner generalised this behaviour, noting “self-harm increased” and another described that: “Some self-harmed, some withdrew into their shells.” Another respondent admitted: “[My] mental health was going through the roof and a lot of self-harm thoughts were coming into my head.” Another prisoner also recalled, “I was a prisoner […] and on my flat I seen people self-harming.” 

3.4.5 Suicide

Suicide attempts and ideation were the most serious and consequential behaviours from the responses linked to the decline in mental health of the Scottish prison population during the pandemic. Some respondents reported seeing others attempt suicide. One person recounted how some fellow prisoners resorted to extreme measures by attempting to take their own lives, giving a graphic description of suicide attempts they had witnessed. Another prisoner recounted that they witnessed people attempting to take their own lives, stating that “it became so bad I witnessed two inmates attempt suicide.” 

Mental health challenges, exacerbated by pandemic events became so bad for one prisoner that they recalled an attempt to take their own life:

Others recalled how prison conditions had deteriorated to the point where they had thoughts of suicide, with one person recalling: “[My] suicidal thoughts were daily, thoughts of just giving up also daily.” 

These accounts by respondents, as well as their observations of fellow prisoners, reflect the regularity with which suicide was discussed in the responses. Responses also detailed how mental health issues rose at an alarming rate due to pandemic lockdown conditions in prisons. When combining this perceived commonness of suicide with the previously mentioned mental health issues and behaviours as shared by respondents such as depression and anxiety, and behaviours such as self-harming or illicit drug use, then much more pressure is put on prison healthcare services.
 

[24] Dickson, Impacts of COVID-19 on Custody, 8.

[25] Toomey, Mapping Drug Use, 3.

[26] Toomey, Mapping Drug Use, 19.