Evaluation of pilot projects on drug treatment and mental health care in prisons: experiences of
service users and professionals
Prison healthcare in Belgium is under pressure, despite the legal and international principle of equivalence of care. People in detention frequently experience mental health and substance use problems, necessitating integrated and accessible services. This qualitative study was conducted in five Flemish prisons to examine professionals’ and service users’ perspectives on two pilot projects: Drugs and Detention (D&D) and the integration of primary care psychologists and social workers into prison medical teams (PMD). Data from observations, interviews, and focus groups were thematically analysed (n = 57 participants). Both pilot projects were perceived as valuable in improving access to tailored mental health and addiction care. Group sessions and individual counselling created safe spaces for support; however, some groups, including women, remained difficult to reach. Key challenges included continuity of care and the structural conditions required for sustainable implementation. Further investment in the availability, accessibility, and continuity of care is crucial to sustainably embed integrated services and mitigate the adverse health outcomes associated with detention.