COVID-related disruptions and adaptations to prison-based mental health and substance use services: a narrative review.

PURPOSE: Public health experts and advocates have long raised concerns about the pandemic preparedness of prison systems worldwide - an issue that became increasingly salient at the start of the COVID-19 pandemic. People in prison experience poorer health outcomes compared to the general population, making timely access to adequate health services in prison critical for their health and wellbeing. This study aims to identify the extent of the literature on initial changes in mental health and substance use services for people in prison during the COVID-19 pandemic, summarize and synthesize the findings and identify areas in need of further study.

DESIGN/METHODOLOGY/APPROACH: The authors conducted a review of the academic literature published internationally in English between 2019 and December 1, 2020 to describe the disruptions and adaptations to mental health and substance use services in prisons during the onset of the COVID-19 pandemic.

FINDINGS: The authors found that mental health and substance use services in prisons around the world were widely disrupted due to the COVID-19 pandemic - predominantly consisting of the complete suspension of services, discontinuation of transfers to off-site treatment sites and limitations on service capacity. Adaptations ranged from virtual service delivery and changes to treatment dispensation processes to information sessions on overdose prevention.

ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first review to examine the nature and extent of the literature on delivery of mental health and substance use services in prisons during the COVID-19 pandemic.