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In this PhD dissertation, I explore health-promoting aspects of Norwegian open prisons. The study of incarceration has long focused on the harmful aspects of imprisonment, with the ‘pains of imprisonment’ being one of the prominent concepts (Sykes, 1958/2007; Haggerty and Bucerius, 2020). More recent (and less prominent) is the growing research literature on the subject of ‘healthy prison’, focusing on health and well-being within prison settings (Baybutt and Chemlal, 2016; Ugelvik et al., 2022). This dissertation combines these two perspectives – the pains of imprisonment on one hand, and the experience of health and well-being on the other. It explores the tensions and intersections between the pains and frustrations that are inevitably part of imprisonment, whilst also accounting for the possibilities inherent in the prison experience. By ‘possibilities’, I refer to the available avenues for achieving improvements in various aspects of life – for instance mental, physical, social, educational, occupational – that may both contribute to overall well-being in the present and foster hope for the future. It is a fundamental premise of this thesis that the two may coexist – that prisons can, under some circumstances, and for some people, be simultaneously painful and constructive places.
The dissertation’s focus on health promotion in open prisons encompasses a comprehensive view of well-being and a phenomenological approach to data collection and analysis, by focusing on participants' own understanding of both painful, and possibility-enhancing, aspects of imprisonment. Data collection consisted of ethnographic fieldwork conducted in two Norwegian open prisons that have been depicted as ‘exceptional’, Leira and Bastøy. Acknowledging the potential coexistence of the inherent pains of imprisonment (Sykes, 1958/2007) and the aspects and characteristics of open prisons sometimes described as ‘exceptional’ (Shammas, 2014), this dissertation aims to nuance our understanding of how opportunities for personal growth may intersect with these pains.
The dissertation empirically explores an understudied part of the Norwegian prison landscape, aiming to expand knowledge of both health-promoting prisons and open prisons. Data was gathered over 745 hours of fieldwork at the two main sites and supplemented by two weeks of fieldwork at two additional (‘contrast’) sites. The empirical data includes 102 interviews with prisoners, prison staff, and staff from various imported health and welfare services. This dissertation comprises an extended introduction and three academic journal articles. All three articles can be read separately, as independent contributions to prison scholarship. The goal of the introduction is to introduce the three articles, tie them together, and subsequently discuss the findings in a way that both connects the dots and draws conclusions based on the work as a whole. The overarching research question guiding this thesis is as follows:
How do ‘exceptional’ penal institutions balance minimising the pains of imprisonment with maximising possibilities for achieving health-promoting and transformative experiences?
Through this overarching question, the dissertation aims to bridge two significant but often separate areas of prison inquiry and scholarship: that of the ‘pains of imprisonment’ and that of ‘healthy/health-promoting prisons’.
Additionally, the dissertation addresses three more specific sub-questions:
1. How do prisoners perceive and experience prison healthcare services?
2. How can the concept of Nordic exceptionalism be understood in light of contemporary challenges and disruptions in the Norwegian penal system?
3. In what ways do open prisons cultivate environments that enhance positive health experiences and promote constructive possibilities?
In addressing these questions, the dissertation includes three independent articles, each drawing on extensive ethnographic data and utilising different sets of interviews. The first article, titled "Patient or Prisoner? Perceptions of Prison Healthcare Services in Norway and the Conflict between Care and Control," published in the journal Incarceration, draws on interviews With 53 prisoners. In it, I examine the prevailing negative perceptions prisoners hold towards prison healthcare services. The article offers a two-fold explanation for these perceptions: first, that there are objective shortcomings in the provision of prison healthcare delivery, and second, that negative perceptions are shaped by participants’ unmet expectations and subjective evaluations. The article finds an array of unmet expectations regarding equal access to healthcare, health autonomy, and compassionate care – all in all, the desire to be treated like a patient, rather than a prisoner – with security considerations within the prison context significantly influencing these negative experiences.
The second article, "Exceptional’ Open Prisons Under Pressure: Austerity, Instability and Distrust", is published in The British Journal of Criminology. Using interviews from 51 prisoners from Leira and Bastøy, this article delves into various disruptions and Challenges which affected these prisons during the time of fieldwork, to illustrate how negative developments within the Norwegian correctional services impact even its most ‘exceptional’ institutions. My findings suggest that Leira experienced fewer disruptions and was not affected with the same severity as Bastøy; potentially due to its smaller size, greater stability regarding routines and staffing, and the preservation of institutional autonomy, which also helped sustain close staff-prisoner relationships.
This third article, "Navigating the ‘Pains of Freedom’ in Open Prisons", has been revised and resubmitted to Punishment & Society. This article focuses exclusively on the first research site, Leira prison, where both prisoners and staff expressed, broadly speaking, highly positive sentiments. Drawing on interview data with 25 prisoners and 15 staff members at Leira, I conclude that the negative experiences related to the ‘pains of freedom’ (Shammas,2014) at Leira can be constructive, under the right conditions. The article highlights five key elements within Leira’s environment that contributed to experiences of personal growth: namely transparency, tolerance, trust, empowerment and engagement.
By highlighting and conceptualising the complex intersection between pains and possibilities within prisons, the dissertation contributes new insights to the prison literature. The study also highlights the importance of differentiating between harmful and more constructive pains. The former should be mitigated as much as possible, while the latter can contribute to personal growth, and may even be a necessary element of the change process. The dissertation thus recognises the potential for growth that emerges from navigating pain in a supportive and positive context. Altogether, the articles identify autonomy, identity, social relationships, and stability as crucial elements for minimising pain and maximising possibilities in the context of prison, and these elements are easier to maintain and promote in smaller and more open prisons.
