{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:09:56Z","timestamp":1790003396063,"version":"4.0.1"},"reference-count":62,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: The Italian Constitutional Court\u2019s decision n. 99\/2019 abolished the distinction between physical and psychological health care in the Italian prison system. However, this and other changes to the penitentiary system present challenges to prison staff, which may vary based on their roles and backgrounds; (2) Purpose: To create a process of dialogue and collaboration that include different points of view, needs, and proposals regarding mental health in prisons, this study collects and integrates the perspectives of 91 prison staff who work in various capacities in eight prisons in northeast Italy. (3) Methods: Each participant was involved in either a focus group or a semi-structured interview, and thematic analysis was used to process the resulting transcripts; (3) Results: Through this process, 10 themes were derived that highlight the difficulties of working with prisoners with psychiatric disorders or psychological distress, including lack of human and economic resources, lack of positive communication between prisoners and society and a sense of professional incompetency; (4) Conclusions: Based on these themes, the need for increased points of view, dialogue, and collaboration between prison professionals and between prison and society is discussed, and the current feasibility of treating psychiatric disorders in prison is considered.<\/jats:p>","DOI":"10.3390\/ijerph182111254","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T23:49:52Z","timestamp":1635292192000},"page":"11254","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Mental Health in Prison: Integrating the Perspectives of Prison Staff"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2325-6450","authenticated-orcid":false,"given":"Ines","family":"Testoni","sequence":"first","affiliation":[{"name":"Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy"},{"name":"Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 31905, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Nencioni","sequence":"additional","affiliation":[{"name":"Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maibrit","family":"Arbien","sequence":"additional","affiliation":[{"name":"Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Iacona","sequence":"additional","affiliation":[{"name":"Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Marrella","sequence":"additional","affiliation":[{"name":"Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Gorzegno","sequence":"additional","affiliation":[{"name":"Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Selmi","sequence":"additional","affiliation":[{"name":"Local Office of External Criminal Execution, 35100 Padova, Italy"},{"name":"Local Office of External Criminal Execution, 45100 Rovigo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Vianello","sequence":"additional","affiliation":[{"name":"Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Nava","sequence":"additional","affiliation":[{"name":"Due Palazzi Prison of Padova, Via Due Palazzi, 25\/a, 35136 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6800-170X","authenticated-orcid":false,"given":"Adriano","family":"Zamperini","sequence":"additional","affiliation":[{"name":"Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1246-0456","authenticated-orcid":false,"given":"Michael Alexander","family":"Wieser","sequence":"additional","affiliation":[{"name":"Department of Psychology, Alpen-Adria-Universit\u00e4t Klagenfurt, 9020 Klagenfurt, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"key":"ref_1","unstructured":"Corte Costituzionale (2021, May 05). Sentenza Nr. 99. Available online: https:\/\/www.cortecostituzionale.it\/actionSchedaPronuncia.do?anno=2019&numero=99."},{"key":"ref_2","unstructured":"(2021, May 05). Senato Della Repubblica Costituzione Della Repubblica. Available online: http:\/\/www.senato.it\/1025?sezione=121&articolo_numero_articolo=32."},{"key":"ref_3","unstructured":"World Health Organization (2021, May 05). Constitution of the World Health Organization. Available online: https:\/\/www.who.int\/about\/who-we-are\/constitution."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1177\/107834580401100204","article-title":"Caring and Custody: Two Faces of the Same Reality","volume":"11","author":"Maroney","year":"2005","journal-title":"J. Correct. Health Care"},{"key":"ref_5","unstructured":"Di Lillo, M., and Associazione Antigone (2021, August 13). Il Problema Della Salute Mentale in Carcere. Available online: https:\/\/antigoneonlus.medium.com\/il-problema-della-salute-mentale-in-carcere-4ae94fe83391."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/S0140-6736(10)61053-7","article-title":"The health of prisoners","volume":"377","author":"Fazel","year":"2011","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1108\/13619322200800021","article-title":"A Theoretical Framework for Goal-directed Care within the Prison System","volume":"13","author":"Bulten","year":"2008","journal-title":"Ment. Health Rev. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/S2215-0366(17)30430-3","article-title":"Suicide in prisons: An international study of prevalence and contributory factors","volume":"4","author":"Fazel","year":"2017","journal-title":"Lancet Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.psychres.2014.11.053","article-title":"Mental disorders in Italian prisoners: Results of the REDiMe study","volume":"225","author":"Meloni","year":"2015","journal-title":"Psychiatry Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Voller, F., Silvestri, C., Martino, G., Fanti, E., Bazzerla, G., Ferrari, F., Grignani, M., Libianchi, S., Pagano, A.M., and Scarpa, F. (2016). Health conditions of inmates in Italy. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-3830-2"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"D\u2019Aurizio, G., Caldarola, A., Ninniri, M., Avvantaggiato, M., and Curcio, G. (2020). Sleep Quality and Psychological Status in a Group of Italian Prisoners. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17124224"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Falissard, B., Loze, J.-Y., Gasquet, I., Duburc, A., De Beaurepaire, C., Fagnani, F., and Rouillon, F. (2006). Prevalence of mental disorders in French prisons for men. BMC Psychiatry, 6.","DOI":"10.1186\/1471-244X-6-33"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ijlp.2015.03.011","article-title":"Psychiatric needs of male prison inmates in Italy","volume":"41","author":"Piselli","year":"2015","journal-title":"Int. J. Law Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1177\/0306624X15617256","article-title":"Dissociative Experiences and Psychopathology Among Inmates in Italian and Portuguese Prisons","volume":"61","author":"Zavattini","year":"2015","journal-title":"Int. J. Offender Ther. Comp. Criminol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s00127-010-0184-4","article-title":"Prison suicide in 12 countries: An ecological study of 861 suicides during 2003\u20132007","volume":"46","author":"Fazel","year":"2010","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.ijlp.2018.09.005","article-title":"Suicide and suicides attempts in Italian prison epidemiological findings from the \u201cTriveneto\u201d area, 2010\u20132016","volume":"61","author":"Castelpietra","year":"2018","journal-title":"Int. J. Law Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1258\/rsmmsl.46.2.127","article-title":"Prison Suicides and Self-harming Behaviours in Italy, 1990\u20132002","volume":"46","author":"Preti","year":"2006","journal-title":"Med. Sci. Law"},{"key":"ref_18","unstructured":"European Court of Human Rights (2021, August 13). Second Section Case Torreggiani and Others vs. Italy (Cases no. 43517\/09, 46882\/09, 55400\/09, 57875\/09, 61535\/09, 35315\/10 and 37818\/10). Available online: http:\/\/www.statewatch.org\/news\/2013\/feb\/italy.pdf."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.2105\/AJPH.2003.057323","article-title":"The World Health Organization European Health in Prisons Project After 10 Years: Persistent Barriers and Achievements","volume":"95","author":"Gatherer","year":"2005","journal-title":"Am. J. Public Health"},{"key":"ref_20","unstructured":"(2021, August 13). Gazzetta Ufficiale. Decreto del Presidente del Consiglio dei Ministri 1 Aprile 2008. Available online: https:\/\/www.gazzettaufficiale.it\/eli\/id\/2008\/05\/30\/08A03777\/sg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ijlp.2018.10.003","article-title":"Evolution of forensic psychiatry in Italy over the past 40 years (1978\u20132018)","volume":"62","author":"Ferracuti","year":"2018","journal-title":"Int. J. Law Psychiatry"},{"key":"ref_22","first-page":"34","article-title":"Across the walls. Treatment pathways of mentally ill offenders in Italy, from prisons to community care","volume":"27","author":"Boaron","year":"2021","journal-title":"J. Psychopathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1002\/cbm.2030","article-title":"Revolutionary reform in psychiatric care in Italy: The abolition of forensic mental hospitals","volume":"27","author":"Traverso","year":"2017","journal-title":"Crim. Behav. Ment. Health"},{"key":"ref_24","first-page":"85","article-title":"From trauma to offending\u2014Some considerations about the impact of traumatic experiences on the clinical pathways of forensic psychiatric patients in secure residential settings","volume":"13","author":"Boaron","year":"2019","journal-title":"Ital. J. Criminol."},{"key":"ref_25","unstructured":"Associazione Antigone (2021, May 05). XVI Rapporto 2020. Available online: https:\/\/www.antigone.it\/news\/antigone-news\/3301-il-carcere-al-tempo-del-coronavirus-xvi-rapporto-di-antigone-sulle-condizioni-di-detenzione."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Testoni, I., Nencioni, I., Ronconi, L., Alemanno, F., and Zamperini, A. (2020). Burnout, Reasons for Living and Dehumanisation among Italian Penitentiary Police Officers. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17093117"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1093\/bjc\/azab015","article-title":"Rehabilitation and dynamic security in the Italian prison: Challenges in transforming prison officers\u2019 roles","volume":"61","author":"Santorso","year":"2021","journal-title":"Br. J. Criminol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1080\/02604027.2018.1445909","article-title":"The professional identity of juridical\u2013educational professionals in prison","volume":"74","author":"Accordini","year":"2018","journal-title":"World Futures"},{"key":"ref_29","unstructured":"Comitato Nazionale di Costruzione e Sviluppo del PDTA (2017). Percorso Diagnostico Terapeutico Assistenziale (PDTA) Raccomandazioni per il paziente con disturbo mentale negli Istituti Penitenziari italiani. Riv. Psichiatr., 52, 1\u201333."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1017\/S1121189X00008344","article-title":"Italian forensic psychiatry: A story still to be written","volume":"9","author":"Fioritti","year":"2000","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_31","first-page":"e304","article-title":"Burnout syndrome: A preliminary study of a population of nurses in italian prisons","volume":"171","author":"Petrelli","year":"2020","journal-title":"Clin. Ter."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1177\/0969733019834976","article-title":"Moral distress in correctional nurses: A national survey","volume":"27","author":"Lazzari","year":"2020","journal-title":"Nurs. Ethics"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1177\/0969733015574926","article-title":"Moral distress in undergraduate nursing students","volume":"23","author":"Sasso","year":"2016","journal-title":"Nurs. Ethics"},{"key":"ref_34","first-page":"E315","article-title":"Correctional nursing in Liguria, Italy: Examining the ethical challenges","volume":"59","author":"Carnevale","year":"2018","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"871","DOI":"10.3233\/WOR-152238","article-title":"Work-related stress among correctional officers: A qualitative study","volume":"53","author":"Viotti","year":"2016","journal-title":"Work"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1080\/1068316031000093414","article-title":"Role conflict in community corrections","volume":"9","author":"Allard","year":"2003","journal-title":"Psychol. Crime Law"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/19361610.2013.738402","article-title":"To Be or Not to Be Committed: The Effects of Continuance and Affective Commitment on Absenteeism and Turnover Intent among Private Prison Personnel","volume":"8","author":"Garland","year":"2013","journal-title":"J. Appl. Secur. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1080\/1478601X.2012.730997","article-title":"Leave it at the gate: Job stress and satisfaction in correctional staff","volume":"26","author":"Mahfood","year":"2012","journal-title":"Crim. Justice Stud."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Gubrium, J.F., and Holstein, J.A. (2001). Focus group interviewing. Handbook of Interview Research, Sage.","DOI":"10.4135\/9781412973588"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1146\/annurev.publhealth.19.1.173","article-title":"Review Of Community-Based Research: Assessing Partnership Approaches to Improve Public Health","volume":"19","author":"Becker","year":"1998","journal-title":"Annu. Rev. Public Health"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1016\/0277-9536(95)00127-S","article-title":"What is a participatory research?","volume":"41","author":"Cornwall","year":"1995","journal-title":"Soc. Sci. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1467-9523.2004.00264.x","article-title":"Still left out in the cold: Problematising participatory research and development","volume":"44","author":"Hayward","year":"2004","journal-title":"Sociologia Rural."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/1467-9566.ep11347023","article-title":"The methodology of Focus Groups: The importance of interaction between research participants","volume":"16","author":"Kitzinger","year":"1994","journal-title":"Sociol. Health Illn."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Illeris, K. (2018). Transformative learning theory. Contemporary Theories of Learning, Routledge.","DOI":"10.4324\/9781315147277"},{"key":"ref_45","unstructured":"Addeo, F., and Montesperelli, P. (2007). Esperienze di Analisi di Interviste non Direttive, Aracne."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/146879410100100307","article-title":"Thematic networks: An analytic tool for qualitative research","volume":"1","year":"2001","journal-title":"Qual. Res."},{"key":"ref_47","first-page":"423","article-title":"Los modos de an\u00e1lisis en investigaci\u00f3n cualitativa en salud: Perspectiva cr\u00edtica Y reflexiones en voz Alta","volume":"76","author":"Amezcua","year":"2002","journal-title":"Rev. Espa\u00f1ola Salud P\u00fablica"},{"key":"ref_48","first-page":"33","article-title":"Metodi qualitativi E sociologia relazionale: Dimensioni culturali E riflessivit\u00e0 nello studio Delle relazioni sociali","volume":"1","author":"Crespi","year":"2017","journal-title":"Sociol. Politiche Soc."},{"key":"ref_49","unstructured":"Muhr, T. (1997). Atlas.ti Short User\u2019s Guide, Scientific Software Development."},{"key":"ref_50","unstructured":"Boyatzis, R.E. (1998). Transforming Qualitative Information: Thematic Analysis and Code Development, Sage."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"619687","DOI":"10.3389\/fpsyg.2021.619687","article-title":"Hardships in Italian Prisons During the COVID-19 Emergency: The Experience of Healthcare Personnel","volume":"12","author":"Testoni","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1177\/0093854809351682","article-title":"Job involvement, job stress, job satisfaction, and organisational commitment and the burnout of correctional staff","volume":"37","author":"Griffin","year":"2010","journal-title":"Crim. Justice Behav."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1080\/15614263.2017.1288120","article-title":"The effects of occupational stress on cognitive performance in police officers","volume":"18","author":"Gutshall","year":"2017","journal-title":"Police Pract. Res."},{"key":"ref_55","first-page":"18","article-title":"La polizia penitenziaria: Condizioni lavorative e salute organizzativa negli istituti penitenziari del Veneto","volume":"10","author":"Maculan","year":"2016","journal-title":"Ital. J. Criminol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Testoni, I., Marrella, F., Biancalani, G., Cottone, P., Alemanno, F., Mamo, D., and Grassi, L. (2020). The Value of Dignity in Prison: A Qualitative Study with Life Convicts. Behav. Sci., 10.","DOI":"10.3390\/bs10060095"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Finney, C., Stergiopoulos, E., Hensel, J., Bonato, S., and Dewa, C.S. (2013). Organisational stressors associated with job stress and burnout in correctional officers: A systematic review. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-82"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1080\/00207594.2012.688132","article-title":"Can intergroup contact improve humanity attributions?","volume":"48","author":"Capozza","year":"2013","journal-title":"Int. J. Psychol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.copsyc.2016.03.009","article-title":"Recent research on dehumanisation","volume":"11","author":"Haslam","year":"2016","journal-title":"Curr. Opin. Psychol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1111\/bjso.12008","article-title":"Defensive dehumanisation in the medical practice: A cross-sectional study from a health care worker\u2019s perspective","volume":"52","author":"Vaes","year":"2013","journal-title":"Br. J. Soc. Psychol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1164\/rccm.1941P1","article-title":"What is burnout syndrome (BOS)?","volume":"194","author":"Mealer","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/15555240.2017.1329628","article-title":"Burnout, coping and suicidal ideation: An application and extension of the job demand-control-support model","volume":"32","author":"Wallace","year":"2017","journal-title":"J. Workplace Behav. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11254\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:24:22Z","timestamp":1760167462000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/21\/11254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,26]]},"references-count":62,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["ijerph182111254"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182111254","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,26]]}}}