Prisoners being released facing drug and mental health crisis, study says

Scottish prisons create the “perfect storm” for prisoners being released, as a new study found they are facing a mental health and drug crisis.

Researchers from the University of Stirling said people being released from Scottish prisons were eight times more likely to be taken to accident and emergency or an ambulance (A&E) than other members of the public, and were five times more likely to be taken to A&E or an ambulance for mental health-related problems.

In what marks the first research project of its kind in Scotland, the Release study tracked more than 8,000 prisoners who were released in 2015 and examined their mental health and substance use in the four years that followed.

They compared the rate of A&E contact with a sample of other people, matched on sex, age, postcode, and deprivation indices.

All people in the sample had not been in prison during the five years prior.

In total, 8,313 people released from prison in 2015 were examined, compared with 41,213 matched individuals.

The study also found that 24% of people released from prison had contact with the ambulance service for mental health and substance-related reasons, and 21% with A&E.

Just 2% of the control group, who had not been in prison, had contact with the ambulance service and A&E during the same timeframe.

The study, funded by the Scottish Government, used data from the Scottish Prison Service (SPS), Public Health Scotland (PHS) and National Records Scotland (NRS), and was assisted by researchers from other Scottish universities.

Following the study, authors have called for more support in for people leaving prison who are at risk of drug use and mental health issues.

Dr Catriona Connell, Release lead investigator and senior research fellow at the Salvation Army Centre for Addiction Services and Research at the University of Stirling, said: “There are high levels of mental health and substance use problems among people in prison.

“These don’t go away when people are released, and may get worse without support.

“We know from other research that there are high rates of suicide and drug-related and alcohol-related deaths on release.

“Scotland’s prisons are overcrowded and Scotland has very high rates of imprisonment.”

She added: “At the same time, people return to an environment where drug-related deaths, alcohol-related deaths and suicides are much higher compared to the rest of the UK.

“All of these create the perfect storm for people following release from prison.

“This is the first study to show the long-term outcomes for prisoners after release. The impact on our health services is huge, and one that health and justice policymakers should address immediately with proper resources.

“That could then have a positive impact on individuals, health services and our public health budgets and resources in the long-term.”

According to researchers, Scotland’s prison population hit 8,431 in November 2025, a record high.

The Scottish Government’s Sentencing and Penal Policy Commission previously called for a rethink to the country’s approach to prison time for criminals.

Dr Connell said: “It is vital that sentencing considers the mental health and substance use harms of a sentence.”

Our Alcohol and Drug Recovery Strategy is also available to view here.

We don’t have responsibility for people after they have returned to their communities, but as the quote states, we try to make sure that services are joined up so the care and support needed continues seamlessly beyond our establishments.

An SPS spokesperson said: “Our population is not only exceptionally high, but extremely complex, and part of this complexity relates to the number of people with a history of mental ill-health and substance use.

“The wellbeing of all those in our care is a key priority and our staff work hard, alongside partners, to meet people’s needs and support them in their recovery journeys.

“This includes preparing them for liberation, seeking to ensure continuation of care from custody to the community, and giving them and their families the best possible chance of a healthy and substance-free future.”

A Scottish Government spokesperson said: “We are committed to ensuring that appropriate support is available to people when they are released from custody and are working with partners to improve services.

“We are clear that everyone leaving custody in Scotland is entitled to support on their release to help them resettle into their community.

“We are working with the Scottish Prison Service and health boards on implementing treatment standards and on developing alcohol and drug recovery pathways including the Prison to Rehab initiative.”