The APEX prison study
Research type
Research Study
Full title
The APEX Study - Addressing the Psychosocial and Existential Well-being of people in prison (PiP) with serious health conditions, and their immediate circle of support (families, friends, staff).
IRAS ID
337482
Contact name
Emma Gilbert
Contact email
Sponsor organisation
University of Bristol
Duration of Study in the UK
3 years, 8 months, 3 days
Research summary
The prison population is ageing, with rising rates of serious, chronic illness. Despite policies promoting equal healthcare for people in prison (PiP), outcomes remain poor. PiP with serious health conditions face multiple losses – of identity, freedom, and purpose, which are compounded by trauma histories and complex needs.
Families often feel excluded from the care process. Whilst a “whole prison” approach to wellbeing is endorsed in policy, implementation is inconsistent, and provision of psychosocial and existential support varies widely.
AIMS
To explore the lived experiences of male PiP with serious health conditions, along with the perspectives of their immediate support networks, focusing on psychosocial and existential well-being.SECONDARY AIMS ARE TO:
• Identify barriers and enablers to equitable, compassionate care.
• Examine how prison systems and staff shape well-being from a whole-prison perspective
• Highlight potential areas for intervention and improvement.DESIGN AND METHODS
This qualitative study has two phases:PHASE ONE - ETHNOGRAPHIC OBSERVATION & INTERVIEWS
~360 hours of ethnographic observation across three prisons. The researcher will spend time observing and speaking with PiP living with serious health conditions to understand how illness and the prison regime shape psychosocial and existential well-being.Observations will be guided by Galvin and Todres’ Humanising Framework, which distinguishes humanising from dehumanising care experiences.
35–40 in-depth interviews across four participant groups:
• PiP with serious health conditions.
• Staff (custodial, healthcare, social care, education/training)
• Family/friends
• Peer Supporters (formal ‘buddies’ or friends offering support)An animated film will communicate key emotional touchpoints from the findings to generate discussion and engage participants in Phase Two.
PHASE TWO - NATIONAL STAKEHOLDER CO-DESIGN WORKSHOPS
A national workshop with lived-experience experts, staff, and policymakers will co-create and prioritise recommendations for policy and practice.PPI & DISSEMINATION
People with lived experience co-designed the study and remain involved. Findings will be disseminated through the film, a podcast in partnership with the Prison Radio Association, policy/practice briefings, and peer-reviewed journal articles.REC name
London - South East Research Ethics Committee
REC reference
25/LO/0827
Date of REC Opinion
27 Jan 2026
REC opinion
Further Information Favourable Opinion