ADR Wales News. Published 11/12/2025
A new analysis of health and justice data has revealed differences in how people released from prison use health services in the years after probation supervision ends.
The study, led by ADR Wales researcher Delyth James, linked administrative datasets to track general practice (GP) appointments, emergency department attendance, hospital admissions, substance misuse treatment and deaths among more than 8,700 former prisoners in Wales. The findings highlight critical periods of vulnerability and suggest that continuity of care after release remains a significant challenge.
The cohort consisted largely of men (89%) and people living in the most deprived areas of Wales. Two-thirds had received a single custodial sentence, while the remainder had experienced multiple sentences—a distinction that proved key to understanding health service engagement. Individuals with single sentences were more likely to attend GP appointments consistently, whereas those with multiple sentences showed persistently lower GP engagement but higher reliance on acute or specialist services. Across all groups, service use peaked during the first year after supervision ended.
Emergency department visits and hospital admissions were particularly high among those with multiple custodial sentences, pointing to more complex or acute health needs. Substance misuse treatment followed a similar pattern, with higher rates among the multiple-sentence group, especially in the initial months after supervision.
Looking at mortality data, three percent of the cohort—237 people—died within three years of ending probation supervision. Drug-related deaths accounted for nearly a third of these cases, while suicide represented 10%, with more than half of suicides occurring in the first year. Deaths followed different patterns depending on sentence history: those with a single custodial sentence were most at risk in the first year, whereas mortality among individuals with multiple sentences increased over time.
Delyth James, study author and ADR Wales Senior Statistical Officer, said: “This study offers a first look at health service use among people who have been in prison after the end of their probation supervision. Future analysis will explore key factors and their link to mortality, providing deeper insights for evidence-based interventions.”