The Scottish Prison Service has published and implemented both an Alcohol and Drug Recovery Strategy and a Mental Health Strategy, placing the SPS health and drug strategy framework at the centre of a sustained, decade-long programme of reform across Scotland’s prison estate.
Two strategies, one decade: the SPS health and drug strategy framework in full
According to ScotPHO, both the Alcohol and Drug Recovery Strategy and the Mental Health Strategy for Prisons run for the period 2024 to 2034, representing a ten-year commitment to improving health outcomes for people in custody. The two documents set out parallel but interconnected ambitions: one addressing substance use and recovery, the other targeting mental health provision across the custodial estate.
The Alcohol and Drug Recovery Strategy 2024-2034 emphasises four principal themes, as detailed by ScotPHO: the accessibility of medication-assisted treatment (MAT), stigma reduction, post-release support, and the management of supply within prisons. The focus on MAT accessibility is particularly relevant given longstanding concerns about the consistency of treatment provision at the point of reception into custody and during transfer between establishments. Post-release support, too, has been a persistent gap in the continuum of care, with many people leaving custody without adequate connections to community-based services.
Stigma reduction as a named strategic priority reflects a broader shift in how custodial health services are framed. Positioning drug dependency as a health matter rather than purely a disciplinary one has implications for how staff are trained, how services are designed, and how people in custody engage with treatment. Embedding that principle across a ten-year horizon gives the strategy a structural character rather than a reactive one.
Mental health provision across nine Health Boards
The Mental Health Strategy for Prisons, also covering 2024-2034, sits alongside the drug and alcohol framework and addresses the substantial overlap between mental health need and substance use in custodial settings. As ScotPHO notes, as of 2025 there are 17 prisons within nine Health Boards in Scotland, all managed by the Scottish Prison Service. That geography matters: health services in prisons are delivered in partnership with NHS Scotland, and the distribution of establishments across multiple Health Boards creates variation in provision that both strategies will need to navigate.
The custodial estate spans a wide range of establishment types, from large urban prisons to smaller and more remote facilities, each with different access to specialist health services. A ten-year mental health strategy that spans nine Health Board areas must account for those differences if it is to deliver consistent outcomes rather than postcode-dependent ones.
From a built environment perspective, the ambitions set out in both strategies carry implications that extend beyond clinical commissioning. Delivering accessible MAT, confidential mental health consultations, and adequate post-release transition support all depend in part on the quality and configuration of the physical spaces in which they are provided. Healthcare wings, consultation rooms, and secure dispensing facilities are infrastructure questions as much as clinical ones, and a decade-long strategy horizon creates an opportunity to align capital investment in the prison estate with the health outcomes the strategies describe.
The publication of both strategies is confirmed in the SPS Annual Report and Accounts 2024-25, which records their implementation alongside other organisational commitments. With the ten-year period now under way, the next phase will involve translating the strategic frameworks into measurable service changes across all 17 establishments, working in step with the nine Health Boards that hold clinical responsibility for the people held within them.
