As we mark Mental Health Awareness Week 2026, we are invited to look beyond what is visible and notice struggles that are too often hidden from view. Behind the walls of Scotland’s prisons, mental ill-health is not the exception; it is the norm. The Mental Welfare Commission for Scotland reports that 76 per cent of people arriving in prison already have a history of mental ill-health.
In Psalm 57, where David cries out to God from a cave. In that dark place, he discovers that what feels like confinement is not abandonment, but refuge. He finds himself held by a loving God whose presence does not disappear behind walls.
But that leaves us with an important question: What happens when the cave door opens?
That question feels painfully relevant just now. A first-of-its-kind study led by the University of Stirling found that people released from prison in Scotland are facing a mental health and substance abuse crisis. The RELEASE study, published earlier this year, tracked every person released from Scottish prisons in 2015 for four years after their release.
The study followed 8,313 people and compared them with more than 41,000 individuals of similar age, sex, and background who had not been imprisoned. The findings are deeply concerning. Compared to those who had not been in prison, those released had:
Eight times more contact with ambulances for mental health and substance use.
Eight times more A&E visits related to substance use.
Five times more A&E visits related to mental health.
Over the four years following release, 24 per cent had contact with the ambulance service for mental health or substance use concerns, and 21 per cent attended A&E. By contrast, only 2 per cent of the comparison group had similar contact with emergency services.
These are not just statistics. They reflect the people our volunteers walk alongside every week; these are individuals reaching crisis point because help did not come soon enough.
The researchers are clear about the wider implications. At a time of prison overcrowding and pressure on the NHS, the impact on health and social care services is described as “huge”, leading to higher costs, greater strain on emergency services and, most importantly, real harm to individuals.
The study draws on data from the Scottish Prison Service, Public Health Scotland, and National Records Scotland, involving researchers from several Scottish universities. Dr Catriona Connell, Senior Research Fellow at the Salvation Army Centre for Addiction Services and Research at the University of Stirling and lead investigator on the RELEASE study, describes the situation starkly:
“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. Scotland’s prisons are overcrowded, and people return to communities where drug-related deaths, alcohol-related deaths and suicides are already much higher. All of these create the perfect storm for people following release from prison.”
And yet, there are signs of hope. The Scottish Prison Service is moving towards a new vision for wellbeing through its Commitment to Change, shifting away from constant crisis response and towards a culture rooted in compassion, safety, and hope. It is a person-centred approach that aims to give people in custody greater agency to stay safe, healthy, and supported.
This shift is mirrored in the service’s broader Mental Health Strategy for 2024 to 2034, which takes a whole-person approach. The goal is to create an environment where every person feels valued and cared for, and where the damaging effects of stigma and discrimination are minimised.
At Prison Fellowship Scotland, this vision reflects what we have long believed: no one is beyond reach, and every life matters. Our volunteers show up faithfully, offering a calm, human presence and a safe space away from the noise and pressure of the prison halls.
This Mental Health Awareness Week, we continue to pray for peace in the storm and for support to be available at the right time. We pray for families carrying the weight of worry, and for a justice system shaped by the compassion of the God who shelters us under His wings.
You can read the RELEASE study here and the SPS Mental Health Strategy for 2024 to 2034 here.
