Reality, policies and practical solutions concerning custody and somatic and mental health care for ageing prisoners in Switzerland


Content and goal of the research project "Agequake-1"

Worldwide a yet unprecedented phenomenon is developing that will force us to make radical changes on multiple levels of society, namely population aging. Due to low births rates and falling death rates, we will face a society where the proportion of elderly people will outweigh the proportion of young people. This phenomenon is also present at the micro-level in prisons. There the age stratification is equally changing towards an increasing number of elderly prisoners, which is reinforced by the rising number of detained people in general.

It is estimated that more than 8.75 million people are currently imprisoned worldwide. Many of these prisoners are likely to grow old in prison and will need access to appropriate medical health care. Very little is known about the provision and quality of health care available to older prisoners.

Therefore it was necessary to investigate the present provision of health care for this vulnerable group in order to provide guidance for professionals working in the field and guidelines for policy-makers concerning the attendance to elderly prisoners. The project will be conducted in the German and French speaking regions of Switzerland to make a comparison between the regional and cultural differences in the health care delivery systems possible.


Content and goal of the research project “Agequake-2”

The focus of Agequake-1 was on physical diseases, as psychiatric disorders were difficult to access because of the complex organization of many health services in the prisons. The aim of this follow-up project is to investigate the mental health of prisoners. The first project showed that the “agequake” phenomenon in the prisons is caused not least by massively increasing numbers of prisoners being sentenced to so-called “measures” (articles 59 and 64 of the Swiss penal code). The treatment of these detainees should be supervised by forensic psychiatrists, among others. Their assessment of the future risks posed by the detainee forms the basis for decisions on liberation by the judiciary. At present there is no systematic data collection on the mental health of prisoners, on the quality of the forensic assessments and on the question how health care is actually constituted.

Consequently, Agequake-2 will contribute on a national and international level to the research on the mental health of two overlapping groups which is urgently needed: elderly prisoners (50 years and older) as well as persons sentenced to measures. The latter constitute a significant part of the future elderly prisoners. Our study will use qualitative and quantitative methods to provide important facts and data that are missing. Thus, we can make a significant contribution to the future organization in prisons and to economic considerations in this regard.



Project start:

Agequake 1: 01.10.2011-31.07.2015

Agequake 2: 01.02.2017-31.01.2020

PhD-Committee of Wiebke Bretschneider

Prof. Dr Bernice Simone Elger, (Faculty representative), Head of the Institute for Bio- and Medical Ethics, University of Basel

Prof. Dr Alexander Morgan Capron, (Thesis supervisor), Professor of Law and Medicine at the University of Southern California, Scott H. Vice Chair in Healthcare Law, Policy and Ethics

Prof. Dr. Winfried Kluth, (Co-referee), Martin-Luther-University Halle-Wittenberg, Chair of public law; Judge at the Landesverfassungsgericht Sachsen-Anhalt

PhD-Committee of Violet Handtke

Prof. Dr Bernice Simone Elger, (Faculty representative), Head of the Institute for Bio- and Medical Ethics, University of Basel

Prof. Dr. med. Christophe Büla, (Thesis supervisor), Full Professor of Gériatrie et réadaptation gériatrique, University of Lausanne

Dr. Tenzin Wangmo (co-supervisor)(additional projects) Institute for Bio- and Medical Ethics, University of Basel

Prof. Dr. med Stefan Winter, (Co-referee), Associate Professor for Health Policy, Hannover Medical School