A hidden challenge: exploring food refusal in prisons

In a nursing career of more than 22 years, food refusal – sometimes referred to in popular culture as a ‘hunger strike’ – is one of the most complex, multifaceted patient safety challenges I have seen facing health professionals. It is also one of the most misunderstood.

For many people, prison nursing itself can seem quite mysterious – a unique environment so rarely in the spotlight, one that conjures up images of high walls, jangling keys and clinking gates. Perhaps it isn't so surprising, then, that food refusal is something of a ‘hidden problem’.

As a nurse with a special interest in safeguarding, I have been closely involved with the management of food refusal cases in prison settings and the complex safeguarding issues around them. I set out to remove some of the mystery – to understand some of the complex reasons behind food refusal, challenge myths and shine a light on the challenging work involved in keeping patients who refuse food safe from harm.