'WORRYING' rates of depression, rising obesity and 'rife' drug use have been raised as issues at Oxfordshire's main prison.

An NHS report has given rare insight into life behind bars at HMP Bullingdon near Bicester, where more than 1,000 men are serving sentences or on remand.

While the overall conclusion was that healthcare at Bullingdon is 'robust', areas of concern included pressure on mental health services and illicit drug use.

One prisoner quoted in the report said: "All prisoners have (mental health) issues, even if it’s just stress or worry, services should assume everyone needs their help.

"Self-secluders are slipping through the net. People are suffering in silence with nowhere to go."

Some prisoners also spoke of a lack of social care for older inmates.

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One, quoted in the report, said: "Old boys are forgotten here.

"It’s like no one cares, they are just left to slowly rot. It’s a disgrace."

The independent report, commissioned by the NHS, said: "Mental health services reported being under a lot of pressure.

"They were described as being in a constant state of 'firefighting' and unable to meet the needs of the prisoners."

The report was dated July 2019, but was only published last Friday on Oxfordshire County Council's data and information site.

Depression levels were said to be rising, with prevalence among the prison population of 16.13 per cent - well above the national average of 9.88 per cent.

Obesity levels were also said to be 'a strong concern', with a prevalence of 14.54 per cent compared to 9.76 per cent nationally.

This is despite a weight management clinic and work to ensure prison food is healthy, which the report praised.

Despite being above the national average, both obesity and depression rates were said to be lower than other similar prisons.

The past three years has seen a 'significant increase' in the number of self-harm incidents, the report said, with 556 recorded in 2018.

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It stated: "Self-harm incidents since 2014 have been increased year on year, following the national trends.

"However, the increase in the past three years is highly significant.

"Systems and practices are in place and services are equipped to effectively address this need - however, the volumes are worrying."

Some prisoners admitted using drugs inside due to 'boredom'.

One quoted in the report said: "It [drug use] is rife, everyone sells everything - heroin, spice, steroids, Valium, cannabis…you name it, it’s being sold.

"Drug debts are collected in one way – violence."

The report said a 'high proportion' felt it was easy to get drugs or alcohol in the prison.

It added: "Clearly there have been incidents where medications have been abused and used as a tradable commodity in the prison.

"Equally there are prisoners who need their medications and may be forced to divert these medications to others through peer pressure and bullying.

"Since 2015 there has been an increasing trend in the number of drug finds."

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The psychoactive substance spice, in particular, was described as 'problematic'.

The report added: "Clearly there is a real perception that substance misuse in the prison is normalised and that there are high proportions of the population who are using substances."

Between April 2015 and the creation of the report, there were 16 deaths at Bullingdon including nine suicides.

The document added: "There has been a significant increase in the number of self-harm incidents reported.

"In most cases the reasons offered by prisoners related to general issues they were having on the wings, being bullied or under threat, healthcare, family issues or mental health issues."

In November the prison pledged to improve procedures, after an inquest into an inmate's death noted behaviour that might have suggested he was a suicide risk.

The prison's health services are overseen by Care UK, which is commissioned by NHS England.

In a survey of staff and stakeholders, one person quoted said Bullingdon was 'chronically understaffed'.

The report said there was 'ongoing difficulty in recruiting healthcare staff' partly due to 'high standards of living in the area'.

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Care UK has identified a need for 15.7 staff members and increased provision in certain areas including dentistry, it said.

This is partly due to Bullingdon being reconfigured in October to focus on 'reception and resettlement'.

The majority of inmates previously were sentenced prisoners, with about a quarter on remand or transfer, but now the split will be closer to half and half.

Its previous governor Ian Blakeman is now governor at HMP Pentonville in London, and an acting governor has taken his place.

The prison was approached for comment.