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Identification and management of prisoners with severe psychiatric illness by specialist mental health services

Identification and management of prisoners with severe psychiatric illness by specialist mental health services
Identification and management of prisoners with severe psychiatric illness by specialist mental health services
Background
The prevalence of mental disorders among prisoners is considerably higher than in the general population. This is an important public health issue as the vast majority of prisoners stay in custody for less than 9 months and, when not in prison, offenders’ lifestyles are frequently chaotic, characterized by social exclusion, instability and unemployment. Multi-disciplinary mental health inreach services were introduced to target care towards prisoners with severe mental illness (SMI) in a similar way to that provided by Community Mental Health Teams outside prison. The aim was to establish the proportion of prisoners with SMI who were assessed and managed by prison mental health inreach services.

Method
A two-phase prevalence survey in six prisons in England measured SMI upon reception into custody. Case-note review established the proportion of those with SMI subsequently assessed and treated by inreach services.

Results
Of 3492 prisoners screened, 23% had SMI. Inreach teams assessed only 25% of these unwell prisoners, and accepted just 13% onto their caseloads.

Conclusions
Inreach teams identified and managed only a small proportion of prisoners with SMI. Prison-based services need to improve screening procedures and develop effective care pathways to ensure access to appropriate services. Improved identification of mental illness is needed in both the community and the Criminal Justice System to better engage with socially transient individuals who have chaotic lifestyles and complex needs.
0033-2917
1-10
Senior, J.
bd80fcea-ed8f-418d-b3b5-1eb71619e745
Birmingham, L.
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Harty, L.
98d0577d-a4be-4ecc-bea2-447bef409317
Hassan, A.
f16d7813-136b-414a-88cc-46c38cddff45
Hayes, J.
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Kendall, K.
7c1c7abc-513b-4da5-b99d-268cd1d8bc58
King, C.
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Lathlean, J.
98a74375-c265-47d2-b75b-5f0f3e14c1a9
Lowthian, C.
a6a3359b-4055-45ff-8710-3497931e85ce
Mills, A.
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Webb, R.
a2c079b2-109c-4ae9-b3b2-c91bfb0fd43a
Thornicroft, G.
ff75ba58-e076-46d1-85da-11fa45bd973b
Shaw, J.
597595f2-31f5-4289-aa40-3dbec3c92778
Senior, J.
bd80fcea-ed8f-418d-b3b5-1eb71619e745
Birmingham, L.
e7ec7f62-5674-49a7-a80b-f13024c066a8
Harty, L.
98d0577d-a4be-4ecc-bea2-447bef409317
Hassan, A.
f16d7813-136b-414a-88cc-46c38cddff45
Hayes, J.
cce8b998-783d-4334-8c5a-17fc6d191eaf
Kendall, K.
7c1c7abc-513b-4da5-b99d-268cd1d8bc58
King, C.
e3dc1ab6-ba9b-463b-9a80-f473f52baa9e
Lathlean, J.
98a74375-c265-47d2-b75b-5f0f3e14c1a9
Lowthian, C.
a6a3359b-4055-45ff-8710-3497931e85ce
Mills, A.
e817a08c-31d0-4aa3-a5bf-e2be57c931e3
Webb, R.
a2c079b2-109c-4ae9-b3b2-c91bfb0fd43a
Thornicroft, G.
ff75ba58-e076-46d1-85da-11fa45bd973b
Shaw, J.
597595f2-31f5-4289-aa40-3dbec3c92778

Senior, J., Birmingham, L., Harty, L., Hassan, A., Hayes, J., Kendall, K., King, C., Lathlean, J., Lowthian, C., Mills, A., Webb, R., Thornicroft, G. and Shaw, J. (2013) Identification and management of prisoners with severe psychiatric illness by specialist mental health services. Psychological Medicine, 43 (7), 1-10. (doi:10.1017/S0033291712002073). (PMID:23084321)

Record type: Article

Abstract

Background
The prevalence of mental disorders among prisoners is considerably higher than in the general population. This is an important public health issue as the vast majority of prisoners stay in custody for less than 9 months and, when not in prison, offenders’ lifestyles are frequently chaotic, characterized by social exclusion, instability and unemployment. Multi-disciplinary mental health inreach services were introduced to target care towards prisoners with severe mental illness (SMI) in a similar way to that provided by Community Mental Health Teams outside prison. The aim was to establish the proportion of prisoners with SMI who were assessed and managed by prison mental health inreach services.

Method
A two-phase prevalence survey in six prisons in England measured SMI upon reception into custody. Case-note review established the proportion of those with SMI subsequently assessed and treated by inreach services.

Results
Of 3492 prisoners screened, 23% had SMI. Inreach teams assessed only 25% of these unwell prisoners, and accepted just 13% onto their caseloads.

Conclusions
Inreach teams identified and managed only a small proportion of prisoners with SMI. Prison-based services need to improve screening procedures and develop effective care pathways to ensure access to appropriate services. Improved identification of mental illness is needed in both the community and the Criminal Justice System to better engage with socially transient individuals who have chaotic lifestyles and complex needs.

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Published date: July 2013
Organisations: Medical Education

Identifiers

Local EPrints ID: 348292
URI: http://eprints.soton.ac.uk/id/eprint/348292
ISSN: 0033-2917
PURE UUID: 4391b691-0ffa-4eeb-a39d-1df9a761883d

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Date deposited: 12 Feb 2013 13:50
Last modified: 11 Nov 2019 20:59

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Contributors

Author: J. Senior
Author: L. Birmingham
Author: L. Harty
Author: A. Hassan
Author: J. Hayes
Author: K. Kendall
Author: C. King
Author: J. Lathlean
Author: C. Lowthian
Author: A. Mills
Author: R. Webb
Author: G. Thornicroft
Author: J. Shaw

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