BMJ 2000;320:1031-1034 ( 15 April )

Papers

Inpatient care of mentally ill people in prison: results of a year's programme of semistructured inspections

John L Reed, medical inspector,  Maggi Lyne, nursing inspector. 

H M Inspectorate of Prisons, Home Office, London SW1H 9AT

Correspondence to: J L Reed drjohnreed{at}excite.co.uk

Objective: To investigate the facilities for inpatient care of mentally disordered people in prison.
Design: Semistructured inspections conducted by doctor and nurse. Expected standards were based on healthcare quality standards published by the Prison Service or the NHS.
Setting: 13 prisons with inpatient beds in England and Wales subject to the prison inspectorate's routine inspection programme during 1997-8.
Main outcomes measures: Appraisals of quality of care against published standards.
Results: The 13 prisons had 348 beds, 20% of all beds in prisons. Inpatient units had between 3 and 75 beds. No doctor in charge of inpatients had completed specialist psychiatric training. 24% of nursing staff had mental health training; 32% were non-nursing trained healthcare officers. Only one prison had occupational therapy input; two had input from a clinical psychologist. Most patients were unlocked for about 3.5 hours a day and none for more than nine hours a day. Four prisons provided statistics on the use of seclusion. The average length of an episode of seclusion was 50 hours.
Conclusion: The quality of services for mentally ill prisoners fell far below the standards in the NHS. Patients' lives were unacceptably restricted and therapy limited. The present policy dividing inpatient care of mentally disordered prisoners between the prison service and the NHS needs reconsideration.

---

© BMJ 2000
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Mentally ill people in prisons

Steve Gannon and John M Hall
BMJ 2000 321: 448. [Extract] [Full Text]

Prison mental health care doesn't match NHS
BMJ 2000 320: 0. [Full Text]

This article has been cited by other articles:

• Walsh, E., Freshwater, D. (2009). Developing the Mental Health Awareness of Prison Staff in England and Wales. J Correct Health Care 15: 302-309 [Abstract]  
• Mead, D., Moseley, L. (2004). Awareness of the health needs of prisoners. Journal of Research in Nursing 9: 194-207 [Abstract]  
• Macpherson, R., Shepherd, G., Edwards, T. (2004). Supported accommodation for people with severe mental illness: a review. Adv. Psychiatr. Treat. 10: 180-188 [Abstract] [Full text]  
• WILSON, S. (2004). The principle of equivalence and the future of mental health care in prisons. Br. J. Psychiatry 184: 5-7 [Full text]  
• Birmingham, L. (2003). The mental health of prisoners. Adv. Psychiatr. Treat. 9: 191-199 [Abstract] [Full text]  
• REED, J. (2003). Mental health care in prisons. Br. J. Psychiatry 182: 287-288 [Full text]  
• EARTHROWL, M., O'GRADY, J., BIRMINGHAM, L. (2003). Providing treatment to prisoners with mental disorders: development of a policy: Selective literature review and expert consultation exercise. Br. J. Psychiatry 182: 299-302 [Abstract] [Full text]  
• Isherwood, S., Parrott, J. (2002). Audit of transfers under the Mental Health Act from prison -- the impact of organisational change. Psychiatr. Bull. 26: 368-370 [Abstract] [Full text]  
• Smith, S., Baxter, V., Humphreys, M. (2002). The interface between general and prison psychiatry - theconsultant's perception. Psychiatr. Bull. 26: 130-132 [Abstract] [Full text]  
• Reed, J. (2002). Delivering psychiatric care to prisoners: problems and solutions. Adv. Psychiatr. Treat. 8: 117-125 [Full text]  
• Gannon, S., Hall, J. M (2000). Mentally ill people in prisons. BMJ 321: 448b-448 [Full text]  

Rapid Responses:

Read all Rapid Responses

Inpatient care of mentally ill people in prison.

J M Hall
bmj.com, 19 Apr 2000 [Full text]

Inpatient care of mentally ill people in prison

Edward Silva
bmj.com, 5 May 2000 [Full text]

In-patients are Out

Steve Gannon
bmj.com, 5 May 2000 [Full text]

Care of mentally ill people in prison

Kumar Anand
bmj.com, 24 May 2000 [Full text]

Online poll

Find out more >>