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

Published online by Cambridge University Press:  23 October 2012

J. Senior ,
L. Birmingham ,
M. A. Harty ,
L. Hassan ,
A. J. Hayes ,
K. Kendall ,
C. King ,
J. Lathlean ,
C. Lowthian  and
A. Mills
...Show all authors
J. Senior*
Affiliation:
The University of Manchester, UK
L. Birmingham
Affiliation:
The University of Southampton, UK
M. A. Harty
Affiliation:
Institute of Psychiatry, King's College London, UK
L. Hassan
Affiliation:
The University of Manchester, UK
A. J. Hayes
Affiliation:
The University of Manchester, UK
K. Kendall
Affiliation:
The University of Southampton, UK
C. King
Affiliation:
The University of Manchester, UK
J. Lathlean
Affiliation:
The University of Southampton, UK
C. Lowthian
Affiliation:
The University of Manchester, UK
A. Mills
Affiliation:
The University of Auckland, New Zealand
R. Webb
Affiliation:
The University of Manchester, UK
G. Thornicroft
Affiliation:
Institute of Psychiatry, King's College London, UK
J. Shaw
Affiliation:
The University of Manchester, UK
*
*Address for correspondence: Dr J. Senior, Offender Health Research Network, Centre for Mental Health and Risk, 2.317, Jean McFarlane Building, The University of Manchester, Manchester M13 9PL, UK. (Email: jane.senior@manchester.ac.uk)
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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.

Keywords

Epidemiologyforensic psychiatryhealth caremental health inreach servicesprison healthprisonerssevere mental illnesstwo-phase prevalence survey

Information

Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 7 , July 2013 , pp. 1511 - 1520
Copyright
Copyright © Cambridge University Press 2012 

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References

Anthony, JC, Folstein, M, Romanoski, AJ, Von Korff, MR, Nestadt, GR, Chahal, A (1985). Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis. Archives of General Psychiatry 42, 667–676.CrossRefGoogle Scholar
Armitage, C, Fitzgerald, C, Cheong, P (2003). Prison in-reach mental health nursing. Nursing Standards 17, 40–42.CrossRefGoogle ScholarPubMed
Birmingham, L (2003). The mental health of prisoners. Advanced Psychiatric Treatment 9, 191–201.CrossRefGoogle Scholar
Birmingham, L, Mason, D, Grubin, D (1996). Prevalence of mental disorder in remand prisoners: consecutive case study. British Medical Journal 313, 1521–1524.CrossRefGoogle ScholarPubMed
BMA (2001). Prison Medicine: A Crisis Waiting to Break. British Medical Association: London.Google Scholar
Bradley, K (2009). The Bradley Report. Lord Bradley's Review of People with Mental Health Problems or Learning Disabilities in the Criminal Justice System. Department of Health: London.Google Scholar
Brooke, D, Taylor, C, Gunn, J, Maden, A (1996). Point prevalence of mental disorder in unconvicted male prisoners in England and Wales. British Medical Journal 313, 1524–1527.CrossRefGoogle ScholarPubMed
Brooker, C, Gojkovic, D (2009). The second national survey of mental health in-reach services in prisons. Journal of Forensic Psychiatry and Psychology 20(Suppl. 1), 11–28.CrossRefGoogle Scholar
DH (1990). The Care Programme Approach for People with a Mental Illness, Referred to Specialist Psychiatric Services, Health and Social Services Circular HC (90)23/LASSL (90)11. Department of Health: London.Google Scholar
DH (2001). Changing the Outlook. A Strategy for Developing and Modernising Mental Health Services in Prisons. Department of Health and HM Prison Service: London.Google Scholar
Dunn, G, Pickles, A, Tansella, M, Vazquez-Barquero, JL (1999). Two-phase epidemiological surveys in psychiatric research. British Journal of Psychiatry 174, 95–100.CrossRefGoogle ScholarPubMed
Endicott, J, Spitzer, RL (1978). A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry 35, 837–844.CrossRefGoogle ScholarPubMed
Fazel, S, Danesh, J (2002). Serious mental disorder in 23,000 prisoners: a systematic review of 62 surveys. Lancet 359, 545–550.CrossRefGoogle Scholar
Grubin, D, Carson, D, Parsons, S (2002). Report on New Prison Reception Health Screening Arrangements: The Results of a Pilot Study in 10 Prisons. University of Newcastle: Newcastle.Google Scholar
Gunn, J, Maden, A, Swinton, M (1991). Treatment needs of prisoners with psychiatric disorders. British Medical Journal 303, 338–341.CrossRefGoogle ScholarPubMed
Health Advisory Committee for the Prison Service (1997). The Provision of Mental Health Care in Prisons. Home Office: London.Google Scholar
HM Inspectorate of Prisons for England and Wales (1996). Patient or Prisoner? A New Strategy for Health Care in Prisons. Home Office: London.Google Scholar
Lee, S (2003). Care co-ordinators and the CPA. Mental Health Nursing 23, 8–10.Google Scholar
Lukoff, D, Nuechterlein, KH, Ventura, J (1986). Appendix A: Manual for Expanded Brief Psychiatric Rating Scale (BPRS). Schizophrenia Bulletin 12, 594–603.Google Scholar
Meiklejohn, C, Hodges, K, Capon, D (2004). In-reach work with prisoners. Mental Health Nursing 24, 8–10.Google Scholar
Ministry of Justice (2007). Population in Custody Monthly Tables, April 2007. Ministry of Justice: London.Google Scholar
Parsons, S, Walker, L, Grubin, D (2001). Prevalence of mental disorder in female remand prisoners. Journal of Forensic Psychiatry 12, 194–202.CrossRefGoogle Scholar
Rogers, WH (1993). Regression standard errors in clustered samples. Stata Technical Bulletin 13, 19–23.Google Scholar
Romanoski, AJ, Folstein, MF, Nestadt, G, Chahal, R, Merchant, A, Brown, CH, Gruenberg, EM, McHugh, PR (1992). The epidemiology of psychiatrist-ascertained depression and DSM-III depressive disorders: results from the eastern Baltimore mental health survey appraisal. Psychological Medicine 22, 629–655.CrossRefGoogle Scholar
Selzer, ML, Vinokur, A, Van Rooijen, L (1975). A self-administered Short Michigan Alcoholism Screening Test. Journal of Studies on Alcohol 36 (Suppl. 1), 117–126.CrossRefGoogle ScholarPubMed
Shaw, J, Tomenson, B, Creed, F (2003). A screening questionnaire for the detection of serious mental illness in the criminal justice system. Journal of Forensic Psychiatry and Psychology 14 (Suppl. 1), 138–150.CrossRefGoogle Scholar
Singleton, N, Meltzer, H, Gatward, R, Coid, J, Deasy, D (1998). Survey of Psychiatric Morbidity Among Prisoners in England and Wales. Office for National Statistics: London.Google Scholar
Skinner, HA (1982). The Drug Abuse Screening Test. Addictive Behaviours 7 (Suppl. 4), 363–371.CrossRefGoogle ScholarPubMed
StataCorp (2008). Stata Statistical Software: Release 10.0. Stata Corporation: College Station, TX.Google Scholar
Steel, J, Thornicroft, G, Birmingham, L, Brooker, C, Mills, A, Harty, M, Shaw, J (2007). Prison mental health inreach services. British Journal of Psychiatry 190, 373–374.CrossRefGoogle ScholarPubMed
Telfer, J (2000). Balancing care and control: introducing the Care Programme Approach in a prison setting. Mental Health Care 41, 93–96.Google Scholar