The prison environment is radically different
from that with which most psychiatrists are familiar. Doctors may
have limited control over health facilities in prisons and the
delivery of services follows a radically different philosophy,
being principally centred on security and control. Resources are
also likely to be limited both in quantity and diversity. The
epidemiology of mental disorder and the nature of the prison
environment result in the role of the psychiatrist in prison being
a particularly challenging one.
This report concerns itself with the
development of psychiatric services in adult prisons in England and
Wales. It is hoped that the guidance will be of relevance to other
jurisdictions (it is not applicable to people under the age of 21
in prison establishments). It concentrates on generic services in
prisons, and so does not generate recommendations on the needs
of prisoners with special needs, nor on the particular needs of
women or people from Black or minority ethnic groups with mental
health problems in prison.
The report makes 26 recommendations to improve
mental healthcare in prisons. These cover the areas of:
- Role of the consultant psychiatrist in
prison.
- Commissioning mental health services in
prisons.
- Addiction services in prisons.
- Learning disability services in prison.
- Female prisoners.
- Old age psychiatry in prisons.
- Rehabilitation psychiatry in prison.
- Psychotherapy services in prison.
- Training.
(This report replaces CR15: Ethical issues
in psychiatric practice in prisons from 1992.)