Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-02T20:32:23.871Z Has data issue: false hasContentIssue false

Chapter 4 - Prison Psychiatry

Published online by Cambridge University Press:  06 June 2024

Mary Davoren
Affiliation:
Broadmoor Hospital and West London NHS Trust
Harry G. Kennedy
Affiliation:
Trinity College Dublin
Get access

Summary

This chapter seeks to provide clinicians with a better understanding of prisons and overcome many of the myths and misconceptions, with the objective of making the environment more attractive and interesting for future psychiatrists. In addition to a wide need and a rich variety of conditions, the psychiatrist in prison must contend with barriers to care such as working without a mental health act and, when a patient needs to be transferred and treated outside of prison, navigating complicated pathways to care. Mental disorder is prevalent in all prison systems. Pathways into prison may be related to general factors, specific factors such as delusions and comorbidities and complications of mental illness such as homelessness and breakdown of relationships, as well as service provision issues. The prevailing policy has been to divert prisoners in need of hospital care out of prisons. Court diversion models can focus on any point in the pathway from community to the criminal justice system. In prison, specialist mental health services are needed to address the high levels of morbidity due to self-harm, drug use, suicide and self-harm, hunger strikes and many other manifestations of developmental problems and traumatic experiences.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommendation CM/Rec(2012)5 of the Committee of Ministers to Member States on the European Code of Ethics for Prison Staff.Google Scholar
Recommendation Rec(2006)2 of the Committee of Ministers to Member States on the European Prison Rules. https://rm.coe.int/european-prison-rules-978-92-871-5982-3/16806ab9ae.Google Scholar
United Nations Office on Drugs and Crime. United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules). A/RES/70/175. (2015) General Assembly, Vienna, Justice Section, UNDOC. www.un.org/en/events/mandeladay/mandela_rules.shtml.Google Scholar
Wilson, S, Cummin, I. The history of prison psychiatry. In Wilson, S, Cummin, I (eds) Psychiatry in Prisons: A Comprehensive Handbook. London, Jessica Kingsley Publishers, 2010.Google Scholar
Walker, N. Why Punish? Oxford, Oxford University Press, 1991.Google Scholar
Howard, J. The State of the Prisons (1777–1784). London, J. M. Dent & Sons, 1929.Google Scholar
Fazel, S, Danesh, J. Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys. Lancet 2002; 359 (9306): 545–50.CrossRefGoogle ScholarPubMed
Fazel, S, Seewald, K. Severe mental illness in 33,588 prisoners worldwide: systematic review and meta-regression analysis. British Journal of Psychiatry 2012; 200 (5): 364–73.CrossRefGoogle ScholarPubMed
Baranyi, G, Scholl, C, Fazel, S et al. Severe mental illness and substance use disorders in prisoners in low-income and middle-income countries: a systematic review and meta-analysis of prevalence studies. Lancet Global Health 2019; 7 (4): e461e471.CrossRefGoogle ScholarPubMed
McKenzie, N, Forrester, A. Editorial: mental health in correctional and criminal justice systems (CCJS) – exploring how diagnosis, treatment and cultural differences impact pathway through the CCJS. Frontiers in Psychiatry 2023; 14: 1293060.CrossRefGoogle ScholarPubMed
Gunn, J, Maden, A, Swinton, M. Mentally Disordered Prisoners. London, Home Office, 1991.Google Scholar
Maden, A, Taylor, CJA, Brooke, D et al. Mental Disorder in Remand Prisoners. London, Home Office, 1995.Google Scholar
Singleton, N, Meltzer, H, Gatward, R. Psychiatric Morbidity Among Prisoners in England and Wales. London, Office for National Statistics, 1998.Google Scholar
Meltzer, H, Gill, B, Petticrew, M. The Prevalence of Psychiatric Morbidity Among Adults Aged 16–64, Living in Private Households in Great Britain. London, Office of Population Censuses and Surveys, 1995.Google Scholar
Birmingham, L, Mason, D, Grubin, D. Prevalence of mental disorder in remand prisoners: consecutive case study. British Medical Journal 1996; 313 (7071): 1521–4.CrossRefGoogle ScholarPubMed
Birmingham, L, Mason, D, Grubin, D. A follow-up study of mentally disordered men remanded to prison. Criminal Behaviour and Mental Health 1998; 8: 202–13.CrossRefGoogle Scholar
Parsons, S, Walker, L, Grubin, D. Prevalence of mental disorder in female remand prisons. Journal of Forensic Psychiatry 2001; 12: 194202.CrossRefGoogle Scholar
Wright, B, Duffy, D, Curtin, K et al. Psychiatric morbidity among women prisoners newly committed and amongst remanded and sentenced women in the Irish prison system. Irish Journal of Psychological Medicine 2006; 23 (2): 4753.CrossRefGoogle ScholarPubMed
Curtin, K, Monks, S, Wright, B et al. Psychiatric morbidity in male remanded and sentenced committals to Irish prisons. Irish Journal of Psychological Medicine 2009; 26 (4): 169–73.CrossRefGoogle ScholarPubMed
Kennedy, HG, Monks, S, Curtin, K et al. Psychiatric morbidity in sentenced, remanded and newly committed prisoners, 2004. www.academia.edu/10489242/Mental_Illness_in_Irish_Prisoners_Psychiatric_Morbidity_in_Sentenced_Remanded_and_Newly_Committed_Prisoners_Contents.Google Scholar
Fazel, S, Doll, H, Långström, N. Mental disorders among adolescents in juvenile detention and correctional facilities: a systematic review and metaregression analysis of 25 surveys. Journal of the American Academy of Child and Adolescent Psychiatry 2008; 47 (9): 1010–19.Google ScholarPubMed
Flynn, D, Smith, D, Quirke, L, Monks, S, Kennedy, HG. Ultra high risk of psychosis on committal to a young offender prison: an unrecognised opportunity for early intervention. BMC Psychiatry 2012; 12: 100.CrossRefGoogle Scholar
Fazel, S, Hope, T, O’Donnell, I, Jacoby, R. Hidden psychiatric morbidity in elderly prisoners. British Journal of Psychiatry 2001; 179: 535–9.CrossRefGoogle ScholarPubMed
Davoren, M, Fitzpatrick, M, Caddow, F et al. Older men and older women remand prisoners: mental illness, physical illness, offending patterns and needs. International Psychogeriatrics 2015; 27 (5): 747–55.CrossRefGoogle ScholarPubMed
Working Group on the Mental Health of Asylum Seekers and Refugees of the Royal College of Psychiatrists. Detention of people with mental disorders in Immigration Removal Centres. Medical Justice, 2013.Google Scholar
Royal College of Psychiatrists. Position Statement PS07/16: Definition of torture in the context of immigration detention policy, 2016. www.rcpsych.ac.uk/pdf/PS07_2016.pd.Google Scholar
Royal College of Psychiatrists. Position Statement PS02/21. Detention of people with mental disorders in immigration removal centres (IRCs), 2021.Google Scholar
Forrester, A, Hopkin, G. Mental health in the criminal justice system: a pathways approach to service and research design. Criminal Behaviour and Mental Health 2019; 29: 207–17.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence. Health of people in the criminal justice system NICE pathways, 2019.Google Scholar
Shaw, J, Creed, F, Price, J, Huxley, P, Tomenson, B. Prevalence and detection of serious psychiatric disorder in defendants attending court. Lancet 1999; 353 (9158): 1053–6.CrossRefGoogle ScholarPubMed
Brown, P, Bakolis, I, Appiah-Kusi, E et al. Prevalence of mental disorders in defendants at criminal court. BJPsych Open 2022; 8 (3): e92.CrossRefGoogle ScholarPubMed
Samele, C, McKinnon, I, Brown, P et al. The prevalence of mental illness and unmet needs of police custody detainees. Criminal Behaviour and Mental Health 2021; 31 (2): 8095.CrossRefGoogle ScholarPubMed
McKenna, B, Furness, T, Brown, S et al. Police and clinician diversion of people in mental health crisis from the Emergency Department: a trend analysis and cross comparison study. BMC Emergency Medicine 2015; 15: 14.CrossRefGoogle ScholarPubMed
Simpson, AIF, Gerritsen, C, Maheandiran, M. A systematic review of reviews of correctional mental health services using the STAIR framework. Frontiers in Psychiatry 2022; 12: 747202.CrossRefGoogle ScholarPubMed
Chaplin, E, McCarthy, J, Marshall-Tate, K et al. A realist evaluation of an enhanced court-based liaison and diversion service for defendants with neurodevelopmental disorders. Criminal Behaviour and Mental Health 2023. doi: 10.1002/cbm.2315.CrossRefGoogle Scholar
Pakes, F, Winstone, J. A site visit survey of 101 mental health liaison and diversion schemes in England. The Journal of Forensic Psychiatry & Psychology 2010; 21: 873–86. doi: 10.1080/14789949.2010.511241.CrossRefGoogle Scholar
Birmingham, L. Diversion from custody. Advances in Psychiatric Treatment 2001; 7: 198207. doi: 10.1192/apt.7.3.198.CrossRefGoogle Scholar
James, D. Court diversion at 10 years: can it work, does it work and has it a future? The Journal of Forensic Psychiatry & Psychology 1999; 10: 507–24.Google Scholar
Pierzchniak, P, Purchase, N, Kennedy, H. Liaison between prison, court and psychiatric services. Health Trends 1997; 29: 2629.Google Scholar
Joseph, PL, Potter, M. Mentally disordered homeless offenders: diversion from custody. Health Trends 1990; 22 (2): 51–3.Google ScholarPubMed
Joseph, PL, Potter, M. Diversion from custody. I: Psychiatric assessment at the magistrates’ court. British Journal of Psychiatry 1993; 162: 325–30. doi: 10.1192/bjp.162.3.325.CrossRefGoogle ScholarPubMed
Joseph, PL, Potter, M. Diversion from custody. II: Effect on hospital and prison resources. British Journal of Psychiatry 1993; 162: 330–4.CrossRefGoogle ScholarPubMed
Reed, J. Review of Health and Social Services for Mentally Disordered Offenders and Others Requiring Similar Services: Final Summary Report. London, Her Majesty’s Stationery Office, 1992.Google Scholar
Chiswick, D. Reed report on mentally disordered offenders. British Medical Journal 1992; 305 (6867): 1448–9.CrossRefGoogle ScholarPubMed
Bradley, K. The Bradley Report: Lord Bradley’s Review of People with Mental Health Problems or Learning Disabilities in the Criminal Justice System. London, Department of Health, 2009.Google Scholar
James, D. Court diversion at 10 years: can it work, does it work and has it a future? The Journal of Forensic Psychiatry & Psychology 1999; 10: 507–24.Google Scholar
Keown, P, French, J, Gibson, G et al. Too much detention? Street triage and detentions under Section 136 Mental Health Act in the North-East of England: a descriptive study of the effects of a street triage intervention. BMJ Open. 2016; 6 (11): e011837.CrossRefGoogle Scholar
McKinnon, I, Grubin, DJ. Health screening in police custody. Journal of Forensic and Legal Medicine 2010; 17 (4): 209–12.CrossRefGoogle ScholarPubMed
Samele, C, McKinnon, I, Brown, P et al. The prevalence of mental illness and unmet needs of police custody detainees. Criminal Behaviour and Mental Health 2021; 31 (2): 8095.CrossRefGoogle ScholarPubMed
McKinnon, IG, Thomas, SD, Noga, HL, Senior, J. Police custody health care: a review of health morbidity, models of care and innovations within police custody in the UK, with international comparisons. Risk Management and Healthcare Policy 2016; 9: 213–26.CrossRefGoogle ScholarPubMed
Kennedy, HG. Models of care in forensic psychiatry. BJPsych Advances 2022; 28 (1).CrossRefGoogle Scholar
Forrester, A, Exworthy, T, Olumoroti, O et al. Variations in prison mental health services in England and Wales. International Journal of Law and Psychiatry 2013; 36 (3–4): 326–32.CrossRefGoogle ScholarPubMed
Shepherd, A, Hewson, T, Hard, J, Green, R, Shaw, J. Equivalence, justice, injustice: health and social care decision making in relation to prison populations. Frontiers in Sociology 2021; 6: 649837.CrossRefGoogle ScholarPubMed
Ismail, N, de Viggiani, N. How do policymakers interpret and implement the principle of equivalence with regard to prison health? A qualitative study among key policymakers in England. Journal of Medical Ethics 2018; 44 (11): 746–50.CrossRefGoogle Scholar
McKenna, B, Skipworth, J, Tapsell, R et al. Impact of an assertive community treatment model of care on the treatment of prisoners with a serious mental illness. Australasian Psychiatry 2018; 26 (3): 285–9.CrossRefGoogle ScholarPubMed
Felthous, AR, Bloom, JD. Jail-based competency restoration. Journal of the American Academy of Psychiatry and the Law 2018; 46 (3): 364–72.Google ScholarPubMed
Moncany, AH, Blanchet, M, Duchêne, L, Malinowski, C, de Ranchin, R. Psychiatric care in specially equipped hospital units. Soins 2022; 67 (870–1): 40–4.Google ScholarPubMed
Tomlin, J, Lega, I, Braun, P et al. Forensic mental health in Europe: some key figures. Social Psychiatry and Psychiatric Epidemiology 2021; 56 (1): 109–17.CrossRefGoogle ScholarPubMed
Salize, HJ, Dressing, H, Fangerau, H et al. Highly varying concepts and capacities of forensic mental health services across the European Union. Frontiers in Public Health 2023; 11: 1095743. doi: 10.1007/s00127-020-01909-6.CrossRefGoogle ScholarPubMed
Lennox, C, Leonard, S, Senior, J et al. Conducting randomized controlled trials of complex interventions in prisons: a Sisyphean task?. Frontiers in Psychiatry 2022; 13: 839958.CrossRefGoogle ScholarPubMed
Senior, J, Shaw, J, Hassan, L et al. An evaluation of the reception screening process used in prisons in England and Wales. Report to Offender Health, Department of Health. Offender Health Research Network, 2009.Google Scholar
Iqbal, MU, Byrne, O, Kennedy, HG, Davoren, M. Admissions to the National Forensic Mental Health Service, Central Mental Hospital Dundrum, before, during and after the COVID-19 pandemic: changes in the need for security and urgency of need for admission. European Psychiatry 2023; 66 (S1): S60S61. doi: 10.1192/j.eurpsy.2023.216.Google Scholar
Simpson, A, Brinded, P, Fairley, N, Laidlaw, T, Malcolm, F. Does ethnicity affect need for mental health service among New Zealand prisoners? Australian and New Zealand Journal of Psychiatry 2003; 37 (6): 728–34. doi: 10.1080/j.1440-1614.2003.01260.x.CrossRefGoogle ScholarPubMed
Grubin, D, Carson, D, Parsons, S. Report on new prison reception health screening arrangements: the results of a pilot study in 10 prisons. University of Newcastle, 2002.Google Scholar
Evans, C, Brinded, P, Simpson, A, Frampton, C, Mulder, R. Validation of brief screening tools for mental disorders among New Zealand prisoners. Psychiatric Services 2010; 61: 923–38. doi: 10.1176/ps.2010.61.9.923.CrossRefGoogle ScholarPubMed
Martin, M, Colman, I, Simpson, A, McKenzie, K. Mental health screening tools in correctional institutions: a systematic review. BMC Psychiatry 2013; 13: 275. doi: 10.1186/1471-244X-13-275.CrossRefGoogle ScholarPubMed
Flynn, G, O’Neill, C, Kennedy, HG. DUNDRUM-2: prospective validation of a structured professional judgment instrument assessing priority for admission from the waiting list for a forensic mental health hospital. BMC Research Notes 2011; 4: 10.CrossRefGoogle ScholarPubMed
Jeandarme, I, Habets, P, Kennedy, H. Structured versus unstructured judgment: DUNDRUM-1 compared to court decisions. International Journal of Law and Psychiatry 2019; 64: 205–10.CrossRefGoogle ScholarPubMed
Forrester, A, Till, A, Simpson, A, Shaw, J. Mental illness and the provision of mental health services in prisons. British Medical Bulletin 2018; 127 (1): 101–9.CrossRefGoogle ScholarPubMed
Pierzchniak, P, Purchase, N, Kennedy, H. Liaison between prison, court and psychiatric services. Health Trends 1997; 29 (1): 26–9.Google Scholar
Byng, R, Lennox, C, Kirkpatrick, T et al. Development and evaluation of a collaborative care intervention for male prison leavers with mental health problems: the Engager research programme. Programme Grants for Applied Research 2022; 10 (8).CrossRefGoogle Scholar
Hopkin, G, Evans-Lacko, S, Forrester, A, Shaw, J, Thornicroft, G. Interventions at the transition from prison to the community for prisoners with mental illness: a systematic review. Administration and Policy in Mental Health and Mental Health Services Research 2018; 45: 623–34.CrossRefGoogle Scholar
McKenna, B, Skipworth, J, Tapsell, R et al. A prison mental health in‐reach model informed by assertive community treatment principles: evaluation of its impact on planning during the pre‐release period, community mental health service engagement and reoffending. Criminal Behaviour and Mental Health 2015; 25 (5): 429–39.CrossRefGoogle ScholarPubMed
Smith, D, Harnett, S, Flanagan, A et al. Beyond the walls: an evaluation of a pre-release planning (PReP) programme for sentenced mentally disordered offenders. Frontiers in Psychiatry 2018; 9: 549.CrossRefGoogle ScholarPubMed
Shaw, J, Conover, S, Herman, D et al. Critical Time Intervention for Severely Mentally Ill Prisoners (CrISP): A Randomised Controlled Trial. Southampton, NIHR Journals Library, 2017.Google Scholar
Brockman, B. Food refusal in prisoners: a communication or a method of self-killing? The role of the psychiatrist and resulting ethical challenges. Journal of Medical Ethics 1999; 25 (6): 451–6.CrossRefGoogle ScholarPubMed
Wynia, M, Cho, EH, Naples-Mitchell, J. The ethics of caring for detained people on hunger strike. Annals of Internal Medicine 2022; 175 (5): 732–4.CrossRefGoogle ScholarPubMed
Eichelberger, M, Joray, ML, Perrig, M, Bodmer, M, Stanga, Z. Management of patients during hunger strike and refeeding phase. Nutrition 2014; 30 (11–12): 1372–8.CrossRefGoogle ScholarPubMed
Favril, L, Shaw, J, Fazel, S. Prevalence and risk factors for suicide attempts in prison. Clinical Psychology Review 2022; 102190.CrossRefGoogle Scholar
Walker, T, Shaw, J, Gibb, J et al. 2020. Lessons learnt from the narratives of women who self-harm in prison. Crisis 2021; 42 (4): 255–62.Google ScholarPubMed
Zhong, S, Senior, M, Yu, R et al. Risk factors for suicide in prisons: a systematic review and meta-analysis. The Lancet Public Health 2021; 6 (3): e164–74.CrossRefGoogle ScholarPubMed
Favril, L, Yu, R, Hawton, K, Fazel, S. Risk factors for self-harm in prison: a systematic review and meta-analysis. The Lancet Psychiatry 2020; 7 (8): 682–91.CrossRefGoogle ScholarPubMed
Shaw, J, Appleby, L, Baker, D. Safer Prisons: A National Study of Prison Suicides 1999–2000 by the National Confidential Inquiry into Suicides and Homicides by People with Mental Illness. London, Department of Health, 2003.Google Scholar
Fazel, S, Grann, M, Kling, B, Hawton, K. Prison suicide in 12 countries: an ecological study of 861 suicides during 2003–2007. Social Psychiatry and Psychiatric Epidemiology 2011; 46: 191–5.CrossRefGoogle ScholarPubMed
World Health Organization (WHO). Preventing overdose deaths in the criminal justice system, 2014. www.euro.who.int/__data/assets/pdf_file/0020/114914/Preventing-overdose-deaths-in-the-criminal-justice-system.pdf.Google Scholar
Vaughan, AD, Zabkiewicz, DM, Verdun-Jones, SN. In custody deaths of men related to mental illness and substance use: a cross-sectional analysis of administrative records in Ontario, Canada. Journal of Forensic and Legal Medicine 2017; 48: 18.CrossRefGoogle ScholarPubMed
Iqtidar, M, Sharma, K, Mullaney, R et al. Deaths in custody in the Irish prison service: 5-year retrospective study of drug toxicology and unnatural deaths. BJPsych Open 2018; 4 (5): 401–3.CrossRefGoogle ScholarPubMed
Yeruva, RR, Mekala, HM, Sidhu, M, Lippmann, S. Synthetic cannabinoids – ‘spice’ – can induce a psychosis: a brief review. Innovations in Clinical Neuroscience 2019; 16 (1–2): 31.Google ScholarPubMed
Shalit, N, Barzilay, R, Shoval, G et al. Characteristics of synthetic cannabinoid and cannabis users admitted to a psychiatric hospital: a comparative study. Journal of Clinical Psychiatry 2016; 77 (8): e989e995.CrossRefGoogle ScholarPubMed
Bloomfield, MA, Ashok, AH, Volkow, ND et al. The effects of Delta9-tetrahydrocannabinol on the dopamine system. Nature 2016; 539 (7629): 369–77.CrossRefGoogle ScholarPubMed
D’Souza, DC, Radhakrishnan, R, Sherif, M et al. Cannabinoids and psychosis. Current Pharmaceutical Design 2016; 22 (42): 6380–91.Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×