Mental health expertise at prison reception

Abstract

Although screening has become an established procedure in prison health care, some difficulties persist. In attempts to improve this, many local adaptations have been introduced, but few have been evaluated. We introduced an adaptation – mental health expertise (a Community Psychiatric Nurse, CPN) – into the reception area of a busy remand prison, and compared standard and enhanced assessment procedures over a six-month period. Referrals (n = 67) were significantly more likely to be suitable for onward caseworking by the clinical team after a CPN was introduced. The team showed little evidence of the ‘mission creep’ (where teams operating at a secondary level absorb mental health problems at a primary care level) that has been described elsewhere in the literature. Despite its limitations, this evaluation suggests that prison pathways can be improved by relatively inexpensive local initiatives, and that advancing specific mental health expertise into prison reception areas can enhance existing processes.

Keywords:

• mental health
• reception
• prison
• screening
• offender health
• in-reach

Acknowledgements

Thanks to the former NHS London, who provided funds to support this evaluation, and to Kevin Valydon (CPN) who assisted with data collection.

Notes

1. The project could only operate two days per week because funding was limited.

2. This equates to an annualised referral rate to MHIT of almost 450 individuals, given that the project only operated for two of the six reception days per week.