Centre for Mental Health

Prisoners suffer from lack of basic care for mental health problems, says Sainsbury Centre

22 November 2007

Every prison in England should have its own dedicated general practice with its own budget, says a policy paper published today by the Sainsbury Centre for Mental Health.

Getting the Basics Right says most prisons fail to offer prisoners with mental health problems a decent standard of primary care. Prisoners with depression and anxiety suffer avoidable distress and go without the care and support that could help them to rebuild their lives. Many are never identified as having mental health problems and few get access to psychological therapy.

Most prison GPs have no training in mental health. In some cases, clinics are staffed by locum doctors with less than five minutes to see each patient. Prison nurses often have mental health training but rarely get the time to use those skills.

Sainsbury Centre prisons and criminal justice programme director Sean Duggan said: "Research across the country has shown that the majority of prisoners experience depression and anxiety. Many also have drug and alcohol problems, learning disabilities and a history of being abused. It is tragic that these problems are being ignored when they go to prison. We need to look urgently at how we can identify prisoners in distress and offer them care and support that might make a difference to them and, ultimately, to their families and communities."

Getting the Basics Right recommends policy changes to help the NHS build up a primary care mental health service in every English prison. It calls for every prison to be given its own GP practice. This would protect prisons from budget cuts in the NHS and allow for an incentive system to be set up to reward those practices that offer high standards of care.

The paper also calls for a new professional body to set standards for prison primary care and for practices outside prison to have clearer incentives to improve the care they offer to former prisoners and those at highest risk of being imprisoned.

Sainsbury Centre primary care adviser Dr Alan Cohen said: "Giving every prison a practice in its own right would not solve the problems we face overnight. But it would put in place the systems to help GPs, nurses, social workers and others to build a service that would help prisoners to manage their mental health problems and give them a better chance of a productive life after release."

Emma Wadey, Nurse Consultant for prisons in South Central England, said: "Prison primary care services have too few staff with the skills to help prisoners when they first experience mental distress. As a result we are often forced to offer a crisis service, helping only those with the most severe needs and doing little for those yet to reach crisis point."