Prison healthcare staff and governors are now working in collaboration with Primary Care Trusts and Health Authorities to jointly provide health services of an equivalent standard to services outside prison. In mental health, this means working to meet the standards set out in the National Service Framework. Thus, the role of primary-care staff in prisons can be summarised as:
- Supporting the governor and other staff to develop an environment that supports mental health and well-being (Standard 1).
- Identifying prisoners with mental and substance abuse disorders (Standard 2).
- Managing prisoners with common mental disorders eg depression (Standard 2).
- Referring appropriately for assessment, advice or treatment (Standard 2).
- Working with diverse groups of patients from many different cultures.
- Providing information and guidance for those who provide regular and substantial care for prisoners with mental-health problems - in prison, often staff as well as family members (Standard 6).
- Contributing to the multidisciplinary work to prevent suicide (Standard 7).
The Guide provides information that supports all the activities listed above. However, health services in prisons are currently in transition. This is reflected in the Guide which includes information:
- about psychological therapies that have been shown to be effective for certain conditions, even though some (perhaps many) prison healthcare staff may not have access to these at the moment
- for generalists to help them in roles that go beyond those expected of primary-care staff outside prisons - for example, advice for generalist nurses working with acutely mentally ill patients in an in-patient setting. We have not, however, included information about running an in-patient Mental Health Unit, even though there are, at the moment, still some such units in prisons that are managed on a day-to-day basis by generalist healthcare staff.