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The Prison
Service in the UK has under its care one of the most vulnerable
and mentally unhealthy populations anywhere. Epidemiological
studies agree that the prevalence of serious personality disorders,
drug and alcohol dependence, suicidal and self-harming behaviour,
and all forms of mental illness (both psychotic and neurotic)
is alarmingly high - much higher than in the general population.
The most seriously ill prisoners need in-patient hospital
treatment and should be moved to a more appropriate setting
at the earliest opportunity. But for most, the aim is for
care equivalent to that available in the community to be provided
within the prison setting.
Prisons require
mental-health services that are abundant and of high quality.
The partnership between the Prison Service and the National
Health Service (NHS) aims to introduce these and, over time,
to achieve an equivalence of care. Even should this aim become
a reality, however, prison healthcare staff (doctors, nurses,
healthcare officers) will still need good mental-health skills
and knowledge to carry out their primary-care role. This Guide
is designed to support them in doing that in collaboration
with others - which, in the prison context, may include chaplains,
probation officers, psychologists and prison officers, as
well as mental-health specialists. The Guide is an adaptation
of a guide for primary-care professionals working in the community.
As such, it provides a directly equivalent resource and supports
the process of achieving equivalence. Although it is not intended
to be viewed as Prison Service policy, it has been developed
with the active participation of many people - especially
prison healthcare staff and NHS mental-health workers. Thus,
it is an example of partnership between the Prison Service
and the NHS. I commend this Guide and hope it is a useful
resource in the years to come.
Mr Martin Narey
Director General, HM Prison Service
Mr John Mahoney
Head Mental Health Branch, Department of Health
Dame Lesley Southgate
President, Royal College of General Practitioners
Professor Sian Griffiths OBE
President, Faculty of Public Health Medicine
Professor John Gunn
Chair Faculty of Forensic Psychiatry, Royal College of Psychiatrists
Dr Felicity Harvey
Head Prison Health Policy Unit
Dr Beverly Malone
General Secretary, Royal College of Nursing
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