Mental Health Primary Care in Prison
Mental disorders
Young people
Interface skills
Legal issues
Suicide & self injury
Groups with other needs
Difficult behaviours
Ethical issues

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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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