PRISON PSYCHIATRY

Dr Melanie BakerConsultant in Forensic PsychiatryVisiting Psychiatrist to HMP Barlinnie

Syllabus for MRCPsych IIPsychiatry in Prisons

Knowledge of the presence of psychiatric disorder in prison populations

Suicide in prisons Psychiatric treatment in prison

settings

PRISONS

There are 15 prisons in Scotland. These operate at different levels of security and cater for individuals on remand and serving sentences

Photo-shoot

Photo-shoot

HMP Barlinnie

STATISTICS – According to Literature

REMAND PRISONERS- 70% psychiatric morbidity

amongst remands– 5% psychotic or affective disorder - Three times more

likely to have psychosis or major depression than the general population

- Co-morbidity with mental illness, substance misuse and personality disorder is the norm

- Officer’s national, statistics 10% of male remands suffer a functional psychosis

- Substance misuse rate 38%, higher amongst remand than serving prisoners

- six times elevated suicide rate amongst prison population (Birmingham)

SENTENCED PRISONERS - 7% of male sentenced

prisoners have a psychotic illness

REASONS FOR ELEVATED PSYCHIATRIC MORBIDITY

Remand Acute withdrawal Addiction in custody New asylum population Demographics

CASE e.g.

Anonymised 36y male Serious offender Assault to severe injury Attempted murder

WHAT DOES THE VISITING PSYCHIATRIST DO?

Triage Case management Transfer to local hospitals Management of difficult prisoners Consultation

TAKE HOME MESSAGES

Syllabus The SPS is not the NHS Itinerant population Forensic experience