The psychiatric aspects of imprisonment revisited

Thirty years ago, in their seminal consideration of the psychiatric treatment received by prisoners, Gunn and colleagues called for a comprehensive system of care and treatment in custodial environments (Gunn, Robertson, Dell, & Way, 1978). The first stage was for the National Health Service (NHS) to take responsibility for prison healthcare from the Home Office. The first foundations were laid in 2000 when the Prison Service and the NHS formed a formal partnership, and in 2006 primary care trusts (PCTs) finally became responsible for commissioning all prison health-care including mental health. Mental health in-reach teams, described as the prison equivalent of community mental health teams (Department of Health & HM Prison Service, 2001), were intended to be the main vehicle for improved mental health service delivery for prisoners.