The Belmarsh Scheme a Prospective Study of the Transfer of Mentally Disordered Remand Prisoners from Prison to Psychiatric Units

BACKGROUND: Contracting in psychiatric services from the NHS into prisons has been advocated to improve the care of the mentally disordered in custody. The Belmarsh Scheme is such a service. METHOD: A prospective study investigating the characteristics of a six-month cohort of remand prisoners requiring transfer to hospital and evaluating the service's effectiveness. RESULTS: Fifty-three (4.3%; 95% CL 3.2% to 5.6%) of the 1229 new remands required transfer to hospital; all were accepted. The transfer group contained a higher proportion of black men (51%) than all other remands (30%) (difference 21%; 95% CL 8% to 35%, P = 0.002). Transfer times were lower than those reported for a neighbouring prison. CONCLUSIONS: The Belmarsh Scheme secured in-patient psychiatric care rapidly for all those identified as needing it.