A follow‐up study of mentally disordered men remanded to prison

Little is known about the extent to which mental disorder is identified and subsequently treated in prison. In this paper the follow‐up stage of a prison study focusing on the natural history of mental disorder in prisoners on remand is presented. During the study, five hundred and sixty‐nine consecutive new unconvicted male remands to Durham prison were screened for mental disorder at prison reception by researchers and then monitored for the duration of their unconvicted remand to determine whether psychiatric treatment needs were identified and addressed. Sixty‐three (11%) of the study population, including forty (24%) of the one hundred and sixty‐eight men with psychiatric treatment needs were referred to the psychiatric service. Six of the 16 men requiring immediate transfer to psychiatric hospital came to the psychiatric service's attention. Of the 260 appointments made with mental health professionals, 63 (24%) were not kept and psychiatric intervention ended abruptly and prematurely in 10 cases. With the majority of mentally disordered prisoners, including those with acute psychosis, remaining undetected and untreated during their remand, and psychiatric intervention being so frequently disrupted by the prison regime and the unforeseen actions of the courts, a unique opportunity to address the psychiatric treatment needs of an otherwise elusive group of men who suffer high rates of serious mental disorder was missed.