Mental health in‐reach teams in English prisons: Aims, processes and impacts

Abstract

Prisoners are at greater risk of developing mental health problems compared with people of a similar age and gender in the community. They are less likely to have their mental health needs recognised, are less likely to receive psychiatric help or treatment, and are at an increased risk of suicide. Prison mental health in‐reach services have been developed in the UK to address these problems. An organisational case study method was used to generate theory about the links between the aims, processes and impacts of the introduction of mental health in‐reach teams to prison contexts. Case studies were undertaken on six sites and included interviews and focus groups with in‐reach team staff, prison healthcare staff, and discipline staff. The aims of prison mental health in‐reach were related to providing an equivalent service to a Community Mental Health Team, with a primary focus on serious mental illness, but a widening role. Achievement of these aims was mediated by the organisational context, active relationship development and leadership. Overall effects were positively reported by all stakeholders. Successful development was not just a function of time in post, but also a function of the effectiveness of leadership within the in‐reach teams. The more effective teams were having a wide impact on the response to mental health problems in the prison setting

Implementing change: staff experiences of changes to prison mental healthcare in England and Wales

“…In 2007 HM Inspectorate of Prisons (HMIP) conducted a review of the conditions and treatment in prison of offenders with mental health needs, concluding that during the period from 1996 to 2006 considerable improvements had been made in the care provided in prison for offenders with mental health needs, in particular the development of mental health in‐reach teams. Ricketts et al (2007) support these findings and discuss the relatively recent development of prison mental health in‐reach teams in the UK, the aim being to provide an equivalent service to Community Mental Health Teams. Their research suggests that “the more effective (in‐reach) teams were having a wide impact on the response to mental health problems in the prison setting”.…”

Prison Mental Health In-reach: The Effect of Open Referral Pathways

“…However, within a relatively short time it became apparent that this remit was widening, driven by both the organisational context and high levels of need (Ricketts et al, 2007). As this widening was further extended by national policy that made a broader remit explicit, 'mission creep' was identified as affecting these services after they had been operating for only a handful of years (Steel et al, 2007).…”