Psychotic Men Remanded in Custody to Brixton Prison

Abstract

All referrals to medical officers in Brixton Prison over a five-month period in 1989 were examined. This paper reports the progress through this remand prison of those men who were considered to be suffering from a major psychiatric disorder. Many men had been charged with relatively minor offences. The net effect of medical intervention was to delay release from custody. Because of the administrative delays inherent in the system of medical referral and hospital admission under section 37 of the Mental Health Act 1983, it was those prisoners who were most ill who tended to remain in prison for the longest periods. Judged in terms of its efficiency to ensure speedy treatment for mentally ill remanded offenders, the present system is regarded as cumbersome and extremely inefficient. It is suggested that greater use should be made of section 48 of the 1993 Act to divert mentally ill, remanded offenders from prison.

Mental disorder and prisons

“…Prisoners who are potential candidates for hospital treatment may be rejected by psychiatric services because they are perceived as too disturbed or dangerous, or seen as criminals who are unsuitable for treatment (Coid, 1988). Poor communication between the prison, court and hospital systems hinders the assessment and management of the mentally disordered offender, and medical intervention can actually delay release from custody (Robertson et al, 1994). When communication breaks down altogether, the result can be the sudden and unpredicted release of someone with acute psychosis who is then lost to follow-up in the community.…”

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

“…Gunn (1984a, 1984b) and Robertson et al (1994) studied outcomes in psychotic men remanded to Brixton prison. The former study incorporated an estimation of the prevalence of psychiatric disorder, but the authors acknowledge that the selection of a prison often used to house individuals remanded for psychiatric reports biases their results and their findings cannot be generalised.…”

“…The remand prisoners studied by Bowden (1978aBowden ( , 1978b, Gunn (1984a, 1984b), Coid (1988aCoid ( , 1988b and Robertson et al (1994) comprised groups of inmates most at risk of mental disorder (usually by virtue of having been remanded for psychiatric reports). These prisoners are not representative of the remand population as a whole.…”

A suitable waiting room? Hospital transfer outcomes and delays from two London prisons

“…In the early 1990s, an average 5-to 6-week delay between a prisoner being offered a bed and being admitted to hospital was standard. 9 Although a later study into the effectiveness of a psychiatric diversion scheme from HM Prison Belmarsh suggested some cause for optimism, 10 a subsequent audit identified lengthy delays before a hospital bed was found. 11 Multiple problems were identified in the second audit, including differences in opinion, legal disputes, diagnostic disagreements, long delays before initial assessments and NHS catchment area disputes.…”

“…Just over a third recognised further training needs, particularly on consent and assessment of memory during and after ECT. 8 There has been a gradual decline from 1985 to 2002 in the number of people in England receiving ECT, 9 and it is likely that this trend has continued. Thus referring psychiatrists will have less experience of this treatment.…”