PRISON PSYCHIATRY
Dr Melanie Baker
Consultant in Forensic Psychiatry
Visiting Psychiatrist to HMP Barlinnie
Syllabus for MRCPsych II
Psychiatry in Prisons
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Knowledge of the presence of
psychiatric disorder in prison
populations
Suicide in prisons
Psychiatric treatment in prison
settings
PRISONS
There are 15 prisons in Scotland.
These operate at different levels of
security and cater for individuals on
remand and serving sentences
Photo-shoot
Photo-shoot
HMP Barlinnie
STATISTICS – According to Literature
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REMAND PRISONERS
- 70% psychiatric morbidity
amongst remands
– 5% psychotic or
affective disorder
- Three times more
likely to have psychosis
or major depression than
the general population
- Co-morbidity with mental
illness, substance misuse
and personality disorder
is the norm
- Officer’s national,
statistics 10% of male
remands suffer a functional
psychosis
- Substance misuse rate 38%, higher
amongst remand than serving
prisoners
- six times elevated suicide rate
amongst prison population
(Birmingham)
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SENTENCED PRISONERS
- 7% of male sentenced
prisoners have a psychotic
illness
REASONS FOR ELEVATED
PSYCHIATRIC MORBIDITY
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Remand
Acute withdrawal
Addiction in custody
New asylum population
Demographics
CASE e.g.
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Anonymised
36y male
Serious offender
Assault to severe injury
Attempted murder
WHAT DOES THE VISITING
PSYCHIATRIST DO?
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Triage
Case management
Transfer to local hospitals
Management of difficult prisoners
Consultation
TAKE HOME MESSAGES
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Syllabus
The SPS is not the NHS
Itinerant population
Forensic experience