POINT PREVALENCE OF MENTAL DISORDER IN UNCONVICTED MALE PRISONERS IN ENGLAND AND WALES

Objectives-To determine prevalence of mental disorder among male uncon victed prisoners and to assess the treatment needs of this population. Design-Semi-structured interview and case note review of randomly sel ected cross section of male remand population. Non-attenders were repl aced by the next name on prison roll. Setting-Three young offenders' i nstitutions and 13 adult men's prisons. Subjects-750 prisoners, repres enting 9.4% cross sectional sample of male unconvicted population. Mai n outcome measures-Prevalence of ICD-10 diagnoses of mental disorder, and associated treatment needs. Results-Psychiatric disorder was diagn osed in 369 (63%) inmates. The main diagnoses were: substance misuse, 285 (38%); neurotic illness, 192 (26%); personality disorder, 84 (11%) ; psychosis, 36 (5%); other and uncertain, 36 (0.5%). Subjects could h ave more than one diagnosis. The average refusal rate was 18%. In tota l 414 inmates (55%) were judged to have an immediate treatment need: t ransfer to an NHS bed, 64 (9%); treatment by prison health care servic es, 131 (17%); motivational interviewing for substance misuse, 115 (15 %); and therapeutic community placement, 104 (14%). Conclusions-Mental disorder was common among male unconvicted prisoners. Psychosis was p resent st four or five times the level found in the general population . Extrapolation of our results suggests that remand population as a wh ole probably contains about 680 men who need transfer to hospital for psychiatric treatment, including about 380 prisoners with serious ment al illness.