THE TRANSFER OF SEVERELY MENTALLY-ILL PRISONERS FROM HMP WAKEFIELD - A DESCRIPTIVE STUDY

The use of s.47 of the Mental Health Act 1993 to transfer prisoners wi th mental illness to hospital was investigated in a large dispersal pr ison. Those satisfying ICD-10 criteria (World Health Organisation, 199 2) for schizophrenia, delusional disorder and major affective disorder , and with a clear history of treatment need, were identified by case- note review. Of a total of 21 prisoners identified, 17 had been subjec t to transfer requests during the current sentence. A comparison of ou tcomes indicated that those with greater chronicity of illness, multip le handicaps and need for long-term care were more likely to be reject ed for transfer. Prisoners serving determinate sentences constituted a greater proportion of those gaining admissions. The transfer process was characterized by lengthy delays at each stage. Assessments using s tandardized rating instruments indicated that those currently referred for transfer had more psychotic symptoms but global functioning of th e whole group was seriously impaired. The results highlight the contin uing shortfall of secure hospital provision, particularly for those ne eding long-term care, Various recommendations are made to improve the existing arrangements.