PRISON PSYCHIATRY by fO947L

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									PRISON PSYCHIATRY



Dr Melanie Baker
Consultant in Forensic Psychiatry
Visiting Psychiatrist to HMP Barlinnie
Syllabus for MRCPsych II
Psychiatry in Prisons


   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
   REMAND PRISONERS                         SENTENCED PRISONERS
    - 70% psychiatric morbidity
    amongst remands
                                              - 7% of male sentenced
    – 5% psychotic or                            prisoners have a psychotic
       affective disorder                        illness
    - 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)
REASONS FOR ELEVATED
PSYCHIATRIC MORBIDITY


   Remand
   Acute withdrawal
   Addiction in custody
   New asylum population
   Demographics
CASE e.g.


   Anonymised
   36y male
   Serious offender
   Assault to severe injury
   Attempted murder
WHAT DOES THE VISITING
PSYCHIATRIST DO?


   Triage
   Case management
   Transfer to local hospitals
   Management of difficult prisoners
   Consultation
TAKE HOME MESSAGES


   Syllabus
   The SPS is not the NHS
   Itinerant population
   Forensic experience

								
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