• L Birmingham, D Mason, and D Grubin.
• Department of Forensic Psychiatry, University of Newcastle upon Tyne, St Nicholas's Hospital, Gosforth.
• BMJ. 1996 Dec 14;313(7071):1521-4.

ObjectiveTo define the prevalence of mental disorder and need for psychiatric treatment in new remand prisoners and to determine to what extent these are recognised and addressed in prison.DesignStudy of consecutive male remand prisoners at reception using a semistructured psychiatric interview.SettingLarge remand prison for men (HMP Durham).Subjects669 men aged 21 years and over on remand, awaiting trial.Main Outcome MeasuresPrevalence of mental disorder at reception, prisoners need for psychiatric treatment, identification of mental disorder by prison reception screening, and numbers placed appropriately in the prison hospital.Results148 (26%) men had one or more current mental disorders (excluding substance misuse) including 24 who were acutely psychotic. The prison reception screening identified 34 of the men with mental disorder and six of those with acute psychosis. 168 men required psychiatric treatment, 50 of whom required urgent intervention; 16 required immediate transfer to psychiatric hospital. Of these 50, 17 were placed on the hospital wing because of mental disorder recognised at prison screening.ConclusionNot only is the prevalence of mental disorder, in particular severe mental illness, high in this population, but the numbers identified at reception are low and subsequent management in prison is poor.

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