Sainsbury Centre for Mental Health: prisons should have own GPs

All prisons should have a dedicated GP practice so that inmates’ mental health needs can be better met by the NHS, a new report says.

Getting the Basics Right by the Sainsbury Centre for Mental Health warns that the fractured nature of existing arrangements mean many prisoners’ mental health problems are not being properly tackled.

A number of different models for delivering mental health services to the UK’s 81,000 prisoners exist, with the most common being for a GP in the prison’s local area to provide treatment as part of general primary care. However, the report says many GPs lack the time and specialist skills to deal with the prisoners, some of whom have severe problems exacerbated by substance misuse. In addition, the ad-hoc nature of the commissioning of these services mean the resources allocated for them are vulnerable to being spent on other things.

Each prison having a dedicated primary care practice – with control of its own budget – would enable services to be better tailored to prisoners’ general and mental health needs, through flexibilities in the GP contract.

The report also calls for a new professional body to set standards for prison primary care and for GP practices outside of prison to have clearer incentives to improve the care they offer to former inmates. Better training for GPs should be part of this as current postgraduate courses are not widely taken up, it adds.

Last month’s report by the chief inspector of prisons Anne Owers found that 80% of inmates with mental health problems weren’t having their needs met. The government is expected to deliver its response to Owers’ findings shortly.

Research has found that prisoners are up to 26 times more likely to suffer from psychosis than the general population, while drug dependency is around 10 times more prevalent.

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