Megan Georgiou

The challenges facing mental healthcare provision in prisons are well established, however these have been amplified by the COVID-19 pandemic. The aim of this paper is to understand mental healthcare service delivery in prisons in the context of the pandemic. Forty-four inspection reports published by Her Majesty’s Inspectorate of Prisons (HMIP) for England and Wales were analysed thematically, focusing solely on sections specific to secondary mental healthcare delivery. Conclusions highlight the need for greater resource and investment in prison mental health services, as well as action to maximise the opportunities to advance service delivery.

The covid-19 pandemic has allowed us to acknowledge the depth and scale of the problems faced by mental health services in the criminal justice system. A recent editorial by Brooker and Coid is welcome but does not go far enough in depicting the profound effect of austerity on the services provided.

A discussion of the White Paper Reforming the Mental Health Act and what the proposed reforms mean for the criminal justice system.

The Care Programme Approach (CPA) can be an effective tool in coordinating the care and treatment needs of people with mental illness and learning disabilities. Within prisons settings, the CPA has been poorly implemented and the principles underpinning this approach have been lost. This paper presents the key themes identified as part of a consultation process to develop quality guidance on planning effective mental healthcare in prisons in relation to the CPA. It was conducted by the Quality Network for Prison Mental Health Services, a quality improvement initiative organised by the Royal College of Psychiatrists' Centre for Quality Improvement. The information derived from the consultation process indicates that there is a substantial need for standardisation and consistency in the application of the CPA process within prisons, for the purposes of enhanced care delivery, greater continuity of care, and improved patient outcomes.

The COVID-19 pandemic has presented significant challenges to health and social care systems world-wide. Within the prison estate, the challenges are amplified and tough measures have been brought in to contain the spread of the disease (Kothari et al, 2020). Mental health service delivery in prisons is greatly restricted and reports are starting to emerge of the impact of COVID-19 on both prisoners and staff members. This blog brings together some of the key issues and outlines how the current measures are placing prisoners and staff members at risk of harm.

Mental health services in prisons in the United Kingdom and Ireland have long received criticism for falling behind that of services available in the community. In recent years, the mental health of people in prison has received increasing attention and developments have been seen in commissioning, provision and quality. This paper summarises the key findings from the first three annual reports of a quality improvement initiative, the Quality Network for Prison Mental Health Services (QNPMHS), organised by the Royal College of Psychiatrists’ Centre for Quality Improvement. Between 2015 and 2018, participating services were subject to review against a set of evidence-based specialist standards via an annual process of self and peer-review. The paper explores whether any changes have been observed in the average compliance of the quality standards during this period. Slight improvements were observed in five of the nine standard domains; however, a longer period of review is required to fully assess the impact of such programmes within prison mental health services.