Psychiatric Bulletin (2003) 27: 173-176. doi: 10.1192/pb.27.5.173
© 2003 The Royal College of Psychiatrists
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Psychiatric Bulletin (2003) 27: 173-176
© 2003 The Royal College of Psychiatrists

Implementation of the Care Programme Approach in prison

Natalie M. Pyszora, Specialist Registrar in Forensic Psychiatry

South London and Maudsley NHS Trust, Community Forensic Services, 108 Landor Road, London SW9 9NT (Formerly Clinical Research Fellow, HMP Belmarsh)

Julia Telfer, Forensic Mental Health Liaison Nurse

HMP Belmarsh, Western Way, Thamesmead, London SE28 0EB

AIMS AND METHOD

Recent government legislation has highlighted the importance of implementation of the Care Programme Approach (CPA) within prisons, as part of the expectation that prisoners receive equivalent standards of healthcare to those provided by the National Health Service. To effectively plan the service provision at HMP Belmarsh, we retrospectively established the number of prisoners in a one-year period who would have fulfilled the criteria for enhanced CPA.

RESULTS

Of the 91 prisoners found to fulfil the criteria for enhanced CPA, the majority (77%) had a diagnosis of schizophrenia, schizoaffective or delusional disorder, and 58% required transfer to a psychiatric hospital. Of those who required hospital treatment, 75% needed conditions of high- or medium-security.

CLINICAL IMPLICATIONS

Successful implementation of the CPA for all prisoners who meet enhanced CPA criteria is likely to have significant resource implications, both for mental health teams working within prisons and local psychiatric services.