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New procedures to cut delays in transfer of mentally ill prisoners to hospital

^*Camden and Islington Mental Health and Social Care Trust, Highgate Mental Health Centre, Dartmouth Park Hill, London N19 5JG, email: n.mckenzie{at}ucl.ac.uk

Becky Sales, Lead General Practitioner

HMP Pentonville, London

Declaration of interest

None.

AIMS AND METHOD

We sought to determine whether new procedures recommended by the UK Department of Health in partnership with the Home Office reduced delays in transferring mentally ill prisoners to hospital. Our main outcome measure was time taken from identification of a prisoner’s need for transfer to actual transfer to hospital. Waiting times for transfers that took place during 6-month periods before and after introduction of the new procedures were assessed. We also assessed adherence to medication while awaiting transfer.

RESULTS

There was a reduction in mean waiting time from 77 days to 53 days (24 days; 95% CI -2 to 50). Approximately 50% of patients offered medication while awaiting transfer were non-adherent.

CLINICAL IMPLICATIONS

Despite the new procedures, many individuals with acute mental illness remain untreated in prison for several months while awaiting transfer to hospital. We recommend that time limits should be specified for hospital transfers from prison comparable to norms under civil sections.