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Mental Health Act transfers from prison to psychiatric hospital over a six-year period in a region of England

Laura Woods (Forensic Healthcare Services, Sussex Partnership NHS Foundation Trust, Hellingly, UK)
Laura Craster (Kent and Medway NHS and Social Care Partnership Trust, Forensic and Specialist Services, London, UK)
Andrew Forrester (Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK and University of Manchester, Manchester, UK)

Journal of Criminal Psychology

ISSN: 2009-3829

Article publication date: 30 June 2020

Issue publication date: 22 September 2020

Abstract

Purpose

There are high levels of psychiatric morbidity amongst people in prisons. In England and Wales, prisoners who present with the most acute mental health needs can be transferred to hospital urgently under part III of the Mental Health Act 1983. This project reviewed all such transfers within one region of England, with an emphasis on differences across levels of security.

Design/methodology/approach

Over a six-year period (2010–2016) within one region of England, 930 psychiatric referrals were received from seven male prisons. From these referrals, 173 (18.5%) secure hospital transfers were required. Diagnostic and basic demographic information were analysed, along with hospital security categorisation (high secure, medium secure, low secure, psychiatric intensive care unit and other) and total time to transfer in days.

Findings

There were substantial delays to urgent hospital transfer across all levels of hospital security. Prisoners were transferred to the following units: medium security (n = 98, 56.9%); psychiatric intensive care units (PICUs) (n = 34, 19.7%); low secure conditions (n = 20, 11.6%); high secure conditions (n = 12, 6.9%); other (n = 9, 5.2%). Mean transfer times were as follows: high secure = 159.6 days; other = 68.8 days; medium secure = 58.6 days; low secure = 54.8 days; and psychiatric intensive care = 16.1 days.

Research limitations/implications

In keeping with the wider literature in this area, transfers of prisoners to hospital were very delayed across all levels of secure psychiatric hospital care. Mean transfer times were in breach of the national 14-day timescale, although transfers to PICUs were quicker than to other units. National work, including research and service pilots, is required to understand whether and how these transfer times might be improved.

Originality/value

This paper extends the available literature on the topic of transferring prisoners with mental illness who require compulsory treatment. There is a small but developing literature in this area, and this paper largely confirms that delays to hospital transfer remain a serious problem in England and Wales. National work, including research and service pilots, is required to understand whether and how these transfer times might be improved. This could include different referral and transfer models as a component of service-based and pathways research or combining referral pathways across units to improve their efficacy.

Keywords

Acknowledgements

Conflicts of interest: The authors have no conflicts of interest to declare .

Citation

Woods, L., Craster, L. and Forrester, A. (2020), "Mental Health Act transfers from prison to psychiatric hospital over a six-year period in a region of England", Journal of Criminal Psychology, Vol. 10 No. 3, pp. 219-231. https://doi.org/10.1108/JCP-03-2020-0013

Publisher

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Emerald Publishing Limited

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