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Research project: Research and development programme on forensic mental health - Dormant - Dormant

Currently Active: 

The prevalence of psychiatric morbidity among prisoners is much higher than that found in the general population (Singleton et al 1998). Traditionally, prison healthcare services were the responsibility of the Prison Service rather than the NHS and were heavily criticised as being inadequate and substandard.


In 1999, a joint Prison Service/NHS Executive working group recommended that prison healthcare services be provided by a formal partnership between the Prison Service and the NHS, with the NHS being specifically responsible for secondary and community mental healthcare. In 2001, the prison mental health strategy 'Changing the Outlook' stated that prisoners should have access to the same range and quality of services as the general population (Department of Health and Prison Service 2001). In order to achieve this equivalence and fulfil the requirements of the NHS Plan, multi-disciplinary in-reach' teams of mental health professionals, similar to Community Mental Health Teams, funded by local PCTs, now aim to provide specialised services to prisoners in the same way as they do to patients in the community.

Main question(s)

  • To evaluate the impact of the introduction of prison mental health in-reach services.
  • To assess the effectiveness of the prison in-reach programme in relation to partnership working between key stakeholders. 
  • To measure staff and patient satisfaction with the implementation and impact of prison in-reach services.
  • To identify key barriers to implementation and to provide examples of good practice and collaboration.


The research is taking place in six prisons across the country. Southampton researchers (led by J. Lathlean) are conducting fieldwork in two prisons in the south.

The study has several different stages:

Stage 1  postal questionnaires to in-reach teams to provide a broad descriptive picture of their size and make up and the service systems in which they operate.

Stage 2  Semi-structured interviews with in-reach team members and prison governors to explore views on the operation and effectiveness of in-reach services and partnership working.

Stage 3 - Structured clinical interviews with prisoners. This stage has two distinct phases:

  • Phase 1: All prisoners newly received into prison will be screened using the short clinical instrument, PriSnQuest (Shaw et al. 2003) and those that screen positive will be asked to complete a full clinical interview to establish the prevalence of severe and enduring mental illness. Documentary analysis of case notes will be used to examine whether those with severe and enduring mental illness have been in contact with in-reach services.
  • Phase 2: Clinical interviews with a cross section of in-reach clientele to establish what proportion of the prison in-reach clients have severe and enduring mental illness.

Main outcomes

The findings will be fed back to local and national stakeholders in order to further develop service provision and delivery. 

Project team

Judith Lathlean 

Project funder

 NHS National R&D Programme

Related research groups

Health Work and Systems
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