PRISON PSYCHIATRY Dr Melanie Baker Consultant in Forensic Psychiatry Visiting Psychiatrist to HMP Barlinnie

Syllabus for MRCPsych II Psychiatry in Prisons Knowledge of the presence of psychiatric disorder in prison populations Suicide in prisons Psychiatric treatment in prison settings

PRISONS There are 15 prisons in Scotland. These operate at different levels of security and cater for individuals on remand and serving sentences

Photo-shoot

Photo-shoot

HMP Barlinnie

STATISTICS – According to Literature REMAND PRISONERS - 70% psychiatric morbidity amongst remands – 5% psychotic or affective disorder - Three times more likely to have psychosis or major depression than the general population - Co-morbidity with mental illness, substance misuse and personality disorder is the norm - Officer’s national, statistics 10% of male remands suffer a functional psychosis - Substance misuse rate 38%, higher amongst remand than serving prisoners - six times elevated suicide rate amongst prison population (Birmingham) SENTENCED PRISONERS - 7% of male sentenced prisoners have a psychotic illness

REASONS FOR ELEVATED PSYCHIATRIC MORBIDITY Remand Acute withdrawal Addiction in custody New asylum population Demographics

CASE e.g. Anonymised 36y male Serious offender Assault to severe injury Attempted murder

WHAT DOES THE VISITING PSYCHIATRIST DO? Triage Case management Transfer to local hospitals Management of difficult prisoners Consultation

TAKE HOME MESSAGES Syllabus The SPS is not the NHS Itinerant population Forensic experience