New Bill Must End The Unfair Treatment Of Mentally Ill Patients In Prison

Mentally ill prisoners wait significantly longer to be transferred to hospital than their counterparts in the community and the new mental health bill must address this inequality, argue two doctors in this week’s BMJ.

Drs Becky Sales and Nigel McKenzie, who work at HMP Pentonville, say at the moment the system is failing a group of people who form a significant proportion of Britain’s overcrowded prison population.

People with a mental disorder are significantly overrepresented in UK prisons – by as much as 70-90%. Each year between 1300 and 2000 (5-8%) patients who have been sectioned in English psychiatric hospitals have come from either court or prison.

The authors want to see a time limit set for transfers to hospital from prison. At the moment they say mentally disordered prison patients are not treated in the same way as their counterparts in the community, which contravenes the Human Rights Act 1998.

Unlike patients in the community, those in prison will wait several months for a hospital bed. They invariably have fully developed psychosis and are left untreated. This is because, apart from the sections relating to transfers, the 1983 Mental Health Act does not apply in prison.

Drs Sales and McKenzie want to see statutory obligations in the bill to ensure that patients judged as needing hospital treatment while in police custody or while they are with the courts cannot be sent to prison.

It is ironic, they say, that at a time when Britain’s prisons are overcrowded there is a significant part of its population waiting for transfers to hospital. They conclude their main argument is impossible to counter – acutely psychotic patients should not be in prison – and say: “It is time for us as health professionals to act on behalf of one of the most forgotten, disempowered and disadvantaged patient groups.”