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57 Med. Sci. & L. 1 (2017)

handle is hein.journals/mdsclw57 and id is 1 raw text is: Original article A retrospective study describing the characteristics of one Mental Health Trust's admissions under sections 47 and 48 of the Mental Health Act 1983 Medicine, Science and the Low 2017, Vol. 57(1) 1-6 @ The Author(s) 2016 Reprints and permissions: sagepub.co. uk/journalsPermissions.nav DOI: 10.1177/0025802416677192 journals.sagepub.com/home/msI *SAGE Ravindran Neeilan and Aileen O'Brien Abstract Sections 47 and 48 of the Mental Health Act 1983 allow prisoners to be transferred from prison to an appropriate health-care setting in order to be treated. There is an awareness that delays exist when transferring prisoners to hospital. However, literature regarding the delay in returning these patients from hospital is limited. The admissions from prison to a Psychiatric Intensive Care Unit (PICU) in South West London were compared to non-offenders on the PICU in order to compare the average length of stay for both groups and the time taken for the discharge from PICU once felt clinically appropriate. The study also compared demographic profiles, reason for admissions, psychiatric diagnosis and index offences. Over six years, there were 18 admissions from prison to a PICU. The control group comprised 37 non- offenders admitted to the same PICU. On average the prison group took longer to be deemed clinically ready for discharge and, even once clinically ready, then took longer to be discharged. The average length of stay in PICU was 77.83 days for prisoners, and 16.46 days for non-offenders. All 55 admissions were between I January 2008 and 31 December 2014. The offender pathway and the difference in the length of stay between prisoners and non-offenders in a PICU warrants further exploration. Possible recommendations to reduce the length of stay of prisoners include improved information sharing between prisons and hospital, and clearer guidelines regarding the level of security required. Keywords Forensic psychiatry, forensic sections, prison Introduction Mental illness is common amongst the prison popu- lation. The Office for National Statistics (ONS) surveyed prison populations for mental ill health in England and Wales in 1997; >90% of prisoners were found to have at least one mental health disorder, including psychosis, neurosis, alcohol misuse, drug dependence and personality disorder.1 The responsibility for managing health care in pris- ons was fully transferred from Her Majesty's Prison Service (HMPS) to the National Health Service (NHS) in April 2006. The aim in involving the NHS was to allow prisoners access to the same quality and range of health services as the general public receives in the community.2 Prisoners who suffer from mental disorders and require inpatient treatment within a secure mental health service are only allowed to be transferred to hospital under the Mental Health Act (MHA) 1983 with consent from the Secretary State for Justice. Sentenced prisoners are transferred under section 47 (s47) of the MHA, and prisoners who are on remand or not yet sentenced are transferred under section 48 (s48). Section 49 (s49) empowers the Home Secretary to attach a restriction direction, imposing restrictions upon the discharge of the offen- der (prisoner). In the UK, under mental health legis- lation, patients are not able to receive treatment in prison without consent.3 Studies carried out by the Home Office demon- strate that between 1993 and 1999, the number of prisoners transferred from prison to hospital under s47 or s48 fluctuated between 723 and 785 per year. In 2000, the number decreased to 662 before rising in St. George's, University of London, UK Corresponding author: Aileen O'Brien, St George's, University of London, Cranmer Terrace, Tooting, London SWI 7 ORE, UK. Email: aobrien@sgul.ac.uk

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