Welcome to the Mental Health Primary Care in Prison website; a guide to mental ill health in adults and adolescents in prison and young offender institutions.

The Prison Service  has under its care one of the most vulnerable and mentally unhealthy populations anywhere. Epidemiological studies agree that the prevalence of serious personality disorders, drug and alcohol dependence, suicidal and self-harming behaviour, and all forms of mental illness (both psychotic and neurotic) is alarmingly high – much higher than in the general population. The most seriously ill prisoners need in-patient hospital treatment and should be moved to a more appropriate setting at the earliest opportunity. But for most, the aim is for care equivalent to that available in the community to be provided within the prison setting.

Prisons require mental-health services that are abundant and of high quality. The partnership between the Prison Service and the National Health Service (NHS) aims to introduce these and, over time, to achieve an equivalence of care. Even should this aim become a reality, however, prison healthcare staff (doctors, nurses, healthcare officers) will still need good mental-health skills and knowledge to carry out their primary-care role.


This Guide is designed to support them in doing that in collaboration with others – which, in the prison context, may include chaplains, probation officers, psychologists and prison officers, as well as mental-health specialists. The Guide is an adaptation of a guide for primary-care professionals working in the community. As such, it provides a directly equivalent resource and supports the process of achieving equivalence. Although it is not intended to be viewed as Prison Service policy, it has been developed with the active participation of many people – especially prison healthcare staff and NHS mental-health workers. Thus, it is an example of partnership between the Prison Service and the NHS.

If this is your first visit you may find it useful to read the forewordinternational forewordabout this site and acknowledgements sections.