Up to 200,000 people flow in and out of prison each year, many staying only a few months. Prisoners have both an extremely high prevalence and complexity of mental disorders, often combining vulnerability factors (such as homelessness or a history of abuse) with multiple disorders and substance abuse. They include some of the most disturbed, disturbing and socially excluded members of our society. They present a tremendous challenge to those charged with their care.
As in the community, most care for mental-health problems in prisons is provided by doctors, nurses and others who are not mental-health specialists. This website has been written to help the generalists carry out the mental health aspects of their role and to help those in Primary Care Trusts and Health Authorities who are their partners. It assumes that generalist staff will have access to specialist advice and treatment and does not attempt to be a guide to secondary- or tertiary-level psychiatry. Nevertheless, it recognises that the role of primary care within prisons is a particularly demanding one.