Abstract
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Highlights
The significant frustration felt by those routinely working in the difficult and challenging environment of prison has rightly had the spotlight shone upon it.[1]
If questionnaires and criteria for diagnosis are employed based on the face value, the error would be an overdiagnosis of personality disorder
The second explanation has taken on absurd dimensions where prison general practitioners (GPs) have refused to continue a prescription of a commonly used antidepressant, started by a GP in the community, without it being authorised by a psychiatrist!
Summary
The significant frustration felt by those routinely working in the difficult and challenging environment of prison has rightly had the spotlight shone upon it.[1] In my experience, general practitioners (GPs) working in these settings are reluctant to prescribe psychotropic medications, often to the point of obstinacy. The reasons put forward are mostly that: (a) the GPs themselves have no experience or confidence in prescribing these medications, and (b) there is a perception that this is solely the remit of in-reach mental health services. I would like to see a similar study done comparing the continuity of prescribing of other chronic medications (i.e. antihypertensives or antihyperglycaemic agents) for newly received prisoners. A recent audit from the Offender Health Research Network[2] hinted that psychotropic medications were more likely to be omitted. This issue highlights the ongoing fault lines of professional disdain and mistrust towards psychiatry among our other medical colleagues.[3,4,5] Solving this problem will have to go beyond the platitude of the ‘additional training required’ and will necessitate a significant drive to improve the image of psychiatry as a credible medical discipline
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