Abstract
Summary In the modern western world severe mental disorders in prisoners are quite common. Medical ethics claims access to medical care for all people, which includes access to mental health care. Regarding compulsive treatment of chronic psychiatric disease in Germany, a change of paradigm has taken place during the last decade. The right of an individual suffering from psychosis to refuse treatment had been strengthened and the options to applicate compulsory pharmacological treatment have dwindled. Therefore, a rising numbers of individuals have dropped out of community mental health care and many are living homeless and almost forgotten in the shelters of the big cities. Therefore, prisons must deal with a rising number of mentally ill individuals incarcerated because of impulsive and aggressive behavior who are refusing pharmacological treatment and but who are severely ill when entering mental health care in prisons. Options for treatment and ethical consequences are discussed.
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