The transfer of severely mentally ill prisoners from HMP Wakefield: A descriptive study

Abstract

The use of s.47 of the Mental Health Act 1993 to transfer prisoners with mental illness to hospital was investigated in a large dispersal prison. Those satisfying ICD-10 criteria (World Health Organisation, 1992) for schizophrenia, delusional disorder and major affective disorder, and with a clear history of treatment need, were identified by case-note review. Of a total of 21 prisoners identified, 17 had been subject to transfer requests during the current sentence. A comparison of outcomes indicated that those with greater chronicity of illness, multiple handicaps and need for long-term care were more likely to be rejected for transfer. Prisoners serving determinate sentences constituted a greater proportion of those gaining admissions. The transfer process was characterized by lengthy delays at each stage. Assessments using standardized rating instruments indicated that those currently referred for transfer had more psychotic symptoms but global functioning of the whole group was seriously impaired. The results highlight the continuing shortfall of secure hospital provision, particularly for those needing long-term care. Various recommendations are made to improve the existing arrangements.