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From first contact with the police to release from prison, people with mental ill health who come into conflict with the law often find that their mental health needs are neglected while they are under the authority of the criminal justice system. In 2008, the Prison Reform Trust surveyed independent monitoring boards in England and Wales, asking them to comment on mental health care. Topics included the adequacy of court diversion schemes, assessments carried out in prison reception units, and preparations to ensure continuity of care upon release. The responses documented some of the consequences of neglect in prisons in England and Wales. Over half of the boards felt that they frequently saw prisoners who were too ill to be in prison. Boards also expressed concerns about assessment processes in prison reception areas, which were by no means adequate to identify mental health problems. A number of boards stated that, too often, people with severe mental illnesses are held in segregation units, where they endure an impoverished regime. The boards observed that many prisons lack any means of identifying people who have learning disabilities, and often their disabilities restrict their capacity to engage fully with the regime.

Prisoners are supposed to receive health care that is equivalent to that provided in the community. There is a high prevalence of mental ill health in prisons, and prisoners tend to have complex needs. Prison mental health care has received only limited attention until recently. The impact of the new in ‐reach teams appears to have been positive, but primary mental health care is weak across the prison estate and the vast majority of prisoners with mental health problems still receive little or no service. The development of prison mental health care has not been evidence‐based and there has been no policy implementation guidance that compares to that provided for reforms in services for the wider community. There is no model for prison mental health care and the role of the prison mental health practitioner is not well defined, nor is the health care workforce prepared for the task.

The purpose of this paper is to explore the perspectives of prisoners and prison staff in relation to mental wellbeing and the negotiation of barriers to accessing and providing support. This small-scale study includes the experiences of 11 prison staff and 9 prisoners within a Category D male prison.

A focus group was conducted with the prisoners and interviews with prison staff. Thematic analysis identified three core themes: “context enabling factors”, “barriers to accessing support for mental wellbeing” and “peer support roles”.

Prisoners conveyed a reluctance in reporting mental health issues due to the fear of being transferred to closed conditions. All staff indicated the benefits of peer support roles.

Further research is required on a wider scale, as it is acknowledged that the findings of this study are from one prison and may not apply to other settings. Although there are barriers that may impact the reporting of mental wellbeing issues, there may be small relational steps that can be taken to address these.

Few studies exist that explore the nuances and barriers within open prisons, perhaps due to the overwhelming need within closed conditions. A context-specific approach considering early prevention strategies to support a safer prison system and successful rehabilitation is explored. The combination of prisoner and staff experiences is of value to both academia and policymakers.

In December 2007, Lord Bradley was asked by the Government, in a six‐month period, to review court liaison and diversion schemes for mentally ill people. A year and a half later, and having extended the brief to encompass the entire criminal justice system, Lord Bradley has reported. The Government has now responded to Bradleys’ findings (Ministry of Justice, 2009) so it is timely to comment on the review particularly in relation to prisons in England. The English prison population is almost at its highest ever level and currently stands at around 82,000 people ‐ according to the Prison Service’s standard of certified normal accommodation, the prison population is now 8000 more than it should be. As HM Chief Inspector of Prisons, Anne Owers, has noted ‘activity and support from staff . . . were the two things thought to be most helpful by prisoners with mental health and emotional problems, in over‐crowded and under‐resourced prisons these essential elements of care are at a premium’ (HM Inspectorate of Prisons, 2007).

The purpose of this paper is to provide an insight into the lived realities of d/Deaf prisoners in England and Wales, and to explore previous claims that they suffer disproportionately during their time in custody.

For the purposes of this study, a qualitative approach was taken. As part of this, 28 semi-structured interviews were carried out at seven adult male prisons in England with a sample of male hard of hearing/d/Deaf prisoners, and staff members who had worked with them. The interviews were recorded using a Dictaphone, and then transcribed as close to verbatim as possible. From this, the transcriptions were analysed using thematic analysis. In addition to interviews, observations were made at each establishment, and later recorded in a fieldwork journal.

Findings from the study showed that the way a d/Deaf person experiences prison depends strongly on the way in which they identify with their d/Deafness. However, it was also shown that there is little room for either deafness or Deafness in prison, with severely deaf and culturally and linguistically Deaf prisoners commonly experiencing the pains of imprisonment more severely than their hearing peers as a result of the Prison Service’s inability to accommodate such difference.

This study fused together the fields of Deaf Studies and Prison Studies in a way that had not been done before, considering d/Deafness in prison on both an audiological and cultural level. Moreover, excluding small-scale unpublished undergraduate dissertations, it was the first empirical study about d/Deaf prisoners in England and Wales to carry out face-to-face interviews with these prisoners. Finally, as the most in-depth research is yet to be carried out about these particular prisoners in England and Wales, a greater level of insight was provided than previously available.

Large numbers of women in prison report significant emotional and mental health problems, and there is evidence to suggest that the prison environment may exacerbate the incidence and severity of these issues (Armour, 2012). However, there has been limited exploration of the extent to which women’s mental health problems exist prior to incarceration, whether symptoms first occur in incarceration, and how incarceration affects this. The paper aims to discuss these issues.

In-depth interviews were conducted with 43 women incarcerated in three English prisons and a thematic analysis of the data was conducted. Review of official prison records provided a form of data triangulation.

Analysis of the data revealed that while many women who experienced mental health issues in prison had experienced these issues in the past, a number of women reported first experiencing mental health and emotional problems only after entering prison. Although these problems often recede, this demonstrates the significant impact that entering prison can have upon the mental health of women. Unusually, the data highlighted many positive experiences of support within prison. However, there was some lack of consistency in the treatment and support offered to women.

The data presented here are in many ways more positive than previous research and – as opposed to much of the existing literature that simply states the prevalence women’s issues in prison – provides insight into the lived experiences of women in prison. This paper documents how prison can present an opportunity for women to engage with treatment, but there is a need for a clearer understanding of women’s needs and consistent and appropriate support.

This article seeks to explore the historical context of government policy in relation to mentally disordered offenders. The article will relate this context to the work of the Probation Service, in particular the development of the Offender Management System (OASys), risk assessment and the implications and challenges that face the National Offender Management Service (NOMS). The key question to be assessed is whether NOMS and OASys can lead to a better service for those with mental disorder, and therefore reduce their risk.

The purpose of this paper is to assess whether mental health symptoms affect one-year reoffending rates upon release from prison for participants engaging in substance dependence treatment in the UK.

A retrospective cohort study was used to assess reconviction outcomes upon release. The Comprehensive Addiction and Psychological Evaluation (CAAPE) was administered to 667 inmates admitted to the programme. The effect of mental health, drug use, and static risk factors on reoffending was assessed at one-year post release.

Logistic regression analysis showed that symptoms of Major Depressive Disorder at the start of substance dependence treatment increased the likelihood to reoffend, whilst Obsessive Compulsive Disorder symptoms and length of sentence decreased the likelihood to reoffend. Antisocial Personality Disorder symptoms show a trend towards increasing the likelihood to reoffend. In addition, previously established risk factors for reoffending, including dependence on heroin, crack/cocaine, and poly drug use significantly increased the likelihood of reconviction.

Depressive symptomatology pre-treatment could affect reoffending outcomes for participants in substance dependence treatment in prison. An integrative approach addressing both substance misuse and mental health factors is pivotal. Future efforts to address both simultaneously can be made to improve assessment, training, treatment, and through care for prisoners in substance dependence treatment.

Few studies have assessed the effect of mental health factors on reoffending outcomes for offenders in substance dependence treatment. A large sample was studied in an understudied population of UK prisoners in substance dependence treatment. The results have implications for clinical settings where mental health symptoms are not addressed concurrently with substance dependence. This finding can inform policy makers and practitioners who provide substance dependence treatment in prison.

The purpose of this paper is to suggest that there was a need for a psychometric measure to assess attitudes specifically towards offenders with mental health problems. The “Community Attitudes towards the Mentally Ill” scale (CAMI; Taylor and Dear, 1981) was adapted to create a new psychometric measure; the “Police and Community Attitudes towards Offenders with Mental Illness” scale (PACAMI-O).

A sample of police and community participants (n=178) completed this scale through the online surveying system, Psychdata. The new psychometric measure utilised the same 40 items featured in the CAMI; although, the wording was adapted.

The internal reliability for the combined sample was high (α=0.929), which implied very good internal reliability. An exploratory factor analysis identified four new factors: Self-Preservation, Societal Reservation, Mental Health Awareness and Treatment Ideology. A t-test revealed there was a significant difference between the scores of the police and community sample, with the effect size depicting a large magnitude between the means (t(176)=p=0.019, η2=0.16).

The PACAMI-O scale appears adequate for measuring attitudes towards its targeted sample and has shown utility with; a professional group (police officers and custody sergeants) who potentially face such offenders (primarily in the context of using Section 136 of the Mental Health Act). It therefore has practical implications in assessing attitudes with other groups within forensic mental health.

Assessing attitudes towards offenders with mental health problems would enable a better understanding of the formation of negative attitudes and stigmatisation and therefore, ways of tackling treatment, rehabilitation and also community reintegration.

The purpose of this paper is to understand the needs and motivations of incarcerated men who self-harm with no apparent suicidal intent. These have received little attention in research and policy, despite men accounting for a high and increasing proportion of self-harm in prisons.

Semi-structured interviews were conducted with 20 adult male prisoners with a recent history or thoughts of non-suicidal self-harm. The interviews were analysed drawing on principles of thematic analysis and discourse analysis.

Against a backdrop of early traumatic experiences and more recent adverse events (including prison-related ones), self-harm was described by many as a desperate – but meaningful – coping strategy; both a means of releasing tension, sadness and frustration, and of being heard in an unresponsive system.

These findings echo those of research conducted with women (including women prisoners) who self-harm, but challenge some of the more negative ways in which non-suicidal male prisoner self-harm has been portrayed in the (scant) previous literature. As well as pointing to the need for greater awareness of the complex needs of men in prisons, they underscore the importance of (also) exploring – and perhaps addressing – the issue of self-harm separately from suicide, and of striving to make prisons, as well as prisoners, “healthier” and better able to cope with pressure.