Making a difference in the mental health of those in compulsory detention

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Making a difference in the mental health of those
in compulsory detention   

• Angela Greatley, Chief Executive,
• Sainsbury Centre for Mental Health

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The Sainsbury Centre

• History
• Support for WHO Health in Prisons project
• Broad issues of public health
• Mental health a prime concern
• Current priorities for Health and Justice
• All offenders should have access to good quality
  health care
• Impact of poor health care for offenders is on
  the whole society
• Public health prisoners should not be
  forgotten people
• Public health and justice authorities have to
  work together for health promotion, prevention
  and good health care.

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Why mental health care?

• Global concern
• 9 million prisoners worldwide at least 1 million
  have a significant mental health disorder
• Even more have common mental health problems
• Co-morbid / complex drug use, personality
  disorder, alcoholism.
• The UK as an example
• Psychoses 8 10 of prisoners
• Personality disorders 66 of prisoners
• Common mental health problems 45 of prisoners
• Drug dependency 45 of prisoners
• Alcohol dependency 30 of prisoners.

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All-Stages Diversion (1)
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All-Stages Diversion (2)
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All-Stages Diversion (3)
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mental health care in detention

• Awareness training for prison staff
• Screening on arrival
• Primary care screening, assessment, evidence
  based treatment e.g. CBT, medication and review
• Prevention and health promotion
• Specialist in-reach from community, health care
  units and specialist outreach
• Address multiple needs in a seamless way.
• .

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What is needed?

• Mental health assessment at all stages Police
  Courts Prison Release
• Mental health promotion work in prisons
• Staff awareness
• Essential treatment in community and in detention
• Key documents and reviews
• WHO Europe (e.g. Trencín Statement on Prisons
  and Mental Health Kyiv Declaration on Womens
  Health in Prison)
• DH (UK) Making It Happen A guide to delivering
  mental health promotion
• Lord Bradley Review of mental health and criminal
  justice (April 2009.)

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• Angela.Greatley_at_scmh.org.uk
• www.scmh.org.uk