ICPA in Prisons

1
ICPA in Prisons

• Calum Meiklejohn
• AWP Prison Mental Health Service Manager

2
Service Provision

• HMP Bristol- On average 600 male prisoners
  covering all AWP area and beyond.
• 2 AWP practitioners
• HMP Eastwood Park- On average 350 female
  prisoners covering all AWP area and beyond.
• 2 AWP secondary and 2 AWP PMH practitioners
• HMP Leyhill 500 1 practitioner every 2 weeks
  and HMP Erlestoke 400 1 practitioner 1 day a
  week

3
Wider Context

• Current media driven rhetoric-representation or
  reality?
• Community care has failed?
• Prisons are full of the mentally ill
• Prisoners are a high risk group?
• Rather than look at prisons we should turn the
  spot light on the courts and custody suits

4
Care pathways
5
Prisoners/CJS on CPA

• We are now using the trust ICPA/Risk policy more
  robustly and will through our care pathways place
  prisoners on ICPA
• PD issues- Is it a diagnosis of inclusion?
• Direction of the trust- Only to provide for
  patients on CPA, we need to work together
• Primary/secondary inter phase-we provide both
  services to the prisons

6
KPIs

• 27 prisoners on ICPA
• Number in the assessment phase- 28 in the remand
  prisons
• 30-40 receiving primary mental health care in
  Eastwood Park

7
Near misses

• For all prisoners remanded to prison who are on
  CPA enhanced should we have an automatic
  review?
• The purpose of this is to gather evidence on the
  use of the ICPA policy and its relationship with
  the CJSs
• Provide evidence to the integrated governance
  process with a view to developing policy and
  protocol

8
Community Rehabilitation Orders

• What is the Trust position/ protocol on this with
  Probation within the ICPA/ Risk policy?
• Should we have robust relationships locally with
  Probation services with a joint policy on ICPA/
  CROs that could reduce the need for patients
  with mental health needs being remanded to prison?

9
Responsibilities ICPA

• Prisoners already on ICPA,
• Prisoners we place on ICPA
• Community staff-PMHS staff defining
• Care co ordinator
• Interim care co ordinator
• Associate worker

10
MHIS

• Difficulty in recording information on MHIS-can
  non AWP information be scanned in? (for example
  court reports)
• MHIS/ system is useful-if effective and user
  friendly ?compatibility with other systems
• Staff training
• Staff time
• Access to PCs
• Administrative support
• Cost of the above against providing clinical
  services to other prisoners who require a
  service
• All to be included in commissioning debate

11
Transfer protocol

• From April 1st 2007, all prison transfers to
  psychiatric hospital under sections 47/48 must be
  done within 14days
• All prisoners identified for transfer will
  automatically be placed using the ICPA/Risk
  policy on enhanced CPA.

12
Release Protocol

• Prison mental health services staff can not be
  responsible for a prisoner on CPA when released.
• For out of AWP catchment areas there is a
  protocol to manage this

13
National ICPA Review

• The national consultation on ICPA asks the
  question how to define higher needs
• Complexity of need and current service provision
  PD, Dual Diagnosis, Housing or lack of, have
  been significant obstacles to prisoners accessing
  services including ICPA.

14
Summary

• Within AWP we will be placing more prisoners than
  before on ICPA in prison.
• AWP PMHS will develop as a service and continue
  to develop within the AWP management and
  governance structures and provide a bridge to
  the development of more robust joint working
  between mental health and the CJSs