ABSTRACT
Many people in prison have mental health problems and imprisonment is often thought to contribute to poor mental health. While the Mental Health Act (MHA) 1983 (as amended by the MHA 2007) allows for prisoners to be transferred to the mental health system for care, in practice, very few people will be transferred to hospital, and therefore the majority of prisoners with mental health problems will remain in prison. This chapter begins by examining the rates of mental disorder, self-harm and suicide in prisons before considering the key challenges involved with caring for those with mental disorder in a prison environment. The chapter outlines how people can be transferred from prison to secure mental health services in England and Wales, and then explores the challenges involved with detaining and treating offenders in these health settings. Throughout the chapter we explore the many conflicts that arise across these secure settings, as practitioners try to achieve a difficult balance between care and control.
