chapter  1
25 Pages


ByJoel Harvey, Kirsty Smedley

In 2001, the government document Changing the Outlook: A Strategy for Developing and Modernising Mental Health Services in Prisons (DH and HMPS 2001) set out a five-year plan to improve the health care provision of prisoners. This document put forward the principle of ‘equivalence’, in that ‘prisoners should have access to the same range and quality of services appropriate to their needs as are available to the general population through the NHS’ (DH and HMPS 2001). In 2006 the transferring of commissioning responsibility from the Prison Service to the NHS was completed. Mental health in-reach teams (MHIRTs) were introduced between 2003 and 2006 in order to support prisoners with severe and enduring mental health problems. In practice, MHIRTs have taken a broader remit and have also attempted to meet the needs of prisoners with a range of mental health difficulties including depression, self-injury and post-traumatic stress disorder (PTSD), to name but a few (see Bradley 2009). However, there still remains a high level of unmet need (Durcan and Knowles 2006; SCMH 2009) and although there are now some primary care services offering psychological therapy (e.g. HMP Liverpool) it is argued that there is still a need for more primary care services within prisons (SCMH 2007; SCMH 2009). In 2009 the Department of Health published the document Improving Access to Psychological Therapy (IAPT) Offenders Positive Practice. This document, aimed at commissioners of IAPT services, states that ‘IAPT services should be available and effective for both men and women who come into contact with the criminal justice system, as well as those who are at risk of offending’ (DH 2009: 4). In recent years there has been a move

to set up IAPT services in prisons, as for example in HMP Brixton, but this work is in progress.