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Luke Birmingham is a senior lecturer at the University of Southampton and an honorary consultant in forensic psychiatry at Ravenswood House Medium Secure Unit (Knowle, Fareham, Hampshire PO17 5NA, UK). His research interests include prison mental health care and mentally disordered offenders, and he has acted as a guest medical inspector for Her Majestys Prison Inspectorate.
Mental health problems are the most significant cause of morbidity in prisons. Over 90% of prisoners have a mental disorder. The prison environment and the rules and regimes governing daily life inside prison can be seriously detrimental to mental health. Prisoners have received very poor health care and, until recently, the National Health Service (NHS) had no obligations to service this group, which was the Home Offices responsibility. The NHS is expected to take responsibility eventually, following a new health partnership with the Prison Service. NHS psychiatrists will have to be much more active in the development and delivery of health care to prisoners who now have the right to equal health care. There are positive developments but concerted and determined action is required to bring prison health care up to acceptable standards.
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