Improving the mental health provision to people in prisons has long been recognised as being a priority. The incidence of Mental Illness in prisons is greater than the incidence in the community. The information on these pages contains, contacts, support and information that will support referral, assessment and interventions.

Our referral process has been developed to enable any person, including the patient to refer into mental health services, our assessment tool enables a professional to make a more detailed assessment.

Working with Her Majesty's Prison Service we have also developed simple guidelines about supporting patients who need to be supervised constantly.

One of the challenges is always providing continuity of care for patients moving between prisons, from the community to prison and from prison to the community our directory provides a list of contacts.

Finally we also provide information on how to support the wider criminal justice workforce improve their awareness of mental health issues.

The Threshold Assessment Grid is a 1 page, 7 tick standardised assessment of the severity of a patient’s mental health problems. It involves the GP and other referrers, or mental health professionals, rating the severity of the patient’s difficulties in three areas:

1. SAFETY assesses the level of concern about intentional self-harm (domain 1) and unintentional self-harm (domain 2)
2. RISK identifies the risk from others (domain 3) and to others (domain 4)
3. NEEDS AND DISABILITIES assesses survival (domain 5), psychological (domain 6) and social (domain 7) difficulties in the patient’s life

The West Midlands Regional Prison Mental Health Practitioners Forum developed the attached referral and assessment form utilising the TAG. The TAG referral and assessment tools have been implemented for use in all 12 prisons within the West Midlands and is in the process of being rolled out across criminal justice liaison services, courts and police stations.

The aim is for all services in direct contact with offenders to be utilising the same evidence based tools, and to minimise the replication of interventions in relation to assessment of offenders mental health.

Further information on TAG can be found at http://www.iop.kcl.ac.uk/ 

Copies of the TAG used in West Midlands Prisons can be downloaded by clicking on the appropriate link.

TAG Referral                                                                     Tag Assessment

We are often approached by Governors for advice on how constant watches should be managed in the context of interaction with the patient and supporting the healthcare assesment process.

As such NHS West Midlands has worked with key stakeholders to develop and produce guidelines for prison officers participating with the management of a patient on a constant watch. the guidelines are available here for you to print off and in the form of a pocket booklet and A4 sheet that can be made available to each prison.

We have produced guidelines on constant supervision activity in consultation with key stakeholders. The guidelines are available here for you to print off and in the form of a pocket booklet and A4 sheet that is to be made available directly to each prison.

South Staffordshire & Shropshire Mental Health Foundation Trust, have been in contact with as many prison in-reach teams as they could across England and produced this directory of providers which was updated in May 2010.  We all hope it will support the improved communication between teams when patients are transferring between prisons. 

We are keen to support the continued development of services aimed at meeting the needs of those requiring access to Primary Care Mental Health Services through the development of a universal, flexible and sustainable framework for service delivery which will be based on a stepped care approach and in accordance with NICE guidelines.

Beyond Inreach is a a joint initiative between NHS West Midlands and the prisons within its catchment area. The project aims to implement a standard framework for service delivery with expected benefits to include;

• Improved, preventative and timely interventions for service usersIncreased range of services and support
• Clear pathways through the service
• An auditable system with measurable outcomes
• Clear governance and accountability for those responsible for service delivery
• Effective supervision and caseload management
• Increased access to a wide range of evidence based interventionsidentifing skills gaps for workers and responding to need
• Effective communication and a collaborative approach between primary and secondary care

For more information about Project Beyond inreach please contact Gary Holland  

NHS West Midlands and West Midlands Probation Service have worked together to develop a basic level Mental Health Awareness Training package. The course which has been designed to be delivered over 1 day is intended to ensure that probation staff have adequate awareness of mental health issues. For information regarding the above package please click here.