Letter

Don’t neglect the mental health needs of offenders

While the government struggles to increase the number and availability of GPs, one group of patients finds it almost impossible to engage with GP services as currently organised. Our recent research (‘Snakes and Ladders’ published July 2003) suggests that offenders with mental health problems and multiple needs face problems at every level.

Prisons have no responsibility to ensure that a prisoner is registered with a GP when he returns to the community. 49% of prisoners with a mental health problem on short sentences leave prison homeless and are therefore unable to register with a GP. Even when they are successful in registering with a doctor they face particular problems using the service. These individuals have serious problems with the length of time they are forced to wait for an appointment and when they do get one the length of consultation that a busy GP can offer is rarely long enough to address their complex mental health and multiple needs issues. The best outcome is that they end up in already overstretched A&E departments; in the worst case it can lead directly to re-offending.

Offenders with mental health problems depend on their GP to refer them to secondary care providers such as drug or alcohol services, to provide evidence of vulnerability to housing agencies, to assess their ability to work, as well as to provide for all their, frequently complex, medical needs. If the service fails these people it’s not just the patient that suffers but society too.