National Institute for Health and Clinical Excellence (NICE)
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Improving mental health of prisoners

NICE will develop guidance aimed at improving the mental health of people in prison, following the latest topic referral from the Department of Health.

It is estimated that around 90 per cent of all prisoners have a diagnosable mental health problem, including personality disorders, and/or a substance misuse problem.

More than 70 per cent of the prison population has two or more mental health disorders, and the suicide rate in prisons is almost 15 times higher than in the general population.

In 2009, a landmark report by former home office minister Lord Keith Bradley concluded that too many offenders with mental health difficulties and learning disabilities are ending up in prison without access to appropriate treatment.

The government pledged to improve outcomes for all people with mental health problems through high-quality services that are equally accessible to all when they set out their mental health strategy - no health without mental health.

Under this latest referral, those working in health, youth and criminal justice, education and social care sectors will be given NICE guidance on the effectiveness and cost effectiveness of interventions for the prevention and early treatment of mental health problems of offenders.

Joint clinical guidelines and public health guidance will be developed alongside this for those working in health, social care and criminal justice sectors on an integrated model for addressing mental health in prisons.

Professor Mike Kelly, Director of Public Health at NICE, said: “We welcome the latest topic referrals from the Department of Health which will focus on improving the health of offenders.

"We know that people in prison have a higher risk of developing mental health problems. NICE will produce guidance that will help ensure prisoners are offered the most clinically and cost effective treatment.”

NICE will also develop public health guidance for those working with offenders to help them with the early identification and management of young people who display sexually harmful behaviour.

Additionally, guidance will be developed for commissioners and service providers working in health and criminal justice sectors on ensuring people in prison have full and appropriate access to clinically and cost effective care for preventing, diagnosing and managing physical health problems.

This will include acute and chronic problems as well as infectious and non-infectious conditions.

All topics put forward to NICE are selected by the Department of Health on the basis of a number of factors, including the burden of disease, the impact on resources, and whether there is inappropriate variation in practice across the country.

Whilst this latest referral is the first to focus solely on the prison population, NICE has previously produced guidance of relevance to the health of prisoners.

Just last month, guidance was published on identifying and treating tuberculosis in hard-to-reach groups which includes the prison population.

Active Wellbeing 2023 is running from 1-28 February