title: Mental health in-reach in an urban UK remand prison.
abstract: OBJECTIVE
  Prison mental health in-reach teams (MHITs) have developed in England and Wales over the last decade. Services have been nationally reviewed, but detailed descriptions of their work have been scarce. The purpose of this paper is to describe the functions of one MHIT in a busy, ethnically diverse, male remand prison in London, UK.
  
  
  METHODS
  Clinical and demographic data were collected for prisoners referred to the MHIT using a retrospective design over an 18-week period in 2008/2009 (n=111).
  
  
  RESULTS
  Foreign national prisoners and sentenced prisoners were significantly under-referred. Most referrals were already known to community mental health services, although around a quarter accessed services for the first time in prison. Around a third presented with self-harm/suicide risks. Substance misuse problems were common. Although the MHIT had evolved systems to promote service access, prisoner self-referrals were limited.
  
  
  CONCLUSIONS
  Foreign national prisoners require enhanced investment to improve service access. MHITs identify people with mental disorders for the first time in prisons, but better screening arrangements are needed across systems. An evaluation of multiple MHIT models could inform a wider delivery template. Originality/value - One of the first ground-level evaluations of MHITs in England and Wales.
authors.affiliation: Consultant and Honorary Senior Lecturer in Forensic Psychiatry, based at Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Forrester
authors.forename: Jagmohan
authors.initials: J
authors.lastname: Singh
authors.forename: Karen
authors.initials: K
authors.lastname: Slade
authors.forename: Tim
authors.initials: T
authors.lastname: Exworthy
authors.forename: Piyal
authors.initials: P
authors.lastname: Sen
mesh_terms: D000293:Adolescent; D000328:Adult; D004739:England; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D011330:Prisons / Q000458:organization & administration*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Evaluation; Foreign national prisoners; Mental health in-reach; Prison; Self-harm; Suicide