Health screening at first reception into prison

The prison service attaches considerable importance to the screening of all prisoners at first reception into prison for physical and mental health problems, substance use and suicide risk. This article compares the findings of the prison reception health screening of 546 consecutive new remand prisoners with independent assessments carried out by research psychiatrists on the same individuals at their reception into prison. Results indicate that a considerable amount of morbidity remains undetected by both the initial health screening performed by prison hospital officers and the subsequent health assessments performed by the prison doctors. In addition, rather than being complementary, these two procedures appear to result in time being wasted because of unnecessary duplication. Our results would indicate that a restructuring of the existing health assessment process at reception into prison could result in a more effective screening process than that which is currently in operation. Because this would require minimal extra resources it could be put into effect promptly. In the long term a far more effective prison reception health screening procedure carried out by adequately trained health care professionals is likely to be a more satisfactory solution, although this would of course have major resource implications for the prison service.