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Most regional health authorities have or plan to have secure units for treating mentally abnormal offenders. A retrospective study was carried out to compare the effectiveness of the health care services for men remanded to Winchester prison from Oxford and Wessex regions over the five years 1979-83. Thirty seven (30%) of 124 prisoners from Oxford region were rejected for treatment compared with 36 (16%) of the 220 men from Wessex region. Men from Oxford region were significantly more likely to be recommended for admission to a special hospital than those from Wessex (13/124 (10%) v 9/220 (4%), respectively) and significantly less likely to be recommended for admission to a hospital in the catchment area (35/124 (28%) v 94/220 (43%)). Men on remand from Oxford region were significantly more often perceived as being disruptive or aggressive by hospital staff and more likely to be labelled as having psychopathic or personality disorders. These differences may have reflected different attitudes towards mentally abnormal offenders and the allowances in the services available in the two regions; in particular, Oxford region did not have a secure unit or a forensic psychiatrist. If mentally ill prisoners do not receive the treatment that they need they run the risk of being criminalised. Most such men are best treated in general psychiatric units; only a few require secure conditions and staff with specialised psychiatric skills.

Mentally abnormal prisoners on remand: II--Comparison of services provided by Oxford and Wessex regions