There are high levels of psychiatric morbidity amongst people in prisons. In England and Wales, prisoners who present with the most acute mental health needs can be transferred to hospital urgently under part III of the Mental Health Act 1983. This project reviewed all such transfers within one region of England, with an emphasis on differences across levels of security.,Over a six-year period (2010–2016) within one region of England, 930 psychiatric referrals were received from seven male prisons. From these referrals, 173 (18.5%) secure hospital transfers were required. Diagnostic and basic demographic information were analysed, along with hospital security categorisation (high secure, medium secure, low secure, psychiatric intensive care unit and other) and total time to transfer in days.,There were substantial delays to urgent hospital transfer across all levels of hospital security. Prisoners were transferred to the following units: medium security (n = 98, 56.9%); psychiatric intensive care units (PICUs) (n = 34, 19.7%); low secure conditions (n = 20, 11.6%); high secure conditions (n = 12, 6.9%); other (n = 9, 5.2%). Mean transfer times were as follows: high secure = 159.6 days; other = 68.8 days; medium secure = 58.6 days; low secure = 54.8 days; and psychiatric intensive care = 16.1 days.,In keeping with the wider literature in this area, transfers of prisoners to hospital were very delayed across all levels of secure psychiatric hospital care. Mean transfer times were in breach of the national 14-day timescale, although transfers to PICUs were quicker than to other units. National work, including research and service pilots, is required to understand whether and how these transfer times might be improved.,This paper extends the available literature on the topic of transferring prisoners with mental illness who require compulsory treatment. There is a small but developing literature in this area, and this paper largely confirms that delays to hospital transfer remain a serious problem in England and Wales. National work, including research and service pilots, is required to understand whether and how these transfer times might be improved. This could include different referral and transfer models as a component of service-based and pathways research or combining referral pathways across units to improve their efficacy.

中文翻译：

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《精神健康法》在六年的时间内从英格兰监狱转移到精神病医院

监狱中的人有很高的精神病发病率。在英格兰和威尔士，根据1983年《精神卫生法》第三部分，可以将最急需精神健康的囚犯紧急转移到医院。该项目审查了英格兰一个地区内的所有此类转移，并着重强调了各级之间的差异在一个英格兰地区的六年（2010-2016年）中，从七所男性监狱中接收了930例精神科转诊。从这些转诊中，需要进行173次（18.5％）安全的医院转运。分析了诊断和基本人口统计信息，以及医院的安全分类（高安全性，中安全性，低安全性，精神病重症监护病房等）以及总转移时间（以天为单位）。在各级医院安全部门中，紧急医院转移的时间大大延迟。囚犯被转移到以下单位：中度安全（n = 98，56.9％）；精神科重症监护病房（n = 34，19.7％）; 安全条件低（n = 20，11.6％）; 安全条件高（n = 12，6.9％）; 其他（n = 9，5.2％）。平均传输时间如下：高安全性= 159.6天；其他= 68.8天；中度安全= 58.6天；低安全性= 54.8天；精神病重症监护室和精神病重症监护室= 16.1天。根据该领域更广泛的文献，在所有安全的精神病学医院护理中，囚犯到医院的转移都非常延迟。平均转移时间违反了国家14天的时间表，尽管转移到PICU的速度比转移到其他单位要快。国家工作，包括研究和服务飞行员，需要了解是否以及如何改善这些转移时间。，本文扩展了有关转移需要强制治疗的精神疾病囚犯的现有文献。这方面的文献很少，但仍在发展中，而本文很大程度上证实了延迟转移医院仍然是英格兰和威尔士的一个严重问题。需要包括研究和服务飞行员在内的国家工作来了解是否以及如何改善这些转移时间。这可能包括不同的推荐和转移模型，作为基于服务和途径研究的组成部分，或者结合跨单位的推荐途径来提高其功效。本文扩展了有关转移需要强制治疗的精神疾病囚犯的现有文献。这方面的文献很少，但仍在发展中，而本文很大程度上证实了延迟转移医院仍然是英格兰和威尔士的一个严重问题。需要包括研究和服务飞行员在内的国家工作来了解是否以及如何改善这些转移时间。这可能包括不同的推荐和转移模型，作为基于服务和途径研究的组成部分，或者结合跨单位的推荐途径来提高其功效。本文扩展了有关转移需要强制治疗的精神疾病囚犯的现有文献。这方面的文献很少，但仍在发展中，而本文很大程度上证实了延迟转移医院仍然是英格兰和威尔士的一个严重问题。需要包括研究和服务飞行员在内的国家工作来了解是否以及如何改善这些转移时间。这可能包括不同的推荐和转移模型，作为基于服务和途径研究的组成部分，或者结合跨单位的推荐途径来提高其功效。需要包括研究和服务飞行员在内的国家工作来了解是否以及如何改善这些转移时间。这可能包括不同的推荐和转移模型，作为基于服务和途径研究的组成部分，或者结合跨单位的推荐途径来提高其功效。需要包括研究和服务飞行员在内的国家工作来了解是否以及如何改善这些转移时间。这可能包括不同的推荐和转移模型，作为基于服务和途径研究的组成部分，或者结合跨单位的推荐途径来提高其功效。