Mental health and prisons: The position in Europe

The collection of evidence and expert opinion about mental health and prisons throughout Europe undertaken by the WHO Health in Prisons Project during 2007 revealed a worrying position, with a very high proportion of prisoners with mental disorders. Without urgent and comprehensive action, prisons will move closer to becoming the twenty-first Century asylums for the mentally ill, full of those who most require treatment and care but who are held in unsuitable places with limited help and treatment available. Some of the evidence on which this is based and an outline of the particular challenges for prison mental health care will be presented. Reference will be made to some complex issues such as involuntary treatment, instruments of restraint and the management of violent patients. The conclusion is that action now is essential, that much can be done and that the integration of public health principles and human rights norms and standards to the issues of mental health and prisons would make a valuable contribution to transforming the current unacceptable position.