Less than a fifth of mental health inreach prison teams feel they are meeting the needs of inmates, five years after they were established, according to a hard-hitting report.
The Mental Health of Prisoners, the first report published by the prison inspectorate for a decade, reveals a gloomy picture of care despite some improvements.
Four out of five teams felt unable to respond adequately to the scale of need, and many were working in isolation, it found. Only half of drug addicts were referred to drugs services and just 43 per cent of those withdrawing from drugs said they were given any emotional support.
GPs lacked specialist training in the care of prisoners with complex health needs and complained of a shortage of talk therapies and other primary care interventions.
The report singled out commissioning as a problem, saying: 'Mental health has a low priority and awareness within the primary care trusts which now commission all prison healthcare.'
It recommends the Department of Health gives PCTs guidance on support, case management, secure beds and care in the community.
It calls for a prison mental healthcare blueprint to specify services needed, taking into account black and ethnic minority prisoners.
Sainsbury Centre for Mental Health prisons director Sean Duggan called for urgent investment to raise staffing levels by two-thirds.
NHS Confederation mental health network director Steve Shrubb said the inreach teams had made 'great strides' but more needed to be done. 'The answer to this cannot be simply the commissioning of more services,' he said.
'As the report itself suggests, the key is to involve the whole range of available services and groups.'
HSJ's Prison Mental Healthcare conference is on 15 November. See www.hsj-prisonmentalhealth.co.uk