Most of our patients have come from prison and some will return to prison once their mental health has improved. Some forensic psychiatrists (and some general psychiatrists) work substantively within prisons and others provide sessional input to prisons. So all forensic trainees must gain a broad experience of prison psychiatry, so that they can understand the particular demands of the prison environment for practice, the differing presentations of mental disorder, the care pathways for mentally disordered prisoners and the ways in which the prison environment and complex mental disorders interact.
Generally trainees spend half a day a week attending a particular prison during their training, in addition to conducting assessments of prisoners that are referred to their clinical service. Typically, a trainee will spend a year attending a local remand prison and then spend 6 months attending other types of prison to broaden their experience.
Some of these prison roles are linked to specific jobs or trainers; others can be arranged ad hoc. As a general rule, where the educational needs of a trainee can be satisfied by attending a prison that is served by their employing Trust, then the trainee should attend that prison.
The available prisons within the West Midlands include:
Local male remand prisons: HMP Birmingham & HMP Hewell; some remand also at HMP Dovegate
Dispersal prison for category A prisoners: HMP Long Lartin
Young Offenders Institutions and prisons for young adults: HMYOI Brinsford; HMYOI Swinfen Hall; HMYOI Stoke Heath
Prisons for female offenders: HMP Drake Hall; HMP Foston Hall
Training prisons: HMP Featherstone; HMP Oakwood; HMP Stafford
Courts & Probation
Elliott House is an approved premises (bail & probation hostel) for mentally disordered offenders in Edgbaston, Birmingham. It was set up as a joint venture between West Midlands Probation Service (as it then was) and Reaside Clinic in the 1980s. For a long time it was the only such specialised probation hostel in the country; there are still very few similar facilities.
Gaining some experience of working at Elliott House, as a special clinical interest, is a particularly valuable part of the West Midlands scheme, offering a really good opportunity to understand probation and community management of offenders.
Forensic services also commonly provide diversion or liaison services to Magistrates Courts. forensic trainees will sometimes be asked to assist these nurse-led schemes, where medical input is required.