Care versus custody: Challenges in the provision of prison mental healthcare

Prison mental health in-reach teams (MHIRTs) were introduced to provide the same range and quality of services to prisoners with severe and enduring mental health problems as is available to the general population (‘equivalence of care’). Drawing on a qualitative study of a MHIRT at an English prison, this chapter highlights the difficulties of striving to provide equivalent care in an anti-therapeutic environment which prioritises security and control. It argues that the team were heavily co-opted into penal governance and risk management activities and faced considerable hostility from those who saw prisoners as undeserving of care. It questions the notion of ‘healthy prisons’ and recommends that resources currently invested in the prison system be redirected into efforts to create socially just communities