Female offenders at HMP Holloway needing hospital transfer: An examination of failure to achieve hospital admission and associated factors

Previous studies have demonstrated high rates of psychiatric morbidity in the female prison population and difficulty in transferring women to psychiatric hospital. This study examines whether female prisoners found by consultant forensic psychiatrists to need hospital are admitted and explores the factors affecting this. All women referred to a specialist prison forensic mental health in‐reach service during 2003 were identified and written documentation from assessing consultant forensic psychiatrists was obtained. This was used to identify demographic, offence, clinical and outcome data. Missing data were sought from the prison database, and individual clinicians were interviewed to clarify clinical records. 119 women were referred for assessment. Of these, 50% of those with personality disorder were rejected compared with only 38% of those with a psychotic illness. A sizeable minority of those identified by specialist forensic mental health in‐reach services as needing treatment in hospital were not transferred. There appears to be a particular problem for those with personality disorders. Long delays in transfer to hospital remain a problem for prison mental health services.