Mental health care in prison: How to manage our care

In the prison system there are high percentages of mentally disordered offenders, often with co‐morbid psychiatric disorders. In addition, the setting and ward atmosphere in prisons are not designed to care for psychiatric patients and places a burden on vulnerable inmates. Management of care of the different subgroups in the prison population is therefore necessary on four different levels, from basic health care to forensic psychiatric treatment. A fifth level is forensic care, which is directed towards re‐integration into the community rather than treatment at the symptom‐level of disease. Continuity of care, evidence‐based care and coercion within mental health care are discussed with regard to their forensic ethical meaning towards both patients and the community. Drawing on the Dutch situation a case is made for the promotion of voluntary treatment for those prisoners