Mental health care in Polish penitentiary system

Hadrys, Tomasz; Kiejna, Andrzej
January 2007
BMC Psychiatry;2007 Supplement 1, Vol. 7, Special section p1
Academic Journal
Background To describe the present situation of mental health care in Polish prisons in terms of law regulations, routine practices, epidemiologic indicators and shortcomings of the whole system. Methods Law regulations defining organizational structure of the system originate from Polish Penal Code, Penal Executive Code, Prison Services Act, Mental Healthcare Act (MHA) and relevant Ordinances. Epidemiological data have been extracted from statistical records of the Healthcare Bureau of the Central Executive of the Prison Services and sparse epidemiologic studies conducted recently in selected penitentiaries. Results Prison mental health care is independent of the civil health care meaning it has its own personnel and facilities placed on prison premises and is budgeted from Ministry of Justice. The model of services provision is mixed but predominantly internal. Services unavailable internally are provided by external medical facilities. Coercive psychiatric treatment and physical restraint measures are only allowed under MHA provisions. In 2005, Polish prisons detained 82,761 inmates (20% over system capacity). Of those 3,630 where placed in any kind of therapeutic environment. Prison psychiatrists provided 62,476 consultations. There are 6 in-prison psychiatric wards (222 beds). Total number of psychiatrists (mainly "part-timers") contracted for the system is 116. In 2005, there were 187 attempted and 32 committed suicides. Most prevalent psychiatric diagnoses were: addiction to alcohol and related disorders (5.3% of all inmates) and personality disorders (3.7%). Conclusion Incompatibility of prison and civil medical systems leads to difficulties. Availability of psychiatric services to prisoners is limited. Mental disorders are underdiagnosed.


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