A controlled evaluation of assessments by doctors and nurses in a magistrates' court mental health assessment and diversion scheme.

In this study, assessments of prisoners by doctors and nurses were compared in a provincial magistrates' court mental health assessment and diversion scheme, and outcomes were compared with the outcomes of those for whom no assessments were available during a control period. Substance misuse was relatively common and psychosis uncommon in the prisoners referred. Assessment by doctors enabled magistrates to reduce remands in custody of persons suspected of suffering from mental disorder and to grant bail in more cases. Only a small proportion of prisoners were admitted to hospital and although doctors and nurses recommended out-patient treatment in many cases, the attendance rate was low. Doctors were more likely than nurses to identify prisoners with medical needs that needed to be brought to the attention of the prison health care service, and to recommend out-patient psychiatric treatment and identify relevant medicolegal issues. Prisoners assessed by nurses were less likely than those assessed by doctors to attend alcohol or drug treatment services if recommended to do so. Prisoners who were admitted to hospital after a remand in custody spent longer on remand if assessed by nurses compared with those assessed by doctors.