Gallagher Margaret, Sheehy Siobhan, Connaughton Michelle, Hickey Philip, Ivers Jo-Hanna
Department of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Dublin, Ireland.
University College, Dublin, Ireland.
Ir J Med Sci. 2025 Apr 14. doi: 10.1007/s11845-025-03938-z.
There are high numbers of people experiencing homelessness (PEH) in Ireland. PEH experience barriers to accessing mental health care and are overrepresented in prison populations, particularly in remand prisons. To date, there has been limited research conducted on this population, and their specific needs.
In this study, we explored homelessness in those referred to prison psychiatry teams in Dublin's remand prisons, and profiled the clinical characteristics of the population.
Participants included all persons referred to prison inreach psychiatry teams in one male and one female remand prison over one year between 01/07/22 and 30/06/2023. We examined key aspects of psychiatric service provision including population characteristics, psychiatric and medical history, referral outcomes, alternative pathways and complex health needs.
A total of 89 PEH were referred to prison mental health services during the study period. High rates of active psychotic illness were found in the cohort, with 68% psychotic at the time of the assessment, and 56% having a diagnosis of serious mental illness. More than half the cohort reported current use of substances and 42% current use of alcohol. Over one-third of referrals were made for those with a history of mental illness, with no current symptoms. Only one-fifth of the cohort were discharged to the prison GP following their initial assessment, the remainder requiring ongoing input from prison inreach or community psychiatric services. Significant vulnerabilities were found within 25% including intellectual disability, and membership of ethnic minorities.
There are high rates of mental illness and co-morbid vulnerabilities found in the population. Appropriately addressing the needs of this population will require an integrated, multisystem approach.
爱尔兰有大量无家可归者。无家可归者在获得心理健康护理方面存在障碍，并且在监狱人口中占比过高，尤其是在还押监狱中。迄今为止，针对这一人群及其特殊需求的研究有限。
在本研究中，我们探讨了都柏林还押监狱中被转介至监狱精神病学团队的人员的无家可归情况，并描述了该人群的临床特征。
研究对象包括在2022年7月1日至2023年6月30日这一年间被转介至一所男性和一所女性还押监狱的监狱内精神病学团队的所有人。我们考察了精神科服务提供的关键方面，包括人口特征、精神病史和病史、转介结果、替代途径以及复杂的健康需求。
在研究期间，共有89名无家可归者被转介至监狱心理健康服务机构。该队列中活动性精神病性疾病的发生率较高，评估时68%患有精神病，56%被诊断为严重精神疾病。超过一半的队列报告目前使用药物，42%目前饮酒。超过三分之一的转介是针对有精神病史但目前没有症状的人。只有五分之一的队列在初次评估后被转至监狱全科医生处，其余人员需要监狱内服务或社区精神科服务的持续干预。在25%的人群中发现了显著的脆弱性，包括智力残疾和少数族裔成员。
该人群中精神疾病和共病脆弱性的发生率较高。适当地满足这一人群的需求将需要一种综合的多系统方法。
