Prison psychiatry: is the training experience safe?

Purpose - Training in the prison settings is a mandatory part of higher training in forensic psychiatry. Violence in prisons is a recognised issue, which can impact on trainee safety and overall training experience. The Royal College of Psychiatrists have produced guidelines regarding the safety of the environment in inpatient mental health settings, but there is currently no such guidance regarding the prison setting. The purpose of this paper is to report on a survey of UK-based ST4-6 trainees in forensic psychiatry regarding their training experience in prisons, focusing on supervision and safety. Design/methodology/approach - The authors constructed an electronic survey which comprised of 18 items. This was sent to each UK training programme director in forensic psychiatry, who were asked to distribute the survey to trainees in their region. Findings - There were 36 unique responses, out of an approximate total of 100 trainees. The questions fell into two broad categories: trainee safety and trainee supervision. The main themes that arose were that the majority of trainees (59 per cent) reported that they had not received a formal induction at their prison and had not received training in using the Assessment, Care in Custody and Teamwork framework (58 per cent) and serious incident review protocol (83 per cent). The vast majority (76 per cent) reported not being allocated a personal safety alarm, and 27 per cent reported having received a direct threat from a patient in prison. Responses with regards to consultant supervision were varied. The majority indicated that they received weekly supervision (62 per cent). Originality/value - The findings indicate that there are a number of areas where both safety and supervision within the prison environment may be improved. This is concerning given the standards outlined by Promoting Excellence (General Medical Council), which highlights the importance of a safe and supported learning environment, and suggests the need for further analysis locally of training opportunities within prisons.