Unmet need among disturbed female offenders

This paper is concerned with a case-note study of 44 women on the psychiatric wing of HMP Holloway who had been referred to NHS psychiatric services by prison medical officers. Half the women were difficult to place, being refused a bed at least once. The other half, the comparison group, obtained beds without difficulty. The 'difficult to place' women were significantly more likely than the comparison group to have suffered physical and/or sexual abuse in childhood; to have committed a variety of offences; to have committed crimes of serious violence and arson; to have spent time in a secure psychiatric facility in the past; to be considered a danger to themselves and a management problem in Holloway; to have a personality disorder diagnosis; and, eventually, to receive a prison sentence or community disposal rather than a hospital order. Arguments about treatability and lack of service provision are important factors in the failure of these extremely disturbed and challenging women to obtain beds. New and specialized treatment facilities are urgently needed.