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Primary care trusts are responsible for commissioning mental health care in prisons. Where possible they aim for an equivalent service to that provided in the community with general practitioners providing the initial assessment and a gateway to psychological therapies, visiting psychiatrists and prison in reach teams. When prisoners' mental health problems require them to be sectioned under the Mental Health Act, they are transferred to secure mental health units.
Measuring relative effectiveness is complicated by the different levels of care provided in each setting. However, the Department has recently commissioned a call for research into the evidence base on secure forensic inpatient services in England (high, medium and low secure forensic services). This review will systematically assess the context and mechanisms through which high, medium and low secure forensic inpatient services produce outcomes. It is envisaged this review will improve current evidence about why services work, what might work in specific circumstances, and the impact on resources, deliverability and health equity.