Mental health care for foreign national prisoners in England and Wales

Background: The foreign national prisoner (FNP) population in England and Wales has disproportionately increased in size, but mental health research in this group has been limited. Aims: Define the FNP group, review their understood characteristics, identify service challenges and make onward recommendations. Methods: A literature search of Pubmed and Google Scholar was undertaken. Relevant articles/reports were identified and reviewed. Results: Many FNPs face challenges: isolation (with limited family contacts); language barriers; difficulties accessing services; prejudice and discrimination; active legal issues regarding immigration. These are compounded by poor quality interpreting services, institutional barriers including racial assumptions propagated by forces of legislation, the disrupted local care pathways and common mental health problems (including post-traumatic stress disorder, depression and anxiety). Pre-detention trauma, self-harm and suicide are over-represented. Conclusions: Further prevalence and unmet needs research is urgently required. A validated screening tool could assist identification and service access for FNPs with mental health problems. Services providing relatively inexpensive interventions specific to the needs of FNPs (e.g. narrative exposure therapy) should be piloted