Psychiatric care in the German prison system

Int J Prison Health. 2012;8(3-4):131-40. doi: 10.1108/17449201211285003.

Abstract

Purpose: The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described.

Design/methodology/approach: The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed.

Findings: The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered.

Originality/value: The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

Keywords: Addiction; German penal system; Germany; Health care; Hepatitis C; Mental disorders; Mental illness; Prison medicine; Prison psychiatry; Prisons.

MeSH terms

  • Germany
  • HIV Infections / epidemiology
  • Health Services Administration
  • Health Workforce
  • Hepatitis C / epidemiology
  • Humans
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy*
  • Mental Health Services / legislation & jurisprudence
  • Mental Health Services / organization & administration*
  • Mental Health Services / standards
  • Prisons / legislation & jurisprudence
  • Prisons / organization & administration*
  • Prisons / standards
  • Quality of Health Care
  • Self-Injurious Behavior / epidemiology
  • Substance-Related Disorders / epidemiology