Chapter 2 Psychiatric care and treatment plans – Therapeutic and rehabilitative psychosocial activities in prison In comparison with the general population, there is a high incidence of psy‑ chiatric symptoms among prisoners. Persons detained in secure psychiatric hospitals and prison inmates have much in common. Both are particularly vulnerable to developing mental health problems. Histories of abuse, deprivation, homelessness, unemploy‑ ment, substance misuse and previous contact with mental health services are commonly encountered. Many prisoners have numeracy and literacy problems, and most prisoners have a below‑average IQ.1 It has been sug‑ gested that about one in seven prisoners have psychotic illnesses or major depression and about half of all male prisoners and one in fve women prisoners have antisocial personality disorder.2 Serious mental disorder is disproportionally prevalent, the highest levels of morbidity being found in the remand and women prisoner populations. Mental disorder (including 1. Singleton N., Meltzer H. and Gatward R: Psychiatric morbidity among prisoners in England and Wales. London: Ofce for National Statistics (1998); Her Majesty’s Inspectorate of Prisons: Unjust deserts: a thematic review by HM Chief Inspector of Prisons of the treatment and conditions for unsentenced prisoners in England and Wales. London: Home Ofce (2000). 2. Fazel S. and Danesh J: “Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys”. Lancet, 359 (2002), 545‑50. Page 29