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Aim and MethodTo describe the reported experiences of 15- and 16-year-old boys on remand in a young offender institution (YOI) as told to a child psychiatrist. Nineteen remanded adolescents were interviewed using the Kiddie-Schedule for Affective Disorders and Schizophrenia as part of a study. During the warm-up conversation prior to this semi-structured interview, the boys were given the opportunity to talk about their experiences of being in a YOI.ResultsThe boys described experiences of institutionalisation, including the deprivation of incarceration and the intimidation of a ‘macho-culture’, which on occasions verged on the abusive. Their responses are described.Clinical ImplicationsAn emotionally deprived prison environment that lacks appropriate care for children is likely to contribute to the very high levels of mental disorder known to exist in this population. A major reform of conditions for young prisoners has commenced since this study was conducted. The prison service and society as a whole must, however, ensure that the planned improved living conditions for children in prison are reached. Child psychiatry has a very important contribution to make by providing mental health care within prison institutions in order to engage young prisoners with mental health problems and their families.

Aims and Method This study was designed to clarify the nature and extent of psychiatric provision that would be needed if a new health screening protocol were to be introduced into the prison system. The reception screening questionnaires for every inmate coming into the prison over a 15-week period were reviewed using the new protocol. A further mental health assessment was undertaken on those who had screened positive. Results 201 men (32.6%) were found to be positive for serious mental illness Clinical Implications Based on this analysis, large increases in psychiatric resources would not be needed if the proposed new reception health screening processes were in place, although a reorganisation of the way in which services are delivered may be required.

800 people are held in immigration detention centres and prisons at any one time. The reasons given for their detention are unclear and often appear arbitrary. The majority are awaiting an initial decision on their claim or the outcome of an appeal against refusal. The average duration of detention is six months, with some asylum seekers in detention for over a year. There is no review of the process by an independent and impartial body. The decision to detain is intern ally reviewed by the Home Office, and detainees are not automatically entitled to bail hearings, a right accorded to all other detained prisoners in the UK. Asylum seekers may be held together with convicted or remand prisoners, despite the fact that they have not committed or been charged with any offence. Many persons so held go on to be recognised as genuine refugees often after prolonged and unnecessary suffering. A number of groups have expressed concern regarding the welfare and health of such people (Amnesty International, 1995; Committee for the Prevention of Torture. 1996). Indeed, in a report published by HM Inspector of Prisons it was noted that "detention without time limit, no

The expertise of a Cesare Lombroso was not required in order to deduce that the remand prisoner sent to me for examination and report was no Einstein. He was obviously dim, but exactly how dim was part of my job to find out. To this end I asked him if he minded answering a few simple questions. He nodded his assent. "Are you good at sums?", was my initial query. "Oright", he replied. 'Tell me then, what are six times seven?" His close-set eyes narrowed even further as he grappled with the problem. And then enlightenment dawned: "Thirty-nine", he said brightly, "Right?" "No, I'm afraid you're wrong", I replied sorrowfully. "What is it, then?" he demanded, looking somewhat vexed. "Fortytwo", 1said. His expression changed to something approaching contempt. "Near enough, innit!", he retorted.