Access to a scheduled psychiatric community consultation for prisoners with mood disorders during the immediate post-release period

Abstract

Background: For incarcerated people, the immediate post-release period is characterized by a range of negative outcomes. The appointment scheduling delay for a psychiatric community consultation in this period is unknown. Methods: A fictional 24-year-old patient with a diagnosis of bipolar disorder with comorbid cannabis use disorder was created and implemented in two different contexts: (1) a release from a prison of the French North district within 48 h (prison-released patient), (2) a move from another district to the French North district within 48 h (outpatient-moving patient). An independent investigator called the 39 outpatient psychiatric clinics of the French North district to get an appointment as quickly as possible for the two fictional patients. Results: In 12 centers out of 39, no appointment could be scheduled for the prison-released patient. For the 27 other centers, there was no statistical difference between the 2 fictional patients’ delay. Three centers refused to make an appointment for the prison-released patient while an appointment was given for the outpatient-moving patient. For the prison-released patient, the median delay was 21 days, which is not consistent with optimal support during the high-risk period of release. Limitations: Only outpatient psychiatric clinics of the French North district were called. Caution is then needed before generalizing the results. Conclusions: French mental health system does not allow for a proper management of the transition from prison to the community for people with mood disorders during the immediate post-release period.

Keywords

• Bipolar disorder
• Prison
• Post-release period
• Healthcare