Pillai, KRouse, PMcKenna, BSkipworth, JCavney, JTapsell, RSimpson, AMadell, D2026-02-262026-02-262016-01-15BMC Psychiatry, ISSN: 1471-244X (Print); 1471-244X (Online), BioMed Central Ltd., 16(1), 9-. doi: 10.1186/s12888-016-0711-21471-244X1471-244Xhttp://hdl.handle.net/10292/20683Background: The high prevalence of serious mental illness (SMI) in prisons remains a challenge for mental health services. Many prisoners with SMI do not receive care. Screening tools have been developed but better detection has not translated to higher rates of treatment. In New Zealand a Prison Model of Care (PMOC) was developed by forensic mental health and correctional services to address this challenge. The PMOC broadened triggers for referrals to mental health teams. Referrals were triaged by mental health nurses leading to multidisciplinary team assessment within specified timeframes. This pathway for screening, referral and assessment was introduced within existing resources. Method: The PMOC was implemented across four prisons. An AB research design was used to explore the extent to which mentally ill prisoners were referred to and accepted by prison in-reach mental health teams and to determine the proportion of prison population receiving specialist mental health care. Results: The number of prisoners in the study in the year before the PMOC (n = 19,349) was similar to the year after (n = 19,421). 24.6 % of prisoners were screened as per the PMOC in the post period. Referrals increased from 491 to 734 in the post period (Z = -7.23, p < 0.0001). A greater number of triage assessments occurred after the introduction of the PMOC (pre = 458; post = 613, Z = 4.74, p < 0.0001) leading to a significant increase in the numbers accepted onto in-reach caseloads (pre = 338; post = 426, Z = 3.16, p < 0.01). Numbers of triage assessments completed within specified time frames showed no statistically significant difference before or after implementation. The proportion of prison population on in-reach caseloads increased from 5.6 % in the pre period to 7.0 % in the year post implementation while diagnostic patterns did not change, indicating more prisoners with SMI were identified and engaged in treatment. Conclusions: The PMOC led to increased prisoner numbers across screening, referral, treatment and engagement. Gains were achieved without extra resources by consistent processes and improved clarity of professional roles and tasks. The PMOC described a more effective pathway to specialist care for people with SMI entering prison.Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Mental health in-reach servicesMental health screening toolOffenderPrisoner mental health5201 Applied and Developmental Psychology4203 Health Services and Systems4205 Nursing42 Health Sciences52 PsychologyClinical ResearchHealth ServicesSchizophreniaSerious Mental IllnessMental HealthMental IllnessBrain DisordersPreventionBehavioral and Social Science8.1 Organisation and delivery of servicesMental health3 Good Health and Well Being1103 Clinical Sciences1117 Public Health and Health Services1701 PsychologyPsychiatry3202 Clinical sciences4202 Epidemiology5203 Clinical and health psychologyFemaleHumansMaleMental DisordersMental Health ServicesNew ZealandPatient Care TeamPrisonersReferral and ConsultationTriageHumansMental DisordersMental Health ServicesPrisonersTriageReferral and ConsultationPatient Care TeamNew ZealandFemaleMaleFemaleHumansMaleMental DisordersMental Health ServicesNew ZealandPatient Care TeamPrisonersReferral and ConsultationTriageJournal ArticleOpenAccess10.1186/s12888-016-0711-2