Abstract
In the Republic of Ireland, as elsewhere, there have been changes in patterns of health service for people with a mental disorder. Fears are often expressed that these changes have had an impact on the prison population. A total of 109 preβtrial and 126 sentenced prisoners were randomly selected from a 1992β93 12βmonth resident population of male prisoners in the Republic of Ireland's largest prison β Mountjoy. Experienced psychiatrists conducted unstructured and semiβstructured clinical interviews with them and diagnoses were made according to criteria in the American Diagnostic and Statistical Manual (DSMβIIIβR). Rates of major mental illness, mainly functional psychosis, were higher than would be expected for the general population, but it was the prevalence of alcohol and also substance misuse that gave rise for greatest concern about unmet need. In the absence of longitudinal data further comment cannot be made on impressions of increase in psychiatric disorder in Irish prisons in the 1980s and 1990s, but there is certainly a major problem with levels of disorder in the study population, for which health service provision does not appear to be meeting need. Innovations in mental health legislation and practical approaches to such people are urgently required. Copyright Β© 1996 Whurr Publishers Ltd.