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Background: Contracting in psychiatric services from the NHS into prisons has been advocated to improve the care of the mentally disordered in custody. The Belmarsh Scheme is such a service.Method: A prospective study investigating the characteristics of a six-month cohort of remand prisoners requiring transfer to hospital and evaluating the service's effectiveness.Results: Fifty-three (4.3%; 95% CL 3.2% to 5.6%) of the 1229 new remands required transfer to hospital; all were accepted. The transfer group contained a higher proportion of black men (51%) than all other remands (30%) (difference 21%; 95% CL 8% to 35%, P = 0.002). Transfer times were lower than those reported for a neighbouring prison.Conclusions: The Belmarsh Scheme secured in-patient psychiatric care rapidly for all those identified as needing it. [ABSTRACT FROM AUTHOR]

Objective: This article presents findings from a study of the causes of homelessness among newly homeless older people in selected urban areas of the United States, England, and Australia., Methods: Interviews were conducted in each country with > or =122 older people who had become homeless during the last 2 years. Information was also collected from the subjects' key workers about the circumstances and problems that contributed to homelessness., Result: Two-thirds of the subjects had never been homeless before. Antecedent causes were the accommodation was sold or needed repair, rent arrears, death of a close relative, relationship breakdown, and disputes with other tenants and neighbors. Contributory factors were physical and mental health problems, alcohol abuse, and gambling problems., Discussion: Most subjects became homeless through a combination of personal problems and incapacities, welfare policy gaps, and service delivery deficiencies. Whereas there are nation-specific variations, across the three countries, the principal causes and their interactions are similar.