Mentally disordered prisoners (MDPs) have an increased vulnerability to victimization and suicide. in the last years, there is a trend to assign their treatment to the civil psychiatric services.

To compare forensic with civil psychiatric services users (FPSUs vs CPSUs) regarding clinical and care needs.

A cross-sectional study of FPSUs and CPSUs from 2 prisons, 1 prison-hospital and 1 general hospital, all located in the Lisbon region, was conducted. the forensic sample was constituted by all users during one year period (2009–2010), and the civil sample was matched for age and gender. the data was collected from users and staff interviews. the instruments included a specific questionnaire, MINI, BPRS and CANFOR.

The samples comprised 114 prisoners and 121 civil patients. FPSUs had better family inclusion and employment status but poorer academic achievement than CPSUs. the FPSUs presented significantly higher prevalence for major depression, suicide risk, anxiety disorders, drugs addiction and anti-social personality disorder than CPSUs. Comparatively, FPSUs had more prescriptions for hypnotics and CPSU had more prescriptions for antidepressants and anxiolytics. the FPSUs rated significantly more needs and unmet needs than CPSUs. However, the staff rated no differences between the two groups.

The FPSUs presented a higher prevalence of non-psychotic pathology than CPSUs. However, it seems that medication is insufficient regarding the clinical severity.

The unmet needs of FPSUs were significantly higher than CPSUs, and cover multiple domains.

The displacement of MDPs to civil psychiatric facilities should consider their specificities and needs.