Dean Saunders, 25, died at HMP Chelmsford, Essex, in January 2016.
He had been arrested after he stabbed his father during a paranoid episode.
Kathy Goodchild, clinical team leader at the prison, told the inquest into his death that psychiatrists were not always present during reviews of care given to vulnerable prisoners.
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She told how when she was involved in a review of Mr Saunders' care on 20 December 2015 he eventually told her he did not intend to harm himself.
However, she said better psychiatric cover was needed and there was "not always a psychiatrist on call" for things like approving medication.
She wrote on 20 December that Mr Saunders should be seen by a psychiatrist the next day but that did not take place.
"Any review," she said, "should be done by people who actually have got the information."
She said Mr Saunders' family - who have strongly criticised the prison service for not watching him more closely - had raised concerns about him harming himself with her.
However, she said: "I can't put people on constant watch because of families, it has to be on presentation or harm."
The hearing continues.

Notts, who have now lost seven of their last eight matches and are only 12 points off the League Two relegation zone, looked comfortable until Bennett shot home just before the break.
Bennett made it 2-0 when he slotted in just after the restart.
A Christian Burgess header and Marc McNulty's lob sealed a win which keeps Pompey five points off the top three.
Better psychiatric cover is needed at a prison where an inmate was found electrocuted in his cell, an inquest has heard.
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