Prisoners have told the Justice Committee that the standard of mental health care in prison is “worse than anyone can comprehend or wants to admit”. The Committee has now published a report on the matter, concluding that there is a high unmet demand for mental health care among offenders.

Mental Health in Prison

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Who is responsible for mental health care in prisons?

The NHS is responsible for all healthcare in prisons, including mental health care. This has been the case since 2005. However, the system is struggling to meet demands. The HM Inspectorate of Prisons reported that 71% of female prisoners and 47% of male prisoners self-reported mental health problems. Many more go unidentified, leading the Justice Committee to conclude that as many as 70% of prisoners have some form of need when it comes to mental health care. Yet just 10% are recorded as receiving treatment.

Why is mental health care in prisons failing?

So why is mental health care in prisons failing? The Justice Committee recently investigated this question and has now published a report on their findings. Problems were identified throughout the judicial process, starting from the moment the offender is sentenced, right up to their release back into the community.

Firstly, prisons are being used as a “place of safety”. In other words, mentally ill people are being sent to prison due to a shortage of mental health services in the community. Many offenders are eligible for a community sentence with a Mental Health Treatment Requirement order attached. But this option is often unavailable, meaning the offender is sent to prison instead.

Secondly, the NHS contract requires providers to carry out a first-day screening for all prisoners arriving in prison, with a follow-up assessment within seven days. However, not all prisoners are screened, and the process itself may not be sufficient. The Committee found that one in 12 prisoners did not have a screening and that mental health conditions are often missed, especially in black and minority ethnic prisoners.

Thirdly, the mental health care provided in prisons is substandard. There are not enough care providers with the necessary expertise. This means many offenders receive no care whatsoever, while others are treated by practitioners who do not have the right skills and resources. Prisoners told the Committee that “the person who shouts the loudest” gets treated.

Finally, there are problems with the continuity of services. When a prisoner moves to a different prison, or is released, their care may be interrupted or stop altogether. This is largely due to communication failures.

Recommendations

The Justice Committee made a number of recommendations to address the issues identified during their investigation. The report states that the NHS, the Prison Service and the Ministry of Justice must work together to:

  • Ensure mental healthcare in prisons is the same as in the community
  • Bridge existing gaps in care to prevent a fragmented service
  • Increase the availability of community sentence treatment requirement orders
  • Improve mental health screening in prisons
  • Train prison officers on identifying mental illnesses and how to support prisoners
  • Improve the availability of prisoner medical records between prisons and the community

Prisons and Mental Health

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