Prisons are failing to meet the mental health needs of four-fifths of its population, despite the involvement of trained NHS professionals, a review by HM Inspector of Prisoners published this week has found.
The Mental Health of Prisoners review noted that there were “too many” gaps in provision in prisons and found that many inmates’ mental health needs were either unmet or undiagnosed, five years after mental health in-reach teams (Mhirts) entered prisons and 10 years after the Inspectorate’s first report on prison health.
In response to the report, Anne Owers, chief inspector of prisons, said: “Prison has become, to a large extent, the default setting for those with a wide range of mental and emotional disorders.” She called for the development of a clear blueprint on delivering mental health services in prison.
The review also found that four out of five Mhirts said they were unable to meet the needs of prisoners with severe or enduring mental illnesses. Since 2001, community mental health teams have operated in prisons as Mhirts working with those with severe or enduring mental illnesses. About 80% of prisons have nurse-led teams but, according to the review, often “lack connections” with other prison services or residential staff such as substance misuse teams.
It also reported a gap in provision in specialised primary mental healthcare and inadequate reception screening of inmate’s mental health, particularly with black and ethnic minority prisoners or inmates with leaning disabilities.
The review emphasised mental health and community services must improve outside of the prison system to support and identify the mental health needs of individuals before they offend. But inspectors said there were “significant weaknesses” and “inconsistencies” with court diversion and liaison schemes, which were introduced in 1989 to refer offenders to mental health settings. It found that only two out of the 23 primary care trusts sampled were aware of the schemes and many were short of funds and lacked accountability.
Sean Duggan, Sainsbury Centre for Mental Health director of prisons and criminal justice, urged the government to increase staffing levels and the investment in primary care to close the gap.
But Steve Shrubb, the director of the NHS Confederation Mental Health Network, argued: “The answer can not be simply the commissioning of more services…the key is to involve the whole range of available services and groups, from commissioners right down to the families of prisoners.”