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.”
More information
HM Inspector
of Prisoners
Essential information
on Mental Health