Prisoners face ‘unacceptable’ waits for mental health beds

Inmates with mental health problems still face “unacceptable” delays for transfers to NHS secure mental health units despite overall improvements in cutting transfer times, the chief inspector of prisons has warned.

In his annual report Nick Hardwick said that progress had been made in reducing waits for transfers to secure mental health units but in parts of the country, including London, “they remained problematic”.

“At the time of our inspection of Brixton, for example, 14 patients were awaiting transfer to NHS mental health beds, one of whom had been waiting over six months. This was unacceptable,” Hardwick wrote.

During an inspection of Brixton last year, concerned staff had introduced the chief inspector to “a very distressed prisoner” who had been waiting months for a secure bed.

“He appeared unable to care for himself in even the most basic way and was in an extremely disordered cell. It was a disgraceful way to hold someone who was little more than a boy and very sick,” Hardwick wrote.

Other findings related to mental health and social care in prisons included:

• Improvements in drug treatment, mental health and first night arrangements had boosted safety in women’s prisons. The number of self-harm incidents fell from 11,517 in 2010/11 to 7,879 in 2011/12.
  
• Prisoners experiencing substance abuse and mental-health related problems still had difficulty accessing specialist services. Some prison mental health teams were “reluctant to see drug users” but examples of good practice in treating dual diagnosis also existed.
  
• Patients with more complex mental health needs had good access to mental health staff, but care for common mental health problems remains underdeveloped.
  
• Training for prison officers in supporting prisoners with mental health problems was “generally inadequate.”
  
• There is a growing need for mental and physical health care among the ageing prison population.
  
• Few health needs analyses used by prisons to inform the design of health and social care provision had included the social care needs of dependant and older prisoners.

Robert Nisbet, an independent social worker and BASW member, told Community Care:

“The issue of delayed transfers is a systemic problem. But unlike the issues with mainstream care where approved mental health professionals are struggling to get beds due to shortages, I don’t think that’s the case in secure psychiatric settings.”

“We used to have people regionally at Strategic Health Authorities whose key responsibility was to bring down transfer times. The question is without them who will watch it?”

Nisbet added: “Delays will also vary considerably according to the resources of local services to be able to get out to those prisons to undertake assessments and then make arrangements for transfer.”

The wide ranging report also considered the quality of outcomes for detainees in police custody suites and immigration detention centres.

Announcing the report findings, Hardwick said that the government’s hopes for a “rehabilitation revolution” in the prison system could be undermined by a lack of resources. He also warned that problems with the abuse of prescription drugs had become a “major concern”.

“Resources are now stretched very thinly. There is a risk of undermining the progress made in recent years. If a rehabilitation revolution is to be delivered, there is a clear choice for politicians and policy makers – reduce prison populations or increase prison budgets,” he said.