Prisons: Mental Health
Lord O’Shaughnessy: We recognise that there are high numbers of people in prison with mental ill health, and it is essential that they are treated in the most appropriate environment for their needs. Whilst some prisoners may be mentally unwell, and despite sometimes complex emotional and behavioural needs, it may not be clinically appropriate for them to be transferred to a mental health inpatient bed. There may be other services more appropriate to their needs that can be delivered outside inpatient mental health facilities.
There are no plans for a review. However there is already work underway to ensure people are diverted to mental health care services outside prison either before or on their release, and to improve mental health services within prisons. Liaison and Diversion services operate at police stations and courts, to identify and assess people with vulnerabilities (substance misuse, mental health problems) and refer them into appropriate services and, where appropriate, away from the justice system altogether. Information from Liaison and Diversion assessments is used by the police and courts to inform sentencing decisions. These services cover 82% of the population with full roll out expected by 2020.
The Department of Health and Social Care and the Ministry of Justice have worked with NHS England and Public Health England to develop a Community Sentence Treatment Requirement ‘protocol’. The protocol aims to increase the use of community sentences with drug, alcohol and mental health treatment requirements as an alternative to custody to improve health outcomes and reduce reoffending. It sets out what is expected from all involved agencies to ensure improved access to mental health and substance misuse treatment for offenders who need it.
Work is also underway to improve support for prisoners whilst they are in prison. NHS England is focussing on an offender mental health pathway which will ensure that offenders are directed to the most appropriate intervention to their needs at the right time in the criminal justice system. The programme of work includes ensuring timely and appropriate transfers to a mental health hospital, timely remission to prison as part of a planned episode of care, and to ensure that those requiring treatment for mental ill health have access to high quality care.
New service specifications have been published for both low and medium secure hospitals as well as prison mental health services. The Prison Mental Health Specification embeds the Quality Standards for Prison Mental Health Services developed by the Royal College of Psychiatrists to ensure high quality care for all. Draft guidance for timely and appropriate transfers and remissions of care to and from a mental health hospital is currently in production.
Following release from prison, NHS England is working with partners to develop better pathways of care from custody. Drawing on learning from existing services we are investigating how best to ensure continuity of care post custody.
