Prison Mental Health Is Failing

Rates of mental illness in prison are high. There is a commonly quoted figure among mental health professionals that around 70% of prisoners have some form of mental health diagnosis, whether a psychotic disorder, mood disorder, addictions, personality disorders, trauma-related disorders e.g. PTSD etc. Most academic literature estimates it to be around 50% but thats still high. No matter your views on the criminal justice system and those who have perpetrated crime, there is no doubt this is a vulnerable group.

There is national guidance from NHS England that if a prisoners needs further assessment and treatment of a mental illness under the legal framework of the Mental Health Act that they should eb transferred to hospital within 28 days of that decision. That includes making the referral to the relevant hospital, them assessing and agreeing that it is necessary and the legal criteria are met, finding a bed, getting a warrant to permit moving the prisoner, and organising transport to take them in with the right level of security to protect the public along the way. There are a lot of moving parts and the new report from the Chief Justice Inspectorates brings home just how bad we are as a country at meeting this target.

Prisoners are waiting an average of 85 days rather than the recommended 28 days. Thats an average, so some are waiting significantly longer and is it a surprise that the mental health of mental ill people then deteriorates further in prison? This is far from the equity of healthcare that we are supposed to be aspiring to.

Furthermore, there were supposed to be new laws to enforce this as part of the reform to the Mental Health Act that our beloved government has now shelved in the leadup to a general election. We’re failing prisoners with mental illness and there are little to no consequences for doing so, and little to no incentives to make improvements. Yes, a lack of beds is one issue (indeed, in my unit, as soon as a bed becomes available it is quickly filled up), but its not the only issue. I think there are attitudinal issues embedded within our specialty and we need to look at ourselves in the mirror about why.