Leading mental health campaign group, The Centre for Mental
Health has published a report on the state of mental health services in English
prisons.
The report written by Dr Graham Durcan ‘The future of
prison mental health care in England’ was commissioned by NHS England and NHS
Improvement and the data used was gathered during the Summer of 2020. It is the
latest in a series of reviews carried out by the Centre for Mental Health over
the past 15 years.
The report finds that in general prison mental health
services are working well and identifies several examples of good and
innovative practice, however it points to actions that need to be taken in some
key areas.
The report notes that the provision of services varies
markedly in quality from prison to prison, noting problems around screening and
assessment and accessing psychological therapies.
Problems were also noted in relation to pathways in
and out of prison, particularly for inmates serving short sentences, support
services for inmates following release and the impact of the pandemic on services
and the mental wellbeing of prisoners.
Many of the problems identified in the report relate
to England and the UK in general using custodial sentences more than its European
neighbors. An issue of particular concern, the report found, was the ‘churn’ in
prisoners serving multiple short sentences, making it problematic to provide
support for those identified as having mental health issues.
There is, the report claims, strong evidence that were
short term prison sentences to be replaced by community ones it would be of
benefit to both individual offenders and wider society. This though, it also
notes, is not reflected in current government policy, which focusses on
building larger prisons to accommodate an ever-growing population.
Problems were identified in relation to communication
between community mental health services and those in the prison system, with
inmates often having difficulty accessing things like medication. Screening and
assessment of newly incarcerated inmates presents problems, the report found
that 75% of people needing support are not identified during induction.
Being released following completion of their sentence
can also be a difficult time for people living with mental health issues. Many have
difficulty finding work and accessing community support services, these
problems have been intensified by cuts to the probation service.
The data used in the report was gathered during the
first national lockdown when prison visits had been stopped and many activities
such as education and work had been suspended indefinitely. These measures,
though necessary to control the spread of the virus, led to most prisoners being
in what amounted to solitary confinement, with an associated impact on their
physical and mental wellbeing.
Unlike in wider society there was no corresponding
move of meaningful activities online to provide at least limited mitigation,
although the report finds that in many cases this could have been done.
The report makes seven recommendations for how
services can be improved across the prison system, these include
Prison staff need to be better trained in understanding
the mental health vulnerabilities of inmates coming into the system and reducing
the use of short-term sentences with a realigned focus on using community punishment
instead. The report also calls for improved continuity of care and support for people
entering and leaving the prison system and improving the digital service
capacity across the prison system.
The full text of the report can be read at:
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