One prisoner in seven in England receives support from mental health services, rising to more than one in four among women in custody, according to a recent survey report by the Centre for Mental Health. The report also highlights a lack of mental health expertise in the prison system, plus the need for robust support systems upon release.
Numbers on the rise
According to a recent survey report by the Center for Mental Health, one prisoner in seven is getting support from mental health services, rising to more than one in four among women in custody.
The report, Prison mental health services in England, 2023, is based on a survey of three-quarters of prisons in England commissioned by NHS England. It finds that more than 7,700 people in the prisons surveyed were receiving support from a mental health service while in custody.
The most common mental health needs were depression and anxiety, but many prisoners had multiple and complex needs for support. Almost 40% of people using prison mental health services also had substance use problems. More than half had histories of self-harm, and 40% had attempted suicide.
The report finds that a quarter of people waiting to transfer to a hospital spent more than 28 days waiting for an assessment or a bed under the Mental Health Act. Most prisons do not employ someone with mental health expertise to carry out screening at reception. This means many people’s needs may be missed when they arrive in prison.
Variance in support levels
The report found that prison mental health services vary widely between regions in England regarding resourcing and workforce. Children in custody tend to get more intensive mental health support than adults. According to researchers, young people moving to the adult estate face a potential ‘cliff-edge’ in the support available to them.
More than a quarter of prisoners receiving mental health support were due to be released within a year. Researchers concluded that it was vital that these people receive adequate support ‘through the gates,’ including from NHS England’s new RECONNECT services. This should consist of help with housing, employment, and benefits.
Prison mental health services in England, 2023 state that more mental health-trained staff should be involved in screening processes. Prison mental health services should also be more consistently staffed, with various professionals with expertise across different disciplines.
The report recommends that the Government goes ahead with its plan to amend the Mental Health Act so that no one waits more than 28 days for a transfer to a hospital. For this to happen, the transfer process must be reformed to prevent multiple assessments and refusals of beds to people needing urgent care.
What do the experts say?
Given that this is a complex and multi-disciplinary area that potentially involves a multitude of agencies, there are, understandably, widespread views on how the situation can be best tackled.
The Report author, Dr Graham Durcan, said,
“Most prisoners have at least one mental health difficulty, and many have multiple and complex needs. Prison mental health services have come a long way since the NHS took responsibility for them two decades ago. They are working with more than 7,000 people at a time and providing services for people who face significant risks and vulnerabilities.”
Dr Duncan continues,
“It is vital that every prison has access to high-quality mental health support, with multi-disciplinary teams to meet people’s needs fully. This must be backed up by speedy transfers to the hospital when someone needs urgent care and effective mental health support in the community when prisoners are released.”
In responding to the research conclusions, Kate Davies, Health and Justice Director at NHS England said,
“We welcome this report and remain committed to reducing the health inequalities faced by patients in health and justice settings. An important driver for this is ensuring that we have mental health services that provide holistic care and support to meet the needs of some of the most vulnerable patients in society.”
Ms Davies added,
“As part of this, we are refreshing the mental health service specification for health and justice settings, which is being rolled out across England, along with the RECONNECT service, which is on target to achieve 100% coverage of English prisons. Together with our justice partners, we are also collaborating on our response to the impact and implementation of the Mental Health Act changes to support the safe and timely transfer of patients to the appropriate services.”
As we all know, the incidents of mental health issues in our society are rising. Those in prison who form part of that society are not exempt from these issues, as this report has illustrated.
However, without the support required being put in place and without post-prison follow-up services ramping up to meet demand, there is a real risk that those coming out of prison will face abandonment as they try to put their lives back together.
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