Duty of care to prisoners needs urgent action

13 December 2017

The Public Accounts Committee report says record levels of self-inflicted deaths and self-harm in prisons are a damning indictment.

Current level of suicide and self-harm in prisons "appalling"

Record high numbers of self-inflicted deaths and incidents of self-harm in prisons are a damning indictment of the current state of the mental health of those in prison and the prison environment overall.

More excuses are not good enough. The Ministry of Justice, HM Prison and Probation Service and NHS England have a duty of care to those in prison, yet do not know where they are starting from, how well they are doing or whether their current plans will be enough to succeed.

The current level of self-inflicted deaths and self-harm incidents in prisons is appalling and the system for improving the mental health of prisoners isn’t working as it should.

Problems exacerbated by a deteriorating prison estate

Government does not have reliable or up to date measure of the number of prisoners who have mental health problems and existing screening procedures are insufficient to adequately identify those who need support and treatment.

People in prison are more likely to suffer from mental health problems than those in the community. Yet prisoners are less able to manage their mental health conditions because most aspects of their day-to-day life are controlled by the prison.

These difficulties are being exacerbated by a deteriorating prison estate, long-standing lack of prison staff and the increased prevalence of drugs in prison.

Improving mental health essential step to reducing reoffending

Improving the mental health of prisoners is a difficult and complex task, but it is an essential step to reducing reoffending and ensuring that those who are released from prison can rebuild their lives in the community.

Despite this, Government's efforts to improve the mental health of those in prison so far have been poorly co-ordinated, and information is still not shared across the organisations involved, and not even between community and prison GP services.

Chair's comment

Comment from Chair of the Committee, Meg Hillier MP:

"There are deep-rooted failures in the management of prisoners' mental health, reflected in what is an appalling toll of self-inflicted deaths and self-harm.

Failing to attend to the mental health needs of inmates can also have devastating effects beyond the prison gates.

The evidence is stark but there is no realistic prospect of these serious issues being properly addressed unless Government rethinks its approach.

This must start with a meaningful assessment of the scale of the problem.

Without adequate data it is simply not possible to determine whether Government action is making a difference—yet, incredibly, the most commonly used estimate of prisoners' mental health problems is 20 years old.

This is clearly not good enough and implementing more robust health screening processes must be a priority.

There are long-standing issues with understaffing in prisons and, as the Government seeks to address these shortfalls, we will expect it to demonstrate swift progress with plans to provide enhanced mental health training.

But reviews elsewhere in the system are desperately needed: prisoners’ increasing use of psychoactive drugs, for example, has laid bare the weaknesses of treatment and detection programmes.

Government must raise its game to understand the problems and we urge it to act promptly on the recommendations set out in our report."

Further information

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