The range of support provided to mentally ill people who commit crimes is set out in the Offender Mental Health Care Pathway (Department of Health, 2005). This outlines best practice in stages from police custody and court appearances through to prison and pre-release arrangements with community mental health teams. Copies have been placed in the Library. It is also available on the Department of Health website at:
Under the Mental Health Act 1983 the courts have powers to assess mentally disordered offenders before sentencing and to divert them to receive specialist treatment in hospital rather than punishment. The police also have the power under the Act to remove a person who appears to be suffering from mental disorder to a place of safety. The Government plan to publish guidance this year to the NHS and partner agencies which supports the development of local diversion services by building on current best practice.
Beginning in 2003, and completing in April 2006, the national health service took over commissioning responsibility for all prison health services in public sector prisons. This was previously the responsibility of the Prison Service. One of the main reasons this transfer was made was to help ensure that prisoners had better access to mainstream health services.
Investment in prison mental health in-reach services has been steadily increasing, with nearly £20 million invested in these services each year since 2004-05, and 360 whole time equivalent staff employed—more than the initial commitment in the NHS Plan to create 300 posts. There are now teams in 102 prisons and their services are available to the entire prison estate.
People who are mentally too ill to remain in prison should be transferred to hospital. We have introduced tighter monitoring to identify prisoners waiting an unacceptably long period for transfer to hospital. A protocol was issued to prisons and primary care trusts in October 2005 setting out what must be done when a prisoner has been waiting for a hospital place for more than three months following acceptance by the national health service.
These measures have helped bring about positive results. In 2006, 33 per cent. more prisoners, with mental illness too severe for prison, were transferred to hospital than in 2002—up to 961 from 723. There has been a significant decrease in the number of people waiting over 12 weeks for a transfer—in the quarter ending March 2007, 40 prisoners were waiting, down from 51 in the same quarter in 2005.
The ACCT (Assessment, Care in Custody and teamwork) care planning process for prisoners in danger of self-harm or suicide has helped contribute to a reduction in the number of suicides in England and Wales. In 2006, these were down 14 per cent. —down to 67 cases, from 95 in 2004. This is the lowest figure since 1996.