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Prisoners: Mental Health

Volume 691: debated on Wednesday 25 April 2007

asked Her Majesty’s Government:

What plans they have to handle mentally ill people in prison, in light of the Prime Minister’s review of the criminal justice system.

My Lords, the Prime Minister’s review provides a valuable framework, through which we will continue to develop and extend health services to mentally ill offenders in prison and other parts of the criminal justice system. We have already taken many important steps: transferring prison mental health services to the NHS; increasing investment; introducing mental health in-reach services; increasing staff awareness; and improving transfers to the NHS of those prisoners who are most severely mentally ill.

My Lords, I thank the Minister for that encouraging reply. I am sure that she welcomes, as do I, the Government’s commitment to get mentally ill people who should not be in prison out of there, as expressed in a number of recent statements. In the light of these statements, can she confirm that the Government plan to provide another 8,000 prison places, costing £1.5 billion in capital expenditure and more than £3 million a year to run? Why are the Government spending this money on prison places, rather than on places of treatment for the mentally ill people who they agree are wrongly placed in the prison system?

My Lords, I can confirm that we intend to build 8,000 more prison places, but that is not in any way to undermine the efforts we are making for mental health provision. I join the noble Baroness in congratulating the efforts made. She will know that we have made a significant improvement. By next year, we will be spending almost £200 million on health in prisons; and about £20 million is available for mental health in-reach services in each year from 2006-07.

My Lords, will the Minister tell us how many court diversion schemes are now in operation, and confirm that these are a very good way to ensure that severely mentally disordered people do not arrive in prison at all?

My Lords, I cannot give the noble Lord the exact figure. I will undertake to see whether we can get it. He will know that various areas have various ways of delivering the schemes. I confirm the importance of early identification of mental illness and risk, and diversion, as appropriate, to meet those needs prior to entry into the criminal justice system. We are doing everything possible to ensure that takes place.

My Lords, while welcoming the transfer of responsibility for health services from the Prison Service to the NHS, do not the figures on reoffending in the review suggest to the Government that unless and until we separate out those large numbers in the prison system with severe mental illnesses we will not make any impact on them? Does not that underline the point the noble Baroness made; that we need separate specialist treatment because prison officers are not trained to deal around the clock with the large number of people in prison with mental illnesses?

My Lords, I agree with my noble friend that we need to do as much as we can in that regard. Therefore, I am delighted to say that we have made significant improvements. Prison officers are being trained in mental health awareness; and £600,000 has been invested over three years in mental health training for prison staff, which has ensured that we have a better provision. We are moving more people than ever before out of prison into secure and appropriate mental health treatment. That inures to the benefit of those individuals; it also enables us to meet better targets on reducing reoffending.

My Lords, is there not a greater problem with the dual problem of mental illness and drug and alcohol addiction?

My Lords, that is a very significant problem. The noble Baroness will know that is the reason we have created specific programmes to deal with both issues. She will be aware that for many the abuse of alcohol and drugs masks an underlying mental illness. Therefore, we have to deal with both issues. We are making real progress, which gives, I know, a number of people in this House a lot of pleasure.

My Lords, the Government's review on security, crime and justice, which we welcome, mentions and proposes hybrid prisons and mental health courts. What is a hybrid prison, and what would be the function of a mental health court?

My Lords, the noble Baroness will know that that was a suggestion in how we better handle the issues of those with mental illness but who are still in need of security. We intend to explore the issue. The noble Baroness will know that it is part of the review, and we will look very hard at it with our mental health colleagues. The real issue is to get the right placements for people, so that any mental illness can be addressed appropriately.

My Lords, I am sure many here would agree that the word “asylum” needs to be rediscovered in the sense of it being a place of safety, compassion and wholeness. Given the very high proportion of people in prison suffering from identifiable mental illness, can the Minister tell us not only what provision is being made for their timely transfer to more appropriate secure accommodation, but also whether in providing that accommodation the spiritual needs of such patients and prisoners will be taken with the utmost seriousness?

My Lords, I can certainly reassure the right reverend Prelate that spiritual needs are taken with the appropriate degree of seriousness. He will know that we have enhanced our chaplaincy work and are doing outreach work not only in prisons but in the community. Further, I hope the House will be reassured that all prisoners are now assessed at the point of reception into prison, and those at risk of having a mental health issue or a vulnerability to suicide are referred for a mental health assessment. There are also new systems to monitor and support those at risk of harming themselves. Together with the in-reach teams, we have 360 extra staff employed on mental health in-reach provision to ensure that we bear down on that very difficult problem.

My Lords, the Minister referred to the Government's intention to get mental health prisoners into hospital. Can she tell us how many of the severely mentally disordered people in prison are awaiting transfer to a hospital and how long is the average time that prisoners spend waiting to be transferred?

My Lords, we have made significant improvements in that regard. The noble Viscount will know that in 1997, 757 prisoners were transferred from prison under the Mental Health Act and delays were common. We have made significant improvements. In 2006, we moved 961 prisoners. The timing and the numbers have greatly improved, and I should be very happy to provide specific details for the noble Viscount.