Thursday, 29 June 2017

Mental Health Failure in Prison

There's hardly a day goes past without a report into the parlous state of our prison system. In the wake of a massive increase in suicides, the National Audit Office weighs in, as reported here in the Independent:-
Government fails to track mental health in UK prisons amid soaring suicide and self-harm rates, finds report

Prison authorities urged to address rising rates of suicide and self harm 'as a matter of urgency' after findings show failure to collect data on inmates' mental health needs.

The Government does not know how many people in prisons have a mental health illness, a report has warned, prompting calls for “urgent” action amid soaring suicide rates and self-harm incidents among inmates. Prison authorities’ response to rising suicide and self-harming rates in British jails has been “poor”, according to research by the National Audit Office (NAO).

Her Majesty’s Prisons and Probation Service (HMPPS), NHS England and Public Health England have set ambitious objectives for providing mental health services, but they are failing to collect enough data on inmate’s wellbeing, the report states. It adds that the Government is unaware of how much it is spending on mental health in prisons and does not know whether it is achieving its objectives.

According to independent research carried out for the report, the NAO estimate that the total spend on healthcare in adult prisons in 2016-17 was around £400m. HMPPS does not monitor the quality of healthcare it pays for in the six privately-managed prisons it oversees. NHS England uses health needs assessments to understand prisoners’ needs, but these are often based on what was provided in previous years and do not take account of unmet need.

The warnings come after five years in which rates of self-inflicted deaths and self-harm in prison have risen significantly, suggesting that – although the data isn’t recorded – mental health and wellbeing among prisoners has steeply declined. Self-harm incidents increased by nearly three quarters (73 per cent) between 2012 and 2016, with 40,161 incidents of self-harm recorded in 2016 alone – the equivalent of one incident for every two prisoners.

The suicide rate among prisoners hit the highest year on record last year, with 120 self-inflicted deaths – almost twice the number in 2012. The Prisons and Probation Ombudsman found that 70 per cent of prisoners who had committed suicide between 2012 and 2014 had mental health needs. In light of the considerable rise in self-inflicted deaths and self-harm among inmates, the NAO warned that the Government must address the rising rates of suicide and self harm in prisons “as a matter of urgency”.

The report states that while the Government has set out an ambitious reform programme to address prisoners’ mental wellbeing, the prison system is under considerable pressure, making it more difficult to manage this. Amyas Morse, the head of the National Audit Office, said it was clear from the findings that the Government does not know what “base they are starting from” in addressing mental health problems in prisons.

She said: “Improving the mental health of those in prison will require a step change in effort and resources. The quality of clinical care is generally good for those who can access it, but the rise in prisoner suicide and self-harm suggests a decline in mental health and wellbeing overall. The data on how many people in prison have mental health problems and how much government is spending to address this is poor. Consequently Government do not know the base they are starting from, what they need to improve, or how realistic it is for them to meet their objectives. Without this understanding it is hard to see how government can be achieving value for money.”

The Ministry of Justice and its partners have undertaken work to identify interventions to reduce suicide and self-harm in prisons, though these have not yet been implemented.

The National Offender Management Service’s funding went down by 13 per cent between 2009-10 and 2016-17 and staff numbers in public prisons reduced by 30 per cent over the same period. When prisons are short-staffed, governors may run restricted regimes where prisoners spend more of the day in their cells, making it more challenging for prisoners to access mental health services, the report states.

It adds that staffing pressures can also make it difficult for prison officers to detect changes in a prisoner’s mental health, and that officers have not received regular training to understand mental health conditions, though the Ministry plans to provide more training in future. The report also raises concerns that while clinical care is broadly judged to be good in prisons, there are weaknesses in the system for identifying prisoners who need mental health services.

Inmates are screened when they arrive in prison, but this does not always identify mental health problems and staff do not have access to GP records, which means they do not always know if a prisoner has been diagnosed with a mental illness. Mentally ill prisoners should wait no more than 14 days to be admitted to a secure hospital, but only 34 per cent of prisoners were transferred within 14 days in 2016-17, while seven per cent waited for more than 140 days.

The process for transferring prisoners is complex and delays can have a negative impact on prisoners' mental health and they may be kept in unsuitable conditions such as segregation units. Previous research has shown that prisoners are more likely to suffer from mental health problems than people in the community, and that those whose mental health needs are not addressed in prison are generally more likely to reoffend.

Commenting, Peter Dawson, the director of the Prison Reform Trust, said it was “horribly clear” that prisoners are facing “disproportionate and unnecessary harm” as a result of the inadequate mental health provision.

“This is a familiar tale of admirable policy objectives not being delivered on the ground. There is a ray of hope in the successful rollout of liaison and diversion schemes in courts and police stations that spot some of the people who are most vulnerable,” he said.

“But this report makes horribly clear that our prisons are holding very many people who will suffer disproportionate and unnecessary harm because of the prison environment. It is futile to expect to improve their situation while prisons are overcrowded and thousands of people are spending a few weeks inside each year simply because there is inadequate community provision. The Government must grip the issue of who goes to prison so that the system can care properly for the minority who really need to be there.”

A Government spokesperson said: “We take the mental health of prisoners extremely seriously, which is why we have increased the support available to vulnerable offenders - especially during the first 24 hours in custody - and invested more in specialist mental health training for prison officers. We’re putting more funding into prison safety and have launched a suicide and self-harm reduction project to address the increase in self-inflicted deaths and self-harm in our prisons. But we recognise that more can be done and continue to work in partnership with HMPPS, NHS England and Public Health England to improve mental health services for offenders at all points of the criminal justice system.”


  1. Court report writers need to be given more time to complete a full and proper assessment in order to gather all the previously required information ( which now just doesn't seem important when chasing targets ) and hopefully those offenders with mental health issues will receive the most appropriate intervention rather than ending up in custody limiting those to whom their offence meets the threshold - even with these cases as has been highlighted by mental health professionals there needs more approriate resources and training for staff in the prison setting. But again money and targets appear more important in the TR fiasco - and with the Gov't constantly backtracking on public sector pay etc it's unlikely that the appropriately skilled professionals will be attracted to take the jobs

    1. Very long article, but we'll worth a read.

  2. Prison is increasingly being used to 'park' social problems. Some might even say it's being used to hide them away.
    I feel very sad when I read articles like the one highlighted below. I don't know the answer, but I do know imprisonment in this case will serve no purpose whatsoever to the individual being imprisoned or to society as a whole. He will be released homeless no doubt, with exactly the same issues and problems as he had when he went in, go as far as his £46 will take him, and back before the magistrates again.
    All of a sudden he will find himself 60 years old (if he lives that long) wondering what happened to his life and how he managed to damage so many other people's lives along the way.
    There must be some other way surely?


    1. JAILED: Homeless alcoholic back behind bars

      A HOMELESS alcoholic with a history of not complying with court orders for previous offences has been jailed for 25 weeks by magistrates in Swindon.

      Joseph James McGlaughlin, 27, of no fixed address in Swindon, appeared before the magistrates on Monday for breaching the conditions of a suspended sentence order, to which he pleaded guilty.

      He also pleaded guilty to failing to comply with the notification requirements as a sex offender and to assaulting a former girlfriend.

      Prosecutor Vyvyan Thatcher told the bench that McGlaughlin was placed on the sex offenders register for seven years in July 2014, when he was also sentenced to six months in prison.

      After release from jail he was required to attend regular weekly appointments with the police, the probation service and Swindon’s drug and alcohol service CGL.

      He had missed the appointments many times, Mr Thatcher said, mainly due to the fact that his mobile phone had died and he did not know where and when he was supposed to be.

      On May 26 this year McGlaughlin went to his girlfriend’s address in Royal Wootton Bassett where they argued. To stop her leaving McGlaughlin grabbed her round the throat.

      The police were called and when they arrived McGlaughlin was holding a knife to his own throat, threatening to kill himself.

      A report from the probation service said the suspended sentence order had been imposed for theft and assault offences and for a breach of the sex offenders order.

      The breach he admitted on Monday was the third breach of the order and probation felt there was willfull non-compliance. They recommended 14 days in custody.

      McGlaughlin had attended no alcohol treatment sessions to date, probation said, missing nine. There had also been two incidents of self-harming this year during both of which he had called the police, on one occasion sparking a helicopter manhunt.

      Defence solicitor Emma Thacker told the magistrates McGlaughlin was homeless and had complex mental health issues. He wanted somewhere stable to live but something always happened.

      “It is very hard for him to manage his life in general. He wants out,” Ms Thacker said, adding that McGlaughlin now had a significant problem with his leg where he had been injecting drugs.

      At this point McGlaughlin shouted from the dock: “I don’t want to be on drugs any more.”

      Bench chairman Mrs Crockett told McGlaughlin the magistrates were going to activate the suspended sentence order of nine weeks in custody with a further six weeks for breaching the order.

      They imposed 10 more weeks custody for the assault, to run consecutively, making a total of 25 weeks in prison.

      They issued an order restraining him for two years from any contact with his former girlfriend and ordered him to pay a victim surcharge of £80.

  3. What are the magistrates supposed to do? The failings of support in our increasingly fragmented society give them little choice. I am supervising someone with similar issues and it is a real challenge trying to keep him out of prison and his potential victims safe. Don't just blame prisons. They are the dumping ground behind bars and probation is the community dumping ground.


  5. Having left probation following the split. What comes around goes around. What a brilliant result from SYCRC.
    ABSOLUTELY amazing report. Despite the negativity on this blog. It is clear that SYCRC are making this work despite a very difficult system. Hats off as in my area this is not happening and we are drowning.
    Great to see a CRC battle and prove itself, I only wish we could do the same.

    1. From the report:

      - Interventions were not always accessible, however, or delivered frequently. Where service users did not access the planned interventions quickly, we found the momentum was lost and the level of meaningful contact became poor, with the requirements of the order not being delivered. Not all local management centres were accessible for disabled service users and staff, and not all interventions were available for those unable to attend during the day.
      - The quality of work to ensure that offenders abided by their sentence was inconsistent. Staff had a sound understanding of how to implement requirements of court orders and licences. Responsible officers and contracted providers understood the importance of clear recording. Practice was underpinned by clear processes and guidance. Checks were in place to see whether requirements were completed before a case could transfer to the central hub and remote contact.
      - The CRC’s aim to complete the main interventions in the first few months of the order was not met in many cases. Instead there were too many examples of cases with a high number of acceptable absences and service users not completing their required interventions, which resulted in drift and little meaningful work. The high number of acceptable absences was particularly poor for unpaid work orders.

      "What a brilliant result from SYCRC"

    2. Wow not in probation mate but nothing like a bias edit there pal report nothing like that sorry

  6. Could this be a motive for the Daily Fail to focus on sotp...?

    BBC news: "Police forces have dropped measures designed to stop convicted sex criminals reoffending, the National Police Chiefs’ Council has said, in a bid to focus more on those who present a greater risk.

    The new approach will see some low-risk offenders no longer being subject to annual home visits or having the risks they pose reassessed as thoroughly as before.

    Rapists may be included in the looser regime, as may those convicted while teenagers who are now adults with stable, law-abiding lives.

    Michelle Skeer, the national police lead for managing sexual offenders, said hundreds may no longer be subject to proactive measures, previously deemed necessary to protect the public. That number may grow and police realise it may be controversial. “It is very highly emotive for members of the public,” Skeer said."

  7. Why have we got a probation service at all. Anything we do appears to have little effect or it would seem increases offending. We are colluding by hitting targets and failing to meet the needs of our clients. No resources for practical help. Probation should have remained true to its ethos rather than becoming puppets of the government. Why has Chris Grayling not been hung out to dry for the destruction of probation. We are now robots of the state.

  8. It is not just probation. Britain itself is gradually becoming a lawless society. All the systems unravelling and only law left is : money = power. It is now up to each and every one of us to resist these developments or we will all end up in a dictatorship. Look beyond probation.