Mental Health in Prisons

Afzal Khan Excerpts

Wednesday 10th January 2018 Westminster Hall

[Imran Hussain]

My hon. Friend makes a very important point. Obviously, it is an issue that is very close to him, as it relates to his constituency, but it is also of concern to us all, and I hope that the Minister will listen and respond.

As recognition of mental illness in society increases, with a greater understanding of just how damaging it can be, so it does in prison. However, prisoners have a much greater likelihood of suffering from mental illness than the general populace, with one in three prisoners estimated to be suffering from mental illness.

[Afzal Khan (Manchester, Gorton) (Lab)]

I will also be very brief. One of the causes of concern is the impact on black and Muslim prisoners. Reports from Her Majesty’s Inspectorate of Prisons and from Dame Anne Owers say that negative outcomes, stereotyping and discriminatory treatment are consistently experienced by Muslim and black prisoners. Does my hon. Friend agree that the Minister could take a number of steps to help address that? First, religion and ethnicity should be recorded on all clinical records. Secondly, the uptake and outcomes of mental health services in prison should be examined by religion and ethnicity. Thirdly, mental health literacy and religious literacy training should be provided to all prison officers.

[Imran Hussain]

My hon. Friend is right to point out some of the particular issues regarding black, minority ethnic and Muslim prisoners. I will come on to the broader recording issues, but he makes some very important and sensible suggestions.

Unfortunately, most evidence suggests that the estimate that one in three prisoners suffers from mental illness is wildly conservative, demonstrating that it is a real problem, which manifests itself in the self-harm that has risen dramatically in recent years. Many of those self-harming and taking their own life are suffering from a mental illness, representing yet another crisis in our prison system that is spiralling out of control. The Government cannot get to grips with the crisis and are not doing enough to address it. I mentioned one of the reasons for that earlier, when I stated that the number of prisoners suffering from mental illness is just an estimate. There is no accurate record, clear marker, or identifiable way to determine who is suffering from a mental illness in prison; there is just an estimation of the scale of the problem—close to sheer guesswork on the part of the MOJ.

Even when prisoners are screened for mental illness, it is done poorly. Rather than a thorough assessment from a qualified mental health professional, most prisoners are briefly assessed, and given 120 questions to complete in often as little as 10 to 20 minutes. When thrown in with the increasingly toxic nature of prisons, the answers that come back are less than truthful. When the MOJ does not even centrally collect the basic number of prisoners in the prison estate who are suffering from mental illness, and when prisoners are not properly assessed, prisons simply do not know who is vulnerable and who is not, so how can they possibly be expected to provide care for them? The MOJ is failing at the first hurdle—being able to treat mental illness—even before we get on to the treatment itself. That is simply not good enough.

Unfortunately, the conditions after a prisoner has entered are little better, which means that even if they are identified as having a mental illness, they are not always properly treated. The commissioning of healthcare means that mental health provision is disjointed and varied across prison estates, with HM Inspectorate of Prisons finding gaps in primary care, professional counselling and therapies across estates, as well as failings in access to services, gaps in those services, and a failure to follow up on mental health concerns. That is bad, and is certainly not improved by the fact that the partnership agreement between the Prison Service and NHS England, setting out the objectives in providing healthcare to prisoners actually expired in April. There has been a transfer of responsibilities from the National Offender Management Service to the new Prison Service during that time, but I do not buy that as an excuse.

Prisoners with serious mental illnesses are treated even worse as they face extended waits for transfer to secure hospitals. NHS England set a target of 14 days from identification to transfer, but the reality is that prisoners awaiting transfer were reviewed in October 2016, with findings showing that prisoners waited an average of 47 days for their first assessment, a further 36 days for their second assessment, and a further 13 days for the Secretary of State to sign a warrant. That is clearly unacceptable.

All of that demonstrates that the Government are just not getting to grips with the crisis and are not moving to address it. To add to that, Government policy is making it worse. Substantial budget cuts to the Ministry of Justice have been passed on to the Prison Service, with the funding that NOMS received significantly falling. That translates to a reduction of around 30% in operational staff, meaning fewer staff on the wings and on the balconies, and crucially fewer staff who are able to understand individual prisoners and recognise when they are vulnerable. Furthermore, staff shortages and safety concerns have resulted in prisoners being forced to spend longer periods of time locked up in cells. Isolation and confinement are bad enough for those without mental health issues, but they can be devastating for those with mental health issues.

Fewer staff also leads to a rise in the number of drugs getting into prisons, as fewer prison officers results in fewer searches and reduced intelligence gathering and awareness. Drugs, both those of which we have an understanding, such as cannabis and cocaine, and those classed as new psychoactive substances, such as spice, are having a major impact on our prison estates and on the mental health of prisoners. Although the Government are introducing powers to stop the use of mobile phones and are training more dogs to combat smuggling, that is simply not enough without more prison officers.

I will conclude there, as I know the Minister has a number of points to come back on. In summing up, I would say that we have seen mental health care in prisons degrade on the Government’s watch. They must prove that they are serious about addressing it, because right now we see no such evidence. They need to record just how big a problem mental health in prisons is, screen prisoners properly and conduct an immediate review, for without that knowledge, they cannot begin to get to grips with the issue. They need to properly invest in getting prison officers back on the wings and the balconies—but not at the expense of support staff.