Mental Health in Prisons

Chris Evans Excerpts

Wednesday 10th January 2018 Westminster Hall

[Chris Evans (Islwyn) (Lab/Co-op)]

Thank you, Mr Howarth, for calling me to speak in this very important debate, and I congratulate my hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) on her succinct but very informative speech.

I also congratulate the Minister—the Under-Secretary of State for Justice, the hon. Member for Bracknell (Dr Lee)—on surviving the reshuffle. He is the sole survivor. However, the reshuffle raises a very important issue. For me, the situation is unacceptable. This is the second time in living memory that the Ministry of Justice has been cleaned out in a reshuffle. It is unacceptable that we have had six Justice Secretaries in seven years. Only one of them has lasted for even two years. That has led to inconsistent policy and inconsistent reform, and a lot of things have been kicked into the long grass.

While all that has gone on and while the Government have reshuffled the Ministry of Justice, a National Audit Office report to the Public Accounts Committee, of which I am a member, said that £400 million was spent on healthcare in prisons in England in 2016-17, treating 7,917 mental health patients. However, the inspector of prisons found that 31,328 prisoners, who make up 37% of the prison population, reported having mental health or wellbeing issues. Incidents of self-harm and suicides increased—there were 120 suicides in prisons in 2016, the highest number on record.

Prisons and the probation service estimate that 70% of the prisoners who ended their own life between 2012 and 2014 had mental health needs. Identification of those who need mental health services is not consistent. It is all very well our standing here and saying, “Well, they’re in prison. They’re locked away.” For those of us who have stood in our constituencies and somehow had to find some sort of comfort for grieving families who have been victims of those with mental health problems, that is simply not good enough.

I will cite an example from my own constituency. In November 2014, Matthew Williams went out one night and met Cerys Yemm. They went back together to the Sirhowy Arms hotel in Argoed, where he violently killed her. The Argoed hotel murder case was launched by the Ministry of Justice and found a series of failures. In 2004, Mr Williams had been diagnosed with schizophrenia after spending five weeks in a mental health in-patient unit. However, Mr Williams had been a highly frequent user of drugs since adolescence. Schizophrenia should not be diagnosed during states of drug intoxication or withdrawal. Drug-induced psychotic episodes have very similar symptoms to schizophrenia. After Mr Williams left the in-patient unit, his diagnosis was never re-evaluated.

The Argoed homicide report found that, during his diagnosis, Mr Williams was experiencing a drug-induced psychotic episode, and that there was insufficient evidence to support a true diagnosis of schizophrenia. Mr Williams was on and off medication throughout his life, and not enough support was given to him when he was leaving prison. In fact, he had 26 convictions for 78 offences.

It could be argued that the key affliction affecting Mr Williams was drug addiction. He had been using drugs on the night that Cerys was murdered. Those people who had been in contact with him described him as being

“low in mood and pessimistic, but not psychotic”.

The report’s authors believe that his drug use on the night of the murder could have triggered a psychotic episode. Drug addiction was overlooked in favour of a schizophrenia diagnosis—the substance abuse was never truly addressed.

There were inconsistent mental health records: there was a schizophrenia diagnosis, an unofficial undiagnosis and an unofficial personality disorder diagnosis. Medication was prescribed and then unprescribed. Most damningly, Mr Williams was released from prison without medication and continued with consistent drug use in the two weeks after his release. The lack of consistency in the mental health diagnoses, both inside prison and outside, led to a terrible, terrible incident, the effects of which are still being felt in Argoed and the local community at the moment.

Even though Mr Williams was ultimately responsible for murdering Cerys in a terrible way—I pay tribute to the quiet dignity of Cerys’s family—the escalation of mental health issues such as drug addiction could have been prevented throughout the different diagnoses and follow-up. Consistent care and consistent support could have been provided to Mr Williams, but both in prison and outside he received neither.

We need more structured interventions for people with mental health issues, including personality disorders and substance misuse. There also needs to be better sharing of healthcare information prior to someone’s discharge from prison, between community mental health teams and mental health in-reach teams. That would provide consistency and would be a protective measure against possible relapse in any mental health condition. There should also be follow-up appointments with individuals. The PAC reported on these issues and we call on the Government to act on that report now.