Mental Health in Prisons

David Drew Excerpts

Wednesday 10th January 2018 Westminster Hall

[Ms Rimmer]

I do, and I thank my hon. Friend for that intervention. What she describes is one major component that is missing and would help to resolve the situation. People are locked up in a small cell for the vast majority of the day, subject to a poor diet and living in inhuman and dirty conditions. Those who were previously healthy often develop depression, anxiety and violent tendencies because they are in effect caged, with little food and no stimulation.

Since March 2017, Her Majesty’s Prison and Probation Service, formerly NOMS—the National Offender Management Service—has been responsible for the management and operation of prisons in England and Wales and for ensuring that the prison environment is safe and decent. The Ministry of Justice is now responsible for prison policy and commissioning of services in prisons. NHS England is responsible for healthcare in prisons, in terms of both physical and mental health. In 2016-17, NHS England spent an estimated £400 million providing healthcare in adult prisons in England. It is estimated that £150 million of that was spent on mental health and substance misuse services, although the exact figure is unknown. All those bodies have a fundamental duty of care, yet as the Public Accounts Committee damningly concluded, they do not even know where they are starting from, how well they are doing or whether their current plans will be enough to succeed in caring for prisoners with mental health needs.

[Dr David Drew (Stroud) (Lab/Co-op)]

Does my hon. Friend accept that another problem is that those bodies do not know where people are going post-prison? I have in my constituency the excellent and nationally reputed Nelson Trust; it has a women’s centre in Gloucester. Its big bone of contention is that it gets very little access to the women before release. With all the mental health problems, drug abuse and victim support issues, it needs access in prison before release. Does my hon. Friend agree that that is crucial?

[Ms Rimmer]

I absolutely agree and will come to that point later in relation to communication.

The Government’s efforts to improve the mental health of people in prison have been poorly co-ordinated. Information is not shared across the organisations involved and not even between community and prison GPs. For example, NOMS advised NHS England to commission mental health services for a male prison at HMP Downview and then decided to open it as a female prison. Six months later, healthcare was still catching up with those changes. What a shocking failure of government! Clearly, quality systems of working and communication are urgently required between prison management, HMPPS, policy makers and commissioners at the Ministry of Justice and the commissioned contractors for health services and NHS England.

It is clear that not enough has been done to prevent increases in deaths in custody. That was the subject of last year’s Joint Committee on Human Rights interim report entitled “Mental Health and Deaths in Prison”. The report homed in on why progress has not been made on preventing deaths in prison, despite the numerous insightful and comprehensive analyses produced on the issue following the Woolf report in 1991. Those include reports by Lord Harris of Haringey, the Joint Committee on Human Rights, the Public Accounts Committee, the National Audit Office, the Howard League and the Select Committee on Justice. Those are just some of them. I hope the Minister would agree that there is no lack of knowledge of or information on the problem, as it has been well reported.

While the Joint Committee on Human Rights inquiry was in progress in March 2017, the Government introduced the Prisons and Courts Bill. Following its Second Reading, the Joint Committee wrote to the Government, proposing key amendments, but unfortunately the Dissolution of Parliament got in the way. The Committee instead published an interim report in May 2017. In November, the Chair of the Joint Committee, my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman), wrote to the Secretary of State for Justice, expressing her disappointment at the non-inclusion in the Queen’s Speech of the prisons Bill promised before the general election and noting that he had said he would take some administrative steps. The Chair stated in her letter to the Government that the Committee’s findings showed that concrete legislation was needed, and outlined clear steps forward, to ensure that prisoners’ humanity is protected and their welfare safeguarded. The Joint Committee’s proposals included a statutory minimum ratio of prison officers to prisoners, a prescribed legal maximum amount of time for prisoners to be kept in a cell and the provision of a key worker for each mentally ill prisoner.

--- Later in debate ---

[Imran Hussain (Bradford East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I thank my hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) for securing this important debate on behalf of my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman). I thank hon. Members from all parties for their informative and well-thought-out contributions.

My hon. Friend the Member for St Helens South and Whiston articulated the real crisis of mental health in our prisons. Other hon. Members also made some very important points about assessment and recording issues, information-sharing issues, pressures on prison officers, isolation and overcrowding issues, and individual tragic cases that perhaps could have been prevented had the system worked better. Government Members also spoke about some of the much-needed recreational activities that are very important to wellbeing, including cooking and gardening, although they will agree with me that some of the underlying and more pressing issues have to be addressed before we move on to those areas.

[Dr Drew]

One of the most stressful and important issues regarding mental health is women who give birth in prison or have young children. I found, to my shock, that Eastwood Park prison, which has a mother and baby unit, was shut for over a year because of an argument about a flood and who was going to pay for the damage. That meant that all women in the whole of the south west and south Wales had nowhere to go to in the vicinity. That is not acceptable, is it?