Mental Health in Prisons

Lisa Cameron Excerpts

Wednesday 10th January 2018 Westminster Hall

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

It is an absolute pleasure to serve under your chairmanship today, Mr Howarth. I pay tribute to and congratulate the hon. Member for St Helens South and Whiston (Ms Rimmer) on securing this timely and necessary debate. I commend the effort she has put into such an important debate.

I declare an interest, having worked in a forensic community mental health team for many years prior to entering Parliament, and also at the local state hospital in Carstairs in Scotland. The debate has been excellent and has raised many of the issues that I hoped to cover. I will speak shortly about the issues that have not been raised. I commend everyone who has spoken. The hon. Member for Henley (John Howell), who sits on the Justice Committee, spoke with great expertise and has undertaken extremely valuable work in this area. The hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts), who has left her seat—I hope I pronounced her constituency correctly—spoke about the importance of learning in prison and language and culture. Learning and having access to education is extremely important in reducing recidivism, in giving people purpose and improving mental health.

The hon. Member for Taunton Deane (Rebecca Pow) is an absolute advocate for Taunton Deane and now also for gardening projects. The importance of recreation in prisons cannot be underestimated. It gives people a holistic approach to their mental health, which is so important alongside other activities such as health and exercise and the other types of industry that we have heard about from the hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney). That is so important because we must see the prisoner as an individual and build upon their skills and resilience.

I thank the right hon. Member for North Norfolk (Norman Lamb), who has absolute expertise in this area. He spoke eloquently about the importance of diversion services and alternatives to prison. The hon. Member for Bridgend (Mrs Moon) made an extremely valuable point regarding supporting and maintaining family lives. The hon. Member for Islwyn (Chris Evans) spoke about failures between liaison links among community services and how picking up mental health problems at an early stage in those who present the greatest risk can prevent crime, which is a valuable and important point. We must learn lessons from the past.

Suicide and self-harm are obviously significant issues in prison because prisoners are adjusting to a situation that they may never have been placed in before. There is a potential feeling of loss of hope. There is also a culture in prison that people have to acclimatise to, which can be extremely difficult. Also, there are significant issues of bullying in prisons that should be addressed. Will the Minister think about how we can address those issues going forward? All of those issues make it difficult for people going into prison. Aside from people who develop mental health problems when they are incarcerated, there are also people who have had mental health issues prior to going into prison.

On pre-morbid conditions, it is crucial that assessment is done at the earliest possible stage, because someone who is already unwell may require transfer to a secure hospital. It might not be appropriate for them to be in a prison. If assessment can be done earlier in the criminal justice system there might be diversion services that would be more appropriate, depending on the offence.

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

With the average cost of a new prisoner being £119,000 a year and the ongoing cost in excess of £40,000 a year, does the hon. Lady agree that it is exceptionally important to invest in mental health provision before people end up in prison? Making sure we assess the numbers who are in prison and having accurate records means we are able to do that beforehand.

[Dr Cameron]

That is a well-made point. Prevention and looking at early diversion and picking up mental health issues where they are the significant issue at play in someone’s offending is crucial. Assessment is more difficult for prison staff and mental health staff in a short-stay prison. I hope the Minister will look at that. There is a high volume of prisoners in short-stay prisons. They come and go in a very short time and it is difficult to get all of the services properly in place, so that will need resourcing. It would help to address those issues.

Co-morbidity has been raised, which is extremely important. We have already heard that many people develop drug problems in prison. That is in fact true and much more must be done to prevent drugs coming into prison, but we also need substance misuse programmes in prison and we need to be mindful of liaison with drug and alcohol services on release, because one of the greatest risks of overdose is when someone has come off drugs in prison and then starts again as soon as they leave. So that is another area of vulnerability.

We must look at particularly vulnerable offenders and services for women and young offenders. We also need an increased awareness of autism in prison. There is a high risk of suicide within that community, particularly if they are incarcerated.

In my experience, far too many of our veterans go into prison. We are failing them, frankly. They have experienced conflict and high levels of trauma, so we really need services and programmes that support them when they come back from active duty. We must prevent them from feeling they are no longer able to cope and committing offences.

Will the Minister also address the availability of programmes in prison for mental health coping skills, cognitive behaviour therapy and managing mental illness programmes? What progress has there been on that? Staff in secure hospitals who work with evidence-based programmes already have substantial experience and their expertise could be utilised in training.

In conclusion, I want to ask about co-ordination of response. In working in this area, I find that access to psychiatry is likely to be access to a liaison psychiatrist who comes in and out of the prison and does not know the prisoners very well. To what extent can we address having full-time psychiatric staff in prisons who are able to assess people repeatedly, know their case history and can prevent people relapsing or pick up issues extremely early?

I want to reiterate the importance of family connections and ensure we build a system whereby we rehabilitate as well as punish people, because that is crucial to protection of the public and to reducing recidivism. Building family connections and giving people hope, aspirations, skills and education, and seeing them holistically as an individual will go some way towards helping their mental health. It is crucial that mental health services are available in prison and as a follow-up.