Mental Health in Prisons

Debate between Marie Rimmer and Kate Green

Wednesday 10th January 2018 Westminster Hall

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

I beg to move,

That this House has considered mental health in prisons.

It is a pleasure to serve under your chairmanship, Mr Howarth. I am pleased to have the opportunity to discuss this intolerable crisis. Suicide and self-harm in prison have reached record highs. In 2016, 119 prison suicides were recorded—the highest number since records began—and there were 41,103 incidents of self-harm in the year to June 2017. Again, that is the highest figure on record. With staff numbers dropping off and some parts of the prison estate unfit for human habitation, it is clear that the Government need to take decisive action to fulfil their statutory duty of care. Some prisoners may have had a mental health problem on entering the criminal justice system, but most prisoners’ mental health deteriorates in prison, because of the conditions imposed on them.

[Kate Green (Stretford and Urmston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Howarth. Before getting into the detail of what happens in prison, my hon. Friend is right to draw attention to the fact that many people have mental health problems before entering prison. Does she agree that when the police identify at interview, as they are required to do, that someone is under the care of mental health services, they should be required then to make contact with that individual’s mental health practitioner to get full information on their suitability for custody?

[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.

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[Ms Rimmer]

I absolutely agree. Undoubtedly, having work would keep people safer outside. It would give them a purpose and be a way of keeping them sane outside, so that they did not go through the revolving door back to prison.

The Chair of the Joint Committee requested, in her letter of 30 November 2017, a response to both the interim report and the letter by 8 January. That has not happened. The Government are refusing to act and therefore showing contempt for the lives of their detained citizens. The Justice Committee’s report of May 2016 stated that the Government had been reluctant to acknowledge the serious nature of the operational and safety challenges facing prisons and the role of their own policy decisions in creating them. Little appears to have changed.

We know that just 10% of the prison population in England are in treatment for mental illness, but recent inspections show that 37% report having emotional wellbeing and mental health problems.

[Kate Green]

Those figures are shocking. I am sure that my hon. Friend agrees that it is even more distressing that 70% of women in custody have mental health problems.

[Ms Rimmer]

I absolutely do. The institute of psychiatry, psychology and neuroscience at King’s College London estimates that more than half of prisoners may have common mental disorders, including depression, post-traumatic stress disorder and anxiety, and believes that 15% of prisoners have more specialist needs. Those are significant figures, but guesstimates are not good enough. The most commonly used estimate, which is that 90% of prisoners have mental health issues, dates from 1998— 20 years ago. The Government have no idea of the scale of the problem. The Ministry of Justice must address that to plan services and meet needs.

The National Audit Office has recently stated:

“Government does not collect enough, or good enough, data about mental health in prisons, which makes it hard to plan services and monitor outcomes.”

It particularly criticised NHS England for the data collected, which

“do not measure outcomes for prisoners, continuity of care or service quality.”

How damning! This failure to monitor poor mental health levels and the mental health services provided in prison simply would not happen in the outside world. It is costing our citizens their wellbeing and sometimes their lives. Let us remember, it is also costing the taxpayer.

The lack of knowledge about prisoners’ mental health exists at all stages of the cycle: on entry to prison, a point raised by my hon. Friend the Member for Stretford and Urmston (Kate Green); during their stay in prison; and after they leave. This means that future prison needs, present prison needs and community needs, and consequently budget requirements, cannot possibly be accurately planned for. For instance, what consideration was given, and finance afforded, to the detained historical sexual abusers? These are elderly people with age-related health needs, such as heart conditions, dementia, diabetes and cancer. The money came from the prison health budget and the issue occurred at the same time as spice arrived. Consequently, there was less money for mental health drug treatment at the most crucial time.

NHS England does not even know what it spends on mental health in prisons. Perhaps the Minister could enlighten us—although I know he is a new Minister.