Mental health crisis amongst male prisoners

Posted Tuesday 4 May 2004

Three quarters of men in prison are affected by two or more mental health problems, including disorders such as schizophrenia.

This mental health crisis - amongst the more than 70,000 adult male prisoners in England and Wales - will be revealed at a conference, Troubled Inside - Responding to the Mental Health Needs of Men in Prison, held today by the Prison Reform Trust and the mental health charity Mind.

The conference will expose the shortcomings of a criminal justice system that imprisons record numbers of men with mental health disorders:

• two thirds of men in prison are diagnosed with a personality disorder and two fifths show symptoms of at least one neurotic disorder such as depression, anxiety and phobias. Among the general population less than a fifth of men are affected by these disorders
• men in prison have a high rate of severe mental health problems such as schizophrenia or delusional disorders - nearly ten per cent compared to less than one per cent of the general population
• one in five men in prison are on prescribed medication such as antidepressants or antipsychotic medicine and there is evidence that use of medication increases whilst in custody
• one in five male prisoners have attempted suicide at some stage in their life and the same number have previously been admitted for inpatient psychiatric care.

Prison regimes do little to address the mental health needs of prisoners who can be locked in their cells for up to 23 hours a day. The conference will hear how prison staff, who are not trained to be mental health professionals, struggle to cope with high numbers of men with mental health problems. Home Office officials have acknowledged that there are thousands of prisoners who should be immediately transferred to secure psychiatric settings.

The Prison Reform Trust and Mind have organised the conference to call on the Government to:

• focus on early intervention and invest in accessible and appropriate mental health care designed to respond to the needs of vulnerable men
• increase the number of court diversion schemes available across the country so that offenders who are acutely ill or at risk of suicide can be given hospital places or the treatment they need
• encourage the courts to use alternatives to custody for men with mental health problems who have committed minor offences
• ensure the Prison Service meets NHS standards, policies, protocols and targets particularly regarding the use of medication, service user involvement, training for doctors and health care staff. An independent agency should monitor mental health provision in prisons.

Speaking today, the Policy Director of Mind, Sophie Corlett, said:

"The prison population is increasingly filling up with some of the most vulnerable and socially excluded members of society, and this is having a devastating effect on both individuals and the community as a whole. Mind has argued for years that we need real community services that will identify vulnerable people and offer them support well before the point where they are caught up in the criminal system. There also needs to be a big investment into mental health provision within the criminal system, so that people don't end up in prison when what they really they need is care, and those in prison get the help they need."

Speaking today, the Director of the Prison Reform Trust, Juliet Lyon, said:

"From the moment mental health policy on care in the community disintegrated into a lack of practical support and neglect in the community, hard pressed prisons began to fill up with petty offenders with complex mental health needs. Proper investment in court diversion, mental health and drug treatment in the community and secure health provision for those who need it, would lift the burden off untrained prison staff and put a stop to the cruel and unnecessary punishment of jailing vulnerable people."

Notes

1. 'Troubled Inside: Responding to the Mental Health Needs of Men in Prison' is being held on 5 May 2004 at the Institute of Child Health, University College London, 30 Guildford Street. Speakers include HM Chief Inspector of Prisons, Ann Owers, the Minister for Prisons and Probation, Paul Goggins and Chairman of the Prison Officers Association, Colin Moses.

2. On 23 April 2004 the male prison population in England and Wales stood at 70,619.

3. There has been a 70 per cent increase over the past year in reported incidents of self-harm amongst prisoners: more than 17,000 in 2003. This is partly a reflection of the Prison Service collecting more accurate statistics on self-harm after changing its procedures last year (Prison Service Safer Custody Unit).
 
4. Research suggests that prisoners are twice as likely to be refused treatment for mental health problems inside prison than outside (Social Exclusion Unit, 2002). The government's Social Exclusion Unit concluded that the mental health care in prisons is in need of significant improvement.

5. Prison regimes do little to address the mental health needs of prisoners. Research has found that 28 per cent of male sentenced prisoners with evidence of psychosis reported spending 23 or more hours a day in their cells - over twice the proportion of those without mental health problems (Singleton et al,  ONS 1998).

6. Prisoners with severe mental health problems are often not diverted to more appropriate secure provision. The Chief Inspector of Prisons has estimated, based on visits to local prisons, that 41 per cent of prisoners being held in health care centres should have been in secure NHS accommodation (HM Chief Inspector of Prisons annual report 2002/3). Research has found that there are up to 500 patients in prison health care centres with mental health problems sufficiently ill to require immediate NHS admission.

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