A NEW report by the Chief Inspector of prisons highlights the plight of desperately unwell men and women languishing in prison waiting for transfer to secure mental hospitals.
Only in hospital can they access care under the Mental Health Act which cannot legally be provided in prison. During that time, many are suffering irreversible harm. Some of these people should never have been sent to prison, which still remains a legal “place of safety” when a secure hospital bed is not available in the community.
Once the need for transfer from prison to hospital has been identified, people should be transferred within 28 days. However, inspectors found only 15 per cent of people were being transferred within this timeframe, with some waiting over a year. In that time, because of the risk of violence to others or to themselves triggered by their illness, patients are held in solitary confinement in bleak cells overseen by prison officers with little or no mental health training.
Charlie Taylor, HM Chief Inspector of Prisons said: “These desperately unwell men and women have no place in prison, but they remain there, out of sight, with nobody to advocate for them and no consequences for what is happening to them. These are people whose psychosis or paranoid delusions make them so violent multiple officers are needed just to deliver their meals.
“Some are so driven to harming themselves, we have, for example come across cases where prisoners have blocked their own airways with bedding, removed their own teeth or have maimed themselves to the point of exposing their own intestines. The longer people are denied access to the treatment that can only legally be provided in hospital, the more unwell they will become. This is a scandalous way to treat some of society’s most vulnerable people.”
Early treatment for mental health disorders is vital and delays in accessing care that cannot be provided in prison can cause irreversible harm. Given this, the current strain on prison places, and the psychological and physical challenge for prison officers attempting to care for such unwell people, their prompt removal from prison to secure hospitals should be a priority. Yet the inspectorate has been raising concerns about this issue for many years with no improvement.
Mr Taylor continued: “We commented on this issue in three quarters of our inspection reports last year, and have been raising concerns on this for years, including a previous report on this issue in 2007. We visited 21 prisons for the fieldwork for this thematic, but we could have walked into any prison and we would have found similar cases.
“The inspectorate has received assurances time and again from successive governments that there are enough secure beds and that processes will be expedited. But nothing has changed. People continue to suffer life-changing harm and they will continue to do so until prison and health authorities work together to put people before process.”
The Howard League for Penal Reform has long campaigned for an end to the practice of keeping mentally unwell people in prison as a ‘place of safety’ or for their ‘own protection’. In 2022, the government published a draft Mental Health Bill, which would have introduced these long-awaited reforms and a statutory 28-day limit for transfers. But the bill was not included in the King’s Speech last year.
Andrea Coomber KC (Hon.), Chief Executive of the Howard League for Penal Reform, said: “This distressing report sets out precisely why the Howard League has long campaigned for an end to the archaic practice of sending acutely unwell people to prison as a ‘place of safety’ or for their ‘own protection’.
“It is a national emergency – and a national scandal – that patients in need of urgent help are being kept in squalid prisons when they ought to be in hospital beds. The government must act now to save lives. Resurrecting the draft Mental Health Bill would be an important step towards a more humane criminal justice system.”
* Read: The long wait: A thematic review of delays in the transfer of mentally unwell prisoners here.