A new report by the Centre for Mental Health identifies keyareas for improvement in mental health care across the criminal justice systemin England and Wales.
With extremely high rates of mental ill-health among theprison population, “Mental health and criminal justice” draws onexperiences from across England and Wales to determine the way forward forimprovement.
Commissioned by the Department of Health and the Ministry ofJustice, the Centre’s Dr Graham Durcan led consultations across England andWales to review the experiences of over 200 people with personal orprofessional knowledge of the interfaces between the criminal justice systemand mental health services.
The report finds that few of the prisons represented at theevents were able to offer psychological therapies, and that primary mentalhealth care remains the weakest element of mental health support in prisons.For many people, leaving prison is a time of crisis. Many have nowhere to liveand no source of income. The report calls for a new ‘concordat’ betweendifferent government agencies to join together better to help people throughthis difficult time.
Key themes from the report include the following:
· CCGs need to take the lead role in commissioninghealth services for people leaving custody
· Transfer from prison to secure psychiatric wardsneeds to happen faster
· Release from prison should be treated as a ‘timeof crisis’ and proper ‘through the gate’ support should be offered
· Government departments need to ensure that professionals in the CJS receivemandatory mental health training
· Court psychiatric reports should be provided bypsychiatrists who work with offenders, understand the court system and worklocally
· All prisons should work towards achieving theRoyal College of Psychiatrists’ Enabling Environments standards
· Probation providers should have access to mentalhealth support (such as consultation surgeries)
· A national framework is needed to set standardsfor prison mental health care.
In addition, participants felt there was a need for:
· Robust screening and assessment processes for arange of vulnerabilities in all justice settings
· Wider availability of support and care forpeople’s vulnerabilities regardless of setting
· Providing pragmatic and practical support (e.g.with housing and debt) at critical periods (e.g. on release from prison)
· Adopting a psychological and trauma focusedapproach across all justice services and providing training in these for allwho work in them
· Increasing access in both the community andcustodial settings to psychological interventions that are adapted to reflectcomplex and multiple need
· Increasing the use of mentors and peers, and thevoice of service users in the planning and provision of services.