Mentally Disordered Prisoners (Hansard, 11 March 1998)

§ The Parliamentary Under-Secretary of State, Home Office (Lord Williams of Mostyn)
My Lords, we cannot state precisely how many prisoners suffer from mental disorder. Studies conducted for the Prison Service by the Institute of Psychiatry have indicated that a psychiatric diagnosis, including substance dependence or abuse, could be given to nearly 40 per cent. of the sentenced prison population of England and Wales and some 66 per cent. of remand prisoners. This would suggest that around 20,000 sentenced prisoners and 8,300 remand prisoners have some kind of mental disorder.

§ Lord Hooson
My Lords, I thank the Minister for that reply. Does it not indicate the huge problem facing this country? Everyone will agree that it is highly undesirable for mentally disturbed prisoners to be in the same establishment as people who are not mentally disturbed, for the sake of both categories. What realistically is the chance of progress on this front? For example, have the Government considered the use of some disused mental hospitals, because the establishments have to be secure, so that some of these mentally disturbed prisoners can at least have treatment?

§ Lord Williams of Mostyn
My Lords, it is undoubtedly a serious problem. We are making funds available to assist mental health assessment schemes at magistrates' courts, we are funding NACRO to the extent of £146,000 in the coming year to carry out development work and we are encouraging the transfer of mentally disordered prisoners, whether remand or sentenced, who need hospital treatment from prison to hospital. That figure has risen from 180 in 1987 to a provisional figure of 750 last year. The number of secure psychiatric beds outside the special hospital regime has now gone up to 1,509 and low level secure beds to about 1,100. We are also looking to developing prisons on the Grendon model which would have 211 therapeutic community places within them. But I accept what the noble Lord indicates—there is a long way to go.

§ Baroness Masham of Ilton
My Lords, what advice are prisoners given if they are put in a cell with a mentally ill prisoner? What training are prison staff given in handling mentally disordered prisoners?

§ Lord Williams of Mostyn
My Lords, prison staff are trained in order that they can recognise the signs of disorder and how to deal with them. About two-thirds of prisons have prisoner support and listening groups, most of which are supported by the Samaritans, who do very good work. But I readily accept, as I said earlier, that there is a good deal still to be done.

§ Lord Hylton
My Lords, the whole House will be grateful to the Minister for disclosing the scale of the problem facing the Prison Service. Can he say what progress is being made in making available the resources of the National Health Service to prisoners, beginning perhaps first of all with those suffering from mental illnesses?

§ Lord Williams of Mostyn
My Lords, the Chief Inspector of Prisons has recommended that the National Health Service should assume responsibility for the delivery of healthcare services to prisoners. Having had that recommendation, the Prison Service and the NHS have set up a joint working group to advise Ministers on options for improving prisoners' healthcare; in particular, to what extent and whether healthcare as an overall responsibility ought to be transferred to the National Health Service.

Lord Renton
My Lords, will the Government bear in mind that mentally disordered people are of two quite distinct kinds? There are those who are mentally ill, many of whom are curable, and those who are mentally handicapped, which is an incurable condition. Those who are severely handicapped mentally have not a clue about what they are doing and need to be dealt with quite differently from others.

§ Lord Williams of Mostyn
My Lords, I entirely accept that proposition. One would have thought that those in the category of serious mental illness identified by the noble Lord have no place in prison in the first place. I am very conscious of that. One needs to bear in mind that the figure I gave to the noble Lord, Lord Hooson, includes psychiatric diagnosis relating to substance dependency or abuse. So the spectrum we are looking at, as the noble Lord, Lord Renton, indicated, is a very wide one indeed.

§ Lord Pearson of Rannoch
My Lords, does the Minister accept that a large part of this problem is that the pendulum has swung too far in favour of care in the community and too far away from the long-stay institutions referred to in the supplementary question of the noble Lord, Lord Hooson? If that is so, as seems indisputable, will the Government consider giving 212 greater encouragement to village community-type institutions for both mentally ill and mentally handicapped offenders instead of allowing local services to pursue their abolition?

§ Lord Williams of Mostyn
My Lords, the noble Lord's point is well made. Indeed, before the general election many of us on all sides of the House were on occasions bitterly critical of care in the community, when there seemed to be little community and precious little care for those who needed both. I shall certainly transmit the noble Lord's suggestion to the joint working group.

§ Lord Hutchinson of Lullington
My Lords, does the Minister agree that the background to this Question is that there are more persons in prison in this country awaiting trial in proportion to the total population than in any other country in Western Europe? As we have heard, 40 per cent. of them are not there because they are dangerous or because they have allegedly committed serious offences but because they are in need of psychiatric help or because they are homeless. Is it not true that the Home Office has established in its research that the use of prisons as assessment centres in this way is inhumane, expensive and ineffective? Can the Government do something about this now, as it does not require legislation and it does not require money? All it requires is some political effort.

§ Lord Williams of Mostyn
My Lords, I do not think the solutions the noble Lord points to are without demand on resources. This requires more than political determination and imagination. Certainly, the deeply troubling question of prisoners on remand is one that the Home Secretary is addressing urgently, because he is intent on reducing delays in the system. That is not a total answer to the noble Lord's question, the thrust of which I largely endorse.