Prisons: Mental Health Services (Hansard, 26 January 2004)

§ The Minister of State, Home Office (Baroness Scotland of Asthal)
My Lords, the Government of course take very seriously the comments and recommendations of Her Majesty's Chief Inspector of Prisons. We are investing in schemes to divert mentally ill people away from custody, and in better mental health services in prisons. We are also improving the 10 way in which we use secure mental health services, so that this specialist treatment is available to those who need it.

§ Lord Dholakia
My Lords, I thank the Minister for that Answer. Does she share the concern that, on average, two prisoners a week kill themselves in our overcrowded prisons? Will she accept that new arrivals, drug users and mentally ill offenders are at most risk of self-harm and suicide in our prison institutions? Why, when the overall crime rate is falling, are we incarcerating more people than ever?
Could we make a start by treating people with mental health problems in specialist units, as recommended by HM Chief Inspector of Prisons and the Director-General of the Prison Service? While considering that proposal, will the Minister also consider how the court diversion scheme promoted by the Prison Reform Trust could help? Surely the state has a responsibility to ensure that those in its care are adequately protected.

§ Baroness Scotland of Asthal
My Lords, I join the noble Lord in highlighting the fact that it is a deep worry to us all that the average suicide rate seems to have increased. Mental health provision is extremely important. Prisoners who need in-patient treatment for mental disorders may, as the noble Lord will know, be transferred to hospital by direction of the Home Secretary, under the Mental Health Act 1983. The number of prisoners so transferred has risen from under 200 a year in the late 1980s to between 600 and 700 now.
Your Lordships will know that, through the Carter review and the changes that we are making to the Prison Service and the Probation Service, we hope to be able to give a more holistic response to those in the community and in our prison estate. There is a scheme now in place that will help us to manage our mentally ill prisoners more easily.

§ Lord Laming
My Lords, does the Minister agree that we are in danger of expecting far too much of the Prison Service? It is right to place a priority on security, training and education, but to expect the service, in addition, to be in the forefront of drug treatment and the treatment of people with serious mental health problems, is to expect too much. Is it not time that the Prison Service was able to focus on its main tasks, without being responsible for the care of mentally ill people?

§ Baroness Scotland of Asthal
My Lords, we certainly think that it is possible to marry a service that provides for security and for the needs of prisoners generally. One of those needs is mental health treatment.
The noble Lord will know that, by the end of March, National Health Service mental health inreach teams will be in place in the 90 prisons in which the need for such services is greatest. Delivered as part of the NHS Plan, the teams will involve more than 300 additional staff and provide specialist community-type mental health services to more than 5,000 prisoners. The 11 important thing is not to separate the prison estate from the community but to do that which will enable there to be a smooth transition, so that individuals receive the care that they need.

§ Baroness Noakes
My Lords, will the Minister comment on the target of moving seriously mentally ill prisoners into NHS care within three months? Will she say whether that target is adequate? What progress has been made towards meeting it?

§ Baroness Scotland of Asthal
My Lords, first, I must say that it is, of course, important that the targets are addressed. There has been huge investment in the National Health Service mental health services in prisons. It will double to £20 million in 2005–06. In the next two years, it will be available in every prison in England and Wales. The extra investment will also help existing inreach teams. That will mean, we hope, that we will be able to manage more easily those in the prison population who have mental health difficulties and within the targets that we have set ourselves.

Lord Acton
My Lords, is my noble friend aware that, in her annual report, the Chief Inspector of Prisons drew attention to the high incidence of mental health disturbance among women prisoners? Will the Government pay particular attention to that and to the need to provide the necessary facilities for women prisoners?

§ Baroness Scotland of Asthal
My Lords, we are giving that issue serious consideration. I assure my noble friend that everything is being done to address the needs of women and others who suffer from mental difficulties. With regard to the figures in the report, I remind noble Lords that a broad spectrum is included in the definition of mental disorder.

§ Lord Avebury
My Lords, the depressing thing about the Chief Inspector's comments is that she is echoing the evidence that was given by her predecessor to the Select Committee on Home Affairs three years ago. Does the noble Baroness recall that, at that time, the Chief Inspector's medical adviser said that there was a shortage of 500 places in special hospitals for which prisoners ought to have been eligible? The Chief Inspector's medical adviser said that that was still the figure two years later. Is the Minister satisfied that adequate provision is being made for special hospitals for this category of mentally ill prisoner?

§ Baroness Scotland of Asthal
My Lords, it is also important to remember that the Chief Inspector acknowledged that there had been material improvements in the way in which we are addressing the mental health issues. The noble Lord will know that the Government's approach to mental health in prisons has three strands. The first is to help to ensure that people with mental health problems do not go to prison inappropriately. The second is to improve mental health services in prisons significantly. The 12 third is to ensure that individuals who are assessed as too ill to remain in prison can be transferred to a hospital setting under the Mental Health Act 1983.
All three of those strands need to be worked on simultaneously, if we are to make sure that individuals get the right treatment at the right time in the most appropriate environment. I accept that we have a way to go, but we believe that we have a system in place that will help us better to deliver what we would like to see.