Mentally Disturbed Prisoners (Hansard, 20 March 1989)

§ Mr. Cohen
To ask the Secretary of State for the Home Department if he will indicate the number of psychiatric reports prepared outside prison department establishments on persons remanded to all prisons and cells in England and Wales for each year from 1980; and if he will make a statement.

§ Mr. Douglas Hogg
The information requested is not available.

§ Mr. Cohen
To ask the Secretary of State for the Home Department what recent and current studies he has408W commissioned into mentally abnormal and disordered offenders in prisons; whether they include those held on remand; whether any recommendations have been made; and if he will make a statement.

§ Mr. Douglas Hogg
Two studies are under way and the Department expects to decide on a third shortly.
In October 1987 a contract was entered into with the institute of psychiatry, university of London, to produce over a three-year period a definitive statement of the dimensions of the problem of sentenced mentally disordered offenders in the prison system. This will provide a basis for the consideration of the development of policy in the medium and long term. In November 1988 the institute of criminology, university of Cambridge, was contracted to research into sentencing by the courts in relation to the use of sections 37 and 41 of the Mental Health Act 1983 in making hospital and restriction orders. The intention is to obtain reliable information on whether, and if so to what extent, the courts are unable to make hospital and restriction orders in all cases that they wish, and to examine the factors affecting their decisions.
The third study is currently under consideration. This would also be carried out by the Institute of Psychiatry. It would focus on the working of the procedures for courts to remand defendants to obtain medical reports.

§ Mr. Cohen
To ask the Secretary of State for the Home Department how many secure units are available to his Department for accommodating mentally disturbed offenders(a) specifically for such offenders and (b) along with convicted prisoners not so categorised; and where they are situated.

§ Mr. Douglas Hogg
Prisoners who meet the criteria under the Mental Health Act 1983 may be transferred to special hospitals or regional secure units. Within the prison service there is a variety of provision for mentally disturbed prisoners. This includes the CRC special unit at Parkhurst C wing, which is intended exclusively for convicted prisoners with a history of psychiatric illness arid who also pose persistent control problems.

§ Mr. Cohen
To ask the Secretary of State for the Home Department when was the last full-scale review in his Department of out-of-prison alternatives for mentally disturbed prisoners who are(a) sectioned and (b) in other categories; and what plans he has for the provision of such alternatives.

§ Mr. Douglas Hogg
An interdepartmental working group of Home Office and DHSS officials on mentally disturbed offenders in the prison system in England and Wales which reported in May 1987 carried out a review of all alternatives to imprisonment for mentally disturbed prisoners. The provision of facilities for the treatment of the mentally disordered outside prison is a matter for the Department of Health. The consultation paper issued last month by the Home Office on bail accommodation and secure bail hostels included discussion of the use of bail hostel accommodation for mentally disturbed defendants.

§ Mr. Cohen
To ask the Secretary of State for the Home Department how he categorises(a) prisoners requiring psychiatric attention and (b) mentally disturbed offenders; how many are in each category; and what is the proportion of the prison population as a whole for each category and in total.
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§ Mr. Douglas Hogg
Prison medical officers, in examining inmates on reception, identify as a priority those who by reason of their mental state may require particular attention whether of a medical or general management nature. In such cases referral to a psychiatrist would be an early course of further action. Where an inmate is considered to be suffering from mental disorder of a nature or degree which would satisfy the criteria of the Mental Health Act 1983 for detention in hospital for medical treatment, the prison medical officer would use the procedures of that Act to seek the inmates removal to an appropriate hospital. Two hundred and ninety inmates of prison service establishments in England and Wales were on 30 September 1988, the latest date for which figures were available, considered by prison medical officers to meet those criteria. That figure represents 0.58 per cent. of the prison population of 49,922 on that date.
Information as to the total number of inmates in the much wider range of those considered to be mentally disturbed but not such as to satisfy the criteria of the Mental Health Act 1983 is not held centrally. Two censuses were undertaken by prison medical officers of inmates serving sentences of six months and more considered to require specialised therapeutic facilities by reason of mental disorder or abnormality. The censuses showed that on 4 December 1985 1,583 inmates and on 1 October 1986 1,340 inmates were in that category. Those figures represent respectively 3.38 per cent. of the prison population of 46,752 on 6 December 1985 and 2.85 per cent. of the prison population of 46,912 on October 1986.
The study being undertaken by the Institute of Psychiatry, referred to in the answer to another question by the hon. Member, is designed to produce a comprehensive psychiatric profile of the sentenced prison population.

§ Mr. Cohen
To ask the Secretary of State for the Home Department what percentage of the prison population the number of inmates referred to National Health Service consultant psychiatrists and other National Health Service psychiatrists represented in the last year for which figures are available, and to what extent inmates may be referred to more than one psychiatrist.

§ Mr. Douglas Hogg
During the period 1 April 1987 to 31 March 1988 12,285 inmates were referred by prison medical officers to NHS psychiatrists appointed to visit establishments on a sessional basis or to NHS consultants for domiciliary consultations. In addition, psychiatric consultations were arranged for 4,151 inmates at the instigation of inmates' legal advisers.
On the imformation available it is not possible to calculate that the sum of those numbers represents a given proportion of the prison population since that population is not static. While the average prison population in 1987–88 was 49,300 (including an average of 750 prisoners in police cells) the number of first receptions to prison service establishments in the course of that year was in the order of 136,000.
Prison medical officers have unfettered clinical discretion to call other medical practitioners into consultation and are not restricted as to the number consulted in any individual case.

§ Mr. Cohen
To ask the Secretary of State for the Home Department if he will indicate the current extent, and regularity, of police training including that involving410W professional psychiatric expertise, in dealing with mentally disturbed individuals who create a disturbance; whether there are any plans to improve this training; and if he will make a statement.

§ Mr. Douglas Hogg
Training for all ranks in the police service aims to develop oficers' interpersonal skills, knowledge and attitudes to enable them to deal effectively with all sections of the community, and to foster an understanding of the social context of policing and the role of other agencies. As part of this integrated approach, officers will study such areas as responding to illness—including mental disturbance—in the street, dealing with distressed persons and the social causes of crime.
Chief officers and commandants may invite members of the psychiatric profession to contribute to training in forces and at district training centres. The police staff college involves members of the psychiatric profession in a number of its courses. Police training is kept under regular review by the police training council, which seeks to ensure that all training meets the needs of the police service and the community at large.

§ Mr. Cohen
To ask the Secretary of State for the Home Department whether disturbances at Bedford prison during 1988 involved mentally disturbed prisoners; and if he will make a statement.

§ Mr. Douglas Hogg
No prisoners diagnosed as mentally ill (who would be held in the prison hospital) were involved in any incident of violent concerted indiscipline at Bedford during 1988.