Professor Harry Kennedy:

I thank Deputy Crowe for his questions. Currently, we have two secure forensic beds per 100,000. Most other countries have between five and 14 beds per 100,000 of population. When we move to the new hospital in Portrane in 2020, we will have 3.5 secure forensic beds per 100,000, comparing like with like. It will give us breathing space, but very short breathing space. I suggest that we need to start planning what comes next which will be a greater tailoring of services, according to need. Within the secure hospitals, we will need admission beds, rehabilitation beds and some slow stream beds, recognising long-term needs which are currently not planned for or recognised in the system we have.

The Deputy asked whether people are safer in prison. That is a really difficult question to answer. I think many people access mental health services for the first time when they come into custody. There are really complicated reasons for that as well as many different reasons, including stigma, but also because general adult services, and I cannot sufficiently emphasise this, are all part of the same service. While I am obviously explaining to members the problems in the forensic part of the mental health service, we are an integral part of the mental health service and it all hangs together. If there is a pressure in one part, it invariably passes up the stream until it lands in the criminal justice system and with us. We are in that sense the canary in the mine, the barometer. If we are having significant problems, it is because there are not only not enough resources for severe mental illness but not enough tailoring and diversity of the type of services. One needs admission beds and intensive care beds. We also need longer term beds and a variety of things within a forensic mental health service and a general adult service.

We have taken community and in-reach services in the prisons in our aftercare services about as far as we can. An endless response to these difficulties is to say that we need to do more in the community but that is not the answer to every question.