Dr. Emma Regan:

Regarding funding and recruitment, I can speak specifically about the psychology service and say the issue is actually not about funding. We are really grateful to get a significant boost in funding for our mental health services, our work with sexual violence, psychiatric nurses and psychologists in the budget for this year. This has allowed us to improve access to treatment. Based on the current numbers in custody and based on international baselines of ratios of psychologists to prisoners, we are almost right on the money regarding the number of psychologists that we have posts for. This does not include specialist units like the national violence reduction unit and a unit we may develop for people with a psychiatric diagnosis, which would be separate. Based on those ratios, we have the correct number of people. However, the challenge is in recruitment. The main reasons we have challenges is that if a person qualifies as a psychologist, they are contracted to the body that sponsored them for the first two to three years. People are contracted to work with the HSE, therefore they are committed to that organisation. Sometimes there are agreements, particularly now that were sponsoring people there is more flexibility regarding someone coming to the Prison Service instead of the HSE because we are all public bodies. However, in general, people want to commit to the contract. By the time they do their two to three years, they are ready for promotion. They are ready for senior psychologist posts of which we have fewer, of course. There are also delays with security clearances and people having to hand in notice, particularly if they are coming from other jurisdictions and moving home with their families. Working in prisons is a bespoke piece of work. People are primarily working with men and working with the most severe clinical presentations. Some clinicians simply do not want to work in this area. We have had to open the doors around prisons and bring psychologists and perhaps also nurses to show the resources we have available for them as clinicians working in this area. We are going to a career fair on Saturday to talk a little bit about what we are doing to budding psychologists.

For assisted decision-making, our national nurse manager rolled out training in some of the larger prisons last year in order that the more senior managers and clinicians in each prison were aware of the updates on assisted decision-making. My understanding is that we have not had yet had to use the Assisted Decision-Making (Capacity) Act 2015. However, we do have some concerns in terms of where we may be able to use it successfully. That is with people who are not currently engaging with the parole board perhaps because of a capacity issue. We want to be able to support people to make their decisions about whether they engage.