Mr. Fergal Black:

On the issue of mental health, I would say a couple of things. First, the Inspector of Prisons has just commenced a thematic inspection of mental health services in prisons. He is a new inspector and he has a concern about the number of people in prison with severe and enduring mental illness. He has engaged some international experts who have a lot of experience in this area, including Dr. Clive Meux, who has been on 35 different delegations with the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment, CPT. We met him yesterday. At this stage, the experts have looked at three prisons in Dublin in terms of mental health services and will look at another three prisons nationally next week. The feedback that myself, Dr. Regan and others got yesterday was that the staff in the prisons, including prison offers, nurses, psychologists and our forensic colleagues, were providing an excellent service and while that is reassuring to hear, everybody is doing that in an environment where people with severe and enduring mental illness should not be. I have to say that, but it is reassuring that we are doing our best.

There are three main issues that come up in the taskforce report specifically pertaining to the Prison Service. One is the need to get the new central mental hospital up and running and functioning properly. The hospital is having difficulties with the recruitment of staff. We have met its representatives numerous times. Traditionally, we had about 97 beds in the hospital and the new facility will provide 130 beds. Currently the hospital is working to an interim capacity of 110 beds but is struggling to get beyond 100. We need access to those beds. The hospital has the same difficulties with recruitment as we have, if not more so.

The second issue, which is also covered in the taskforce report, is that 50% of prisoners who have been sent to the central mental hospital have been there for more than five years. It is an acute tertiary facility. The previous executive clinical director was very clear that it needs to go back to where it was ten years ago. Ten years ago, we were getting 50 to 70 admissions per year but last year we got less than ten. The recommendation adopted by the taskforce is for a new model of care whereby if somebody is acutely unwell in prison, he or she is assessed, put on a waiting list and gets into the central mental hospital quickly for a treatment period of 16 weeks in an acute facility. If the treatment is not completed after 16 weeks, it can be extended once only for a further 16 weeks.

If we could get that model of care operating, that silting up would be gone and we would start to see people go to the Central Mental Hospital. The challenge at number three, which is the final one is for us, is that when they come back, we need to provide an environment that sustains that stability. That is what we are talking about. The Central Mental Hospital needs to be working optimally, if our colleagues in the National Forensic Service can introduce the new model of care. We should be able to provide a service with psychiatric nurses and occupational therapists. As Dr. Regan has said, we have approval for that. Does she want to talk about the service that we provide in the unit we are considering?