Ms Molly Joyce:

Yes, absolutely. As a starting point, this is recommendation 2.2 of the high-level task force report on further research on the prevalence and impact of mental health conditions and addiction across the prison estate. I said at the outset that the Irish Penal Reform Trust, IPRT, does not even have up-to-date data on the rates of addiction and mental health needs within the prison estate. That would, therefore, be a really useful starting point. Professor Flynn already flagged some of the broader points in terms of broader research around the mental health and addiction side, which is in subgroup 3. She can pick up that point in terms of the mental health needs across the forensic system.

In terms of additional research identified by this report, as I said earlier, there was some identification of the issue around gender and the treatment of female patients within the CMH. There were particular concerns that there is no stratification in that male patients are stratified according to their needs but that does not happen for females because there are so few of them. Then, they are all in one unit together. That may be addressed to a certain extent by the new CMH because it will provide more female spaces. Equally, however, it creates a potential concern that the more spaces are created, the more likely they are to be filled. Therefore, we may end up seeing more women being detained in the CMH. In terms of gender, the report says this is a potential issue but there is definitely room to do some further research around whether there are particular issues for gender minorities within the CMH and forensic mental health settings.

I would just flag in this regard that the Irish Penal Reform Trust focuses a lot on women in prison as well. There are certainly some indications that there are particular needs there in terms of addiction, higher addiction needs, potentially higher levels of experienced trauma, and physical and sexual abuse of the women who end up in the prison system. From that, there may be scope to try to look further into the National Forensic Mental Health Service. As far as I am aware I do not believe that this has really ever been done.

With regard to further research, for us this was a scoping study. It was a small scale research study funded by the Irish Human Rights and Equality Commission, IHREC. Part of what we were trying to do with this was to identify the gaps that potentially affect patients within the National Forensic Mental Health Service Hospital, and to forward them in terms of the advocacy organisations. There is the Irish Penal Reform Trust working on behalf of people in prison. There are also organisations such as Mental Health Reform and others working on behalf of people with mental health needs. I do not know of anyone looking specifically at this particular cohort. That is why we did the research. The scoping study is great in that it identified issues but there is further work to be done around asking if someone or some organisation need to be actually taking a handle on this and saying "This is what we do now". Obviously, that is for every organisation to decide for themselves, but there is further research to be done. This was initially about identifying some of the concerns. Further work needs to be done between ourselves and others in the sector to identify how we might best address some of those needs, along with our colleagues in academia and across all key decision-making bodies.