Dan Neville (Limerick, Fine Gael) | Oireachtas source

I appreciate the opportunity to welcome this Bill. It will allow for the complete closure of St. Patrick's Institution. It is part of the Mountjoy Prison complex which dates back to 1850. It is located in the former Mountjoy women's prison. It is currently described by the Prison Service as "A closed, medium security place of detention for 17 year old males, held on remand or for trial". It has previously held male prisoners between the ages of 16 and 21. It currently has operational capacity for 34 prisons. Responsibility for 16 year old males remanded in custody or sentenced to detention was transferred from the Prison Service to the children's detention schools at Oberstown in May 2012.

St. Patrick's Institution has been widely criticised for holding male prisoners aged 16 to 21 years. Best international practice suggests that children under the age of 18 years should be separated from adult prisoners. Article 37 of the UN Convention on the Rights of the Child prohibits the detention of children with adults. The Children Act 2001 provides that children must be detained in a children detention school or centre rather than a prison. Children detention schools have particular objectives for children in their care, which is very different from those in prisons. The Child Act 2001 provides that it shall be the principal objective of children detention schools to provide appropriate educational and training programmes to facilitate children referred to them by the court and by having regard to their health, safety, welfare and interests, including their physical, psychological and emotional well-being. It also provides that they should cater for providing proper care, guidance and supervision for them and preserving and developing satisfactory relationships between them and between their families. It further provides that they should exercise proper moral and disciplinary influences on them and recognise the personal, cultural and linguistic identity for each of them in order to promote their reintegration into society and prepare them to take their place in the community as persons who observe the law and are capable of making a positive and productive contribution to society.

I want to raise an issue, to which Deputy Finian McGrath referred, namely, the system for dealing with prisoners with mental health illness in our prison system. The mental health experts have warned of systematic discrimination against people with serious mental health illness in the criminal justice system. Recent figures show a high level of psychosis among remand prisoners. A private project in Cloverhill Prison identified psychosis arising from conditions such as schizophrenia and bipolar disorder in 561 new remands from 2006 to 2011. Research shows that almost 8% of male remand prisoners have psychotic symptoms, which is ten times the rate of the community at large. Experts have stressed that psychosis is defined as an abnormal condition of the mind, and should not be confused with psychopathic behavioural disorders. Professor Harry Kennedy, who has one of the best reputations for psychiatry, is the clinical director of the Central Mental Hospital. He has stated that figures across the entire prison system are "quite frightening", with an estimated 300 people with severe mental illness coming into the prison service every year. He spoke of the multiplying of this over a period.

Professor Kennedy pointed out: "There is a very strong chance that any young man with a recent onset of schizophrenia or bipolar disorder may spend some time in prison – and it’s no respecter of class." I welcome that the Minister of State at the Department of Health and Children, Deputy Kathleen Lynch, has reiterated the Government’s pledge to create four regional intensive care units to relieve pressure on the Central Mental Hospital, the State’s only specialist forensic mental health facility. It has complained for some time about the scale of court referrals and has a constant waiting list. In addition, we are developing an exit programme from prisons, which would give support to vulnerable people re-entering society. This would run alongside existing court diversion and in-prison mental health services. This is important and it has been neglected not just over the decades but over the centuries. The Cloverhill project has diverted more than 700 prisoners to mental health care settings since it was established in 2006 but it covers fewer than 60% of the remand population, according to mental health campaigners.

All over the State, people are falling foul of the law because of behaviour arising from mental illness and often they end up in custody, either in the Central Mental Hospital, Dundrum, or in mainstream prisons where, according to repeated inspection reports, their mental and physical health deteriorates. If two people commit a minor offence, the one with a mental illness is much more likely to be incarcerated because, according to Doctor O'Neill:

To get bail all you need is an address, a sum of money or someone to vouch for you. These are things people with mental illness don’t tend to have. They are often homeless, impoverished, and they have lost contact with their families.

We discussed this aspect recently during the two recent debates on homelessness and those who are on the streets as a result of mental illness. They are released from prison and discharged from psychiatric units back on to the streets without services being available for them. There are factors relating to mental health in our prison population. Lack of early intervention, the prevalence of drug abuse and inadequate community resources all contribute to the high rate of mental illness in prison. Even the closure of psychiatric hospitals may play its part, as the phenomenon known as Penrose’s Law suggests. It says a country’s prison population increases as its number of psychiatric beds decreases.

Dr. Brendan Kelly, a consultant psychiatrist at the Mater Hospital, has studied the trend in Ireland, and says:

The obvious hypothesis is that persons released from psychiatric hospitals somehow end up in prison, but that’s not at all clear. Is there a subgroup of patients who have ended up in prisons as a result of hospital closures? The answer is probably yes, but it is a small subgroup and it needs to be addressed. The correct solution is not to reopen custodial-style institutions, because they resulted in casual violations of human rights.

In 2012, in his annual report, the Inspector of Prisons, Judge Michael Reilly, concluded that the management of prisoners with mental illness remained a "significant problem", and a review group operating under the Department of Justice and Equality recently admitted that "imprisonment can aggravate mental health problems, heighten vulnerability and increase the risk of self-harm and suicide". However, there have been improvements. A few years ago, when prisoners arrived at Mountjoy, they were brought straight up to the landings and put into shared cells. Now they spend their first night in a committal unit, where they see a nurse and, if necessary, a doctor. They are allowed a phone call and given details of the Samaritans listener service, a counselling network run by fellow inmates. Enda Kelly, Mountjoy’s nurse manager said: "We are much more proactive in identifying risk. Officers will approach us and say, 'X is not well.' That is probably the single most important development: the changing culture". If mental illness or a suicide risk is diagnosed on admission, prisoners can be transferred to the high support unit. Prior to this, they were placed in a padded cell in totally unsuitable conditions.

There is a natural tension between balancing the need to address a mental illness with the necessity to provide justice. Of course, it is important in all aspects of this issue to ensure the protection of society and to ensure there is no danger to citizens of violence in our communities but if the resources were there, it would be an excellent opportunity to move people on, because the one thing about prison is that there is a captive audience.

People working in the sector stress that mental illness does not excuse bad deeds. According to Dr. Brendan Kelly:

Most people may have some irrationality as a result of mental illness, but they also have a lot of rationality. The majority of psychiatrists and citizens would agree there are occasions when individuals are so mentally ill they can’t be held responsible for their actions. But, even in these cases, victims and families of victims have a legitimate expectation of justice. The issue is complicated by the fact that mental illness is “not a binary state” and can evolve over a life. Kelly stresses, however, “the vast majority of mentally ill people are in no way more violent than other people. They are more likely to be the victims of crime than other people.

I welcome the closure of St. Patrick's Institution and I congratulate the Minister and the Government for bringing the Bill forward.

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