Written answers

Thursday, 29 November 2018

Department of Justice and Equality

Prison Mental Health Services

Photo of Mick WallaceMick Wallace (Wexford, Independent)
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24. To ask the Tánaiste and Minister for Justice and Equality his views on the fact that there may be an inadequate level of mental health support for prisoners here as highlighted by a recent report by the IPRT; his further views on the fact that Irish prisons may not be meeting the standards of best international practice; and if he will make a statement on the matter. [49796/18]

Photo of Charles FlanaganCharles Flanagan (Laois, Fine Gael)
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It is assumed that the question refers to the Irish Penal Reform Trust (IPRT) report launched on 26 October 2018, called Progress in the Penal System 2018 which is the second in a series of annual reports benchmarking progress in Ireland's penal system. This deals with, inter alia, the issue of provision for mentally ill prisoners.

Before detailing below the services that are available in this respect, I would firstly say that the views of the IPRT are welcome. The provision of appropriate mental health services to those in custody is one of the major challenges to effective healthcare in prisons. Prisons form part of society and those in custody must not be discriminated against in terms of their mental health.

To address this issue, an Interdepartmental Group, involving representatives from the relevant Government bodies, has been established to examine issues relating to people with mental illness who come in contact with the criminal justice system Its first interim report was published in September 2016. That deals with how diversion could be facilitated, where appropriate, at all stages of the criminal process up to the conclusion of a criminal trial.

The second report of the Interdepartmental Group explores matters relating to mental health services for prisoners and persons subject to community sanctions, matters relating to patients detained under the Criminal Law (Insanity) Act 2006 and post-release mental health services for former prisoners. This report is currently being finalised and will be published on completion. Upon publication of the second report, the work of the Interdepartmental Group will be complete and the implementation of their recommendations will then be considered.

In addition, a general review of healthcare in the prisons is being carried out by a Working Group involving officials from my Department, the Department of Health and the HSE. This flows from a report in 2016, from the then Inspector of Prisons on Healthcare in the Irish Prison Service.

Currently, a range of mental health services are available to prisoners, in collaboration with the Health Service Executive (HSE) and involving the National Forensic Mental Health Service (NFMHS).

In-reach mental health services involving the provision of weekly forensic mental health sessions are available in the Dublin and Portlaoise prisons. The HSE also provides specialist in-reach, psychiatric services to those in custody in Limerick and Cork prisons.

The Irish Prison Service has access to a limited number of places in the Central Mental Hospital for prisoners who require residential mental health treatment. There is currently an average of 25 prisoners each week awaiting transfer to the Central Mental Hospital, and the NFMHS has acknowledged the challenge of access for prisoners to in-patient treatment beds. It is anticipated that the opening of the new Central Mental Hospital in 2020 will help address capacity issues for prisoners in need of in-patient treatment.

The HSE has confirmed that approval has been granted for the appointment of a consultant-led team to Castlerea, Limerick, and Cork prisons. The HSE has also advised that difficulties have been encountered in recruiting a consultant psychiatrist for Castlerea Prison.

The NFMHS also provides an assessment and liaison service for all other prisons where a prisoner requires a forensic assessment, or access to an admission bed in the Central Mental Hospital. Consultant Forensic Psychiatrists are leading these services and can be supported by Non-Consultant Hospital Doctors, Community Psychiatric Nurses, and Social Workers.

Two dedicated areas have been established for the provision of high support to vulnerable prisoners with mental illness; D2 wing in Cloverhill Prison (for remand prisoners), and the High Support Unit in Mountjoy (for sentenced prisoners). Both units provide a dedicated area within the prison where mentally ill and vulnerable prisoners, who present with a risk of harm to self or to others, can be separated from the general prison population and closely monitored in a safer environment.

A psychiatric in-reach and Court Liaison Service is available at Cloverhill Prison. The diversion service ensures, as far as possible, that those people presenting before the courts, or indeed at an earlier stage of the criminal justice system where the infraction is a reflection of an underlying mental illness, are referred and treated appropriately. This approach has reduced the number of mentally ill people committed to prison.

The IPS Psychology Service plays a key role in the provision of mental health services for people in custody. In conjunction with the multi-disciplinary team the Psychology Service provides various evidence-based primary, secondary and tertiary care talking therapies for people in custody who experience mental health difficulties.

The Irish Prison Service is in the process of further developing the Psychology Service in order to better meet the mental health needs of those in custody.

The Irish Prison Service has also developed a bespoke mental health training programme for staff, which is currently being delivered to all staff. In addition, all persons in custody in closed prisons have access to the Samaritans Listeners Scheme.

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