Important new report from the Centre for Mental Health
Commissioned by the Department of Health and the Ministry of Justice, Dr Graham Durcan from the Centre for Mental Health has authored a key report entitled Mental health and Criminal Justice (published on 21 April 2016) which identifies key areas for improvement across the criminal justice system.
The report was based on 17 consultation events held across England and Wales plus a small number of one to one interviews and meetings with small groups of stakeholders. In all the report gathered the experiences of over 200 people with personal or professional knowledge of the interfaces between the criminal justice system and mental health services with most of the interviews carried out in February 2015.
It is a shame that a report of such importance does not have current large scale studies about the prevalence of mental health amongst offenders to rely on. The last large scale studies of mental health in prisoners were conducted in 1998.
However, the report does assimilate information from a number of smaller, more recent studies and highlights these key findings:
- A 2008 study of 1435 sentenced prisoners found that 16% of the sample reported symptoms indicative of psychosis. This was considerably higher
in female prisoners, 25% of whom reported symptoms indicative of psychosis (males = 15%).
- A single CMH study of the probation service in 2012 found that around 40% of people on probation have a current mental health problem.
- A survey of those on community orders (between October 2009-December 2010) found that 35% of offenders had a formal mental health diagnosis and 29% reported having a current mental health problem. For female offenders the proportion reporting a current problem was much higher (46%)
- Data on police contact with people with mental health problems from 2013 and 2014 suggest that between 15-40% of police contacts are with people with mental health problems and related vulnerabilities.
- Personality disorder features prominently in the prison population and is likely to be highly prevalent in both probation caseloads and police contacts.
- Prisoners seldom have a single problem or vulnerability and typically will have multiple and complex needs. Histories of trauma, unhelpful use of substances, poor relationships, poor life skills, learning difficulties and learning disabilities, acquired brain injury, poor education and work histories are all common among prisoners, and make the provision of care and support all the more challenging.
The report finds that few of the prisons represented at the consultation events were able to offer psychological therapies, and that primary mental health care remains the weakest element of mental health support in prisons. For many people, leaving prison is a time of crisis. Many have nowhere to live and no source of income. The report calls for a new ‘concordat’ between different government agencies to join together better to help people through this difficult time.
In addition, participants felt there was a need for:
- Robust screening and assessment processes for a range of vulnerabilities in all justice settings;
- Wider availability of support and care for people’s vulnerabilities regardless of setting;
- Providing pragmatic and practical support (e.g. with housing and debt) at critical periods (e.g. on release from prison);
- Adopting a psychological and trauma focused approach across all justice services and providing training in these for all who work in them;
- Increasing access in both the community and custodial settings to psychological interventions that are adapted to reflect complex and multiple need;
- Increasing the use of mentors and peers, and the voice of service users in the planning and provision of services.
The CMH has also provided a helpful infographic with summarises the main themes:
You can also watch Dr Graham Durcan, the report’s author, explain some of the key points:
[Click here if this clip doesn’t play on your device.]