Mental Health in Prison
Justice Committee
Closed
Inquiry
This inquiry seeks to understand the current scale of mental health need in prisons, and to identify what support exists and whether there are any gaps in provision. Read the terms of reference to find out more about the inquiry .
12
Recommendations
21
Conclusions
1
Report
2
Events
Activity timeline 4 events
4 Feb
2022
2022
29 Sep
2021
2021
Report published
22 Jun
2021
2021
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
8 Jun
2021
2021
Formal meeting (oral evidence session) · Virtual meeting
Reports 1 report · click to expand
| Title | HC No. | Published | Items | Response |
|---|---|---|---|---|
| 5th Report - Mental health in prison | HC 72 | 29 Sep 2021 | 33 | Responded |
Recommendations & Conclusions
15 results
1
Conclusion
Accepted
5th Report - Mental health in pris…
Unmet need for mental illness treatment in prisons remains surprisingly high
While there have been improvements in prison mental healthcare, provision is still not adequate. The high unmet need for treatment for mental illness in prisons is surprising and disappointing. Around 10% of prisoners were recorded as receiving treatment for mental …
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Government Response
The government has commissioned a National Mental Health Needs Analysis by the Centre for Mental Health, due by end of 2021/22, which will inform a review of NHS England's prison mental health specification starting by April 2022 to identify and address service gaps.
Ministry of Justice
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3
Recommendation
Accepted
5th Report - Mental health in pris…
Set out plans to bridge fragmented healthcare service gaps for prisoners
Healthcare services can be fragmented, meaning people receive no or inadequate care. NHS England and NHS Improvement should set out how they intend to bridge existing gaps in care and resolve the problems that result from fragmented service provision to …
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Government Response
The government response details that healthcare provision is commissioned through a robust procurement process guided by Public Contracts Regulations (2015) and NHS England Standing Financial Instructions, which ensures a balance of cost and quality.
Ministry of Justice
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4
Recommendation
Accepted
5th Report - Mental health in pris…
Set out how to balance cost and quality criteria when procuring services
Cost and quality are essential criteria on which to assess bid submissions in procurement processes. All commissioned services need to be cost effective and provide value for money, but cost should not be prioritised at the expense of quality. NHS …
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Government Response
NHS England and NHS Improvement are reviewing existing service specifications for mental health, substance misuse, and primary care, aiming for readiness by April 2023. They are also developing guidance for Integrated Care Systems on prison population healthcare responsibilities.
Ministry of Justice
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5
Conclusion
Accepted
5th Report - Mental health in pris…
Specific integrated healthcare initiatives show welcome, but limited, progress in prisons
Initiatives such as integrated healthcare, the trauma-informed approach in the women’s estate, SECURESTAIRS in the youth estate, and the intensive programmes used on the Offender Personality Disorder pathway, are all welcome as far as they go. The comparatively few such …
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Government Response
The government agrees on the importance of tackling substance misuse and violence, detailing a zero-tolerance approach and plans from the Prisons Strategy White Paper. They are investing £120 million through the 10-year Cross-Government Drugs Strategy and rolling out enhanced gate security to 42 high-risk sites by March 2022.
Ministry of Justice
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6
Conclusion
Accepted
5th Report - Mental health in pris…
Integrated healthcare for prisoners requires expansion to ensure timely access to services
The NHS should expand on its work to commission integrated healthcare across all three estates so that prisoners can access proper physical and mental healthcare services at primary and secondary level as appropriate and without undue delay.
Government Response
The government states Drug and Alcohol Treatment Requirements and secondary care Mental Health Treatment Requirements are already available, with efforts to raise awareness. Through the Community Sentence Treatment Requirements Programme, they are on track to introduce primary care MHTRs to half of England by 2023.
Ministry of Justice
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7
Conclusion
Accepted
5th Report - Mental health in pris…
HMPPS needs plans to reinvigorate measures controlling substance abuse and violence
As the covid-19 restrictions in prisons are released, HMPPS (including the Youth Custody Service), should have plans ready for how it will reinvigorate its measures to control unwelcome and unintended issues such as substance abuse and violence in prisons. (Paragraph …
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Government Response
NHS England and NHS Improvement, as commissioners, currently review performance indicators like screening completion to identify underperforming providers. They then work with prison establishments to develop action plans to improve performance in healthcare provision.
Ministry of Justice
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10
Conclusion
Accepted
5th Report - Mental health in pris…
Racial disparity exists in identifying mental health conditions during prisoner health screenings
It is unacceptable that one in 12 prisoners do not have a health screening appointment within 24 hours of arrival and that Black, Asian, and other Minority Ethnic prisoners who have a mental health condition are less likely to have …
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Government Response
HMPPS is committed to improving mental health identification and support by providing introductory training for new staff, refreshing safety training, and exploring enhanced mental health training. They are also commissioning a Core Capabilities Framework and developing bespoke learning products, including a specialised recruitment and training proposal for staff supporting vulnerable women.
Ministry of Justice
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16
Conclusion
Accepted
5th Report - Mental health in pris…
Prison staff experienced significant pressure and uncertainty during the pandemic.
We recognise that prison staff have been under extra pressure during the pandemic and may face uncertainty as the prison restrictions are eased. We would like to express our appreciation again of all those who work in prisons.
Government Response
HMPPS is introducing a formal process to identify and support prisoners with mental capacity issues during parole, including accessing legal representation. Additionally, a 12-month Mental Health Streamlining Pilot was launched in November 2021 to expedite release suitability reviews for certain restricted patients.
Ministry of Justice
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18
Conclusion
Accepted
5th Report - Mental health in pris…
Increase urgent provision of mental healthcare services for prisoners affected by the pandemic.
The Ministry of Justice, HMPPS and NHS England should take urgent steps to increase provision of mental healthcare services over the coming 12 months so that prisoners whose mental health has deteriorated because of the pandemic can be treated.
Government Response
The government welcomed the ongoing roll-out of NHS England's RECONNECT service for prison leavers and is commissioning an evaluation for 2022/23. HMPPS has introduced Health and Justice Partnership Coordinators in four probation regions and plans to expand them to all regions in England and Wales by 2024/25, with an evaluation report due in Autumn 2022.
Ministry of Justice
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23
Conclusion
Accepted
5th Report - Mental health in pris…
Interoperable medical information systems are vital for appropriate care between prison and community.
Making medical information systems interoperable between prisons and the community is challenging but vital if appropriate care (including the correct medication) is to be provided from arrival in prison through to release. Progress has been made during covid-19 and this …
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Government Response
The government commits to automatically transferring health records between community and prison health services, with implementation for the male estate by April 2023 and the female estate by the end of 2023, building on interoperability.
Ministry of Justice
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24
Recommendation
Accepted
5th Report - Mental health in pris…
Introduce urgent arrangements for swift availability of prisoners' medical records between prisons and community.
As a matter of urgency, the Ministry of Justice, the Department for Health and Social care, HMPPS and NHS England should introduce arrangements so that all prisoners’ medical records are swiftly available between prisons and between the community and prison …
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Government Response
The government commits to automatically transferring health records between community and prison health services, with implementation for the male estate by April 2023 and the female estate by the end of 2023.
Ministry of Justice
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25
Conclusion
Accepted
5th Report - Mental health in pris…
Undiagnosed mental illness and poor community support cause parole decision delays for prisoners.
Some parole decisions are delayed because prisoners applying for parole have undiagnosed mental illness that limit their participation in the parole application process. There are further delays due to insufficient co-operation from community mental health teams in arranging packages of …
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Government Response
The government acknowledges problems causing parole delays and is implementing a formal process within HMPPS to identify and support prisoners with mental capacity issues, alongside a Mental Health Streamlining Pilot to expedite reviews for restricted patients.
Ministry of Justice
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26
Recommendation
Accepted
5th Report - Mental health in pris…
Systematic mental health assessment lacking for parole-eligible prisoners before application.
Prison healthcare providers should systematically assess the mental health of prisoners 30 Mental health in prison coming up for parole and make sure that any needing support and treatment have it in good time before they make an application.
Government Response
HMPPS is introducing a formal process to identify and support prisoners with mental capacity issues during parole, including legal representation and capacity assessments, and launched a Mental Health Streamlining Pilot to expedite reviews for restricted patients.
Ministry of Justice
View details
27
Recommendation
Accepted
5th Report - Mental health in pris…
Persistent challenges arranging mental health treatment packages for parole-eligible prisoners identified.
NHS England should liaise with the Parole Board to identify local areas where there are problems arranging mental health treatment packages for prisoners under consideration for parole. NHS England should then work with the new NHS Integrated Care Systems and …
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Government Response
NHS England is developing guidance for Integrated Care Systems on their responsibilities for the prison population's care pathways, which will incorporate the interface between prison healthcare, the parole board, and continuity of care upon release.
Ministry of Justice
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28
Conclusion
Accepted
5th Report - Mental health in pris…
NHS RECONNECT programme remains in infancy, failing to ensure continuity of care.
Despite longstanding difficulties arranging continuity of healthcare for prisoners on their release, the NHS RECONNECT programme, which is meant to resolve these problems, is in its infancy. In the meantime, prisoners who have been receiving treatment in prison for mental …
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Government Response
The government welcomes the roll-out of NHS RECONNECT for prison leavers and is expanding Health and Justice Partnership Coordinators to improve local pathways to mental health and substance misuse services across all probation regions by 2024/25.
Ministry of Justice
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