Download Mental health in prisons

Mental health and criminal
justice: current position and
what needs to happen in the
future
Sean Duggan, Joint Chief Executive
13th November 2010
Mental health in prisons
Prison population reached 85,600 on 31st
August 2010
Majority of prisoners have MH problems
Over 90% have one MH problem
More than 70% suffer from two or more MH
problems
Many have complex mix of other issues
Prison mental health care
Improvements in some prisons as a result of mental
health in reach teams but picture still mixed
Little provision for vast majority of prisoners with
common MH problems such as depression
Funding no more than one-third of what is needed to
deliver policy objective of equivalence
Young people (1)
On 31st August 2010, 11,770 young people (aged 15-20) were
in custody
High risk of multiple health inequalities and poor life chances
One third have mental health needs, often undiagnosed and
untreated
8 in 10 young people (aged 16-20) in custody have more than
one mental health need; almost all meet criteria for a diagnosis
of personality disorder
1 in 5 young people in community and custodial settings meet
criteria for a learning disability
Young people (2)
Importance of early intervention
Conduct problems most common childhood
mental health difficulties
Estimated 80% of criminal activity
attributable to people who had conduct
problems in childhood, at a cost of £60 billion
a year
Programmes aimed at prevention or early
intervention most effective
Adapting diversion techniques for
young offenders
Point of arrest pilots
‘Wraparound’ approaches
Police
Bradley recommendations on section 136
Transfer commissioning of health services
from police to NHS
Diversion
All Stages Diversion Model
Interventions to address complexity of need
564896
Secure services
Around 4,000 people in secure services (compared
with an estimated 8,000 prisoners with severe mental
illness)
Cost the NHS £1.2 billion in 2009/10
Vast majority of places are in medium secure units
Growing concern about capacity
Excessive delays for prison transfers
Recommended 14-day maximum transfer waiting time
Need to improve pathways through security levels
and between prisons and secure services
Current government
strategies (1)
NHS White Paper
Commissioning: GP consortia; prison health care
to be commissioned nationally
Health and Wellbeing Boards in local authorities
Outcomes framework
MH Strategy
Current government
strategies (2)
MoJ ‘Rehabilitation Revolution’
3,000 fewer prisoners by 2014
More rigorous and effective community sentences
Key role for private sector and voluntary
organisations
Payment by results and Social Impact Bonds –
Peterborough prison pilot
Common theme: need to ensure crossdepartmental and agency working
Thank you
[email protected]
www.centreformentalhealth.org.uk