Healthcare in prisons, including mental healthcare, has improved since April 2005, when the NHS took over responsibility for healthcare in prisons, however, much more still needs to be done. There are many longstanding problems that have existed for many years where insufficient progress has been made. Most urgently, action must be taken to prevent mentally ill people being sent to or kept in prison due to a shortage of mental health services in the community.
Those responsible across the health and justice systems are committed to continuing to improve mental healthcare for prisoners and there are some promising areas where some initial steps have been taken but these need to be seen through. These areas include improved flow of medical information, increased use of integrated models of care, and improving the continuity of mental healthcare from prison through to release.
The Ministry of Justice, HM Prisons and Probation Service, and NHS England, surprisingly, do not know the extent of the need for mental healthcare services in prisons, but it appears from the evidence for this inquiry that there is a significant unmet need. We welcome the work commissioned by the NHS to quantify this, but this analysis must be used to plan and resource prison mental healthcare services properly, if it is to have any worth.
The covid-19 restrictions saved lives but have had a severe impact in prisons and the deterioration on prisoners’ mental health as a result is concerning. We recognise this reflects the experiences of the general population and that there now exists an unprecedented level of demand for mental health and wellbeing services across the country. There does not appear to be an action plan nor additional resources set aside to deal with the inevitable increased demand for prison mental healthcare services that will result.
We would like to thank all those who provided evidence to this inquiry. We would also like to thank all those working in prisons (operational, healthcare, and other staff) for their great efforts during the pandemic.