Prisoner care improved by mental health unit

A groundbreaking mental health unit in the country’s most notorious jail has greatly improved care for inmates and boosted compliance with international human rights standards.

Prisoner care improved by mental health unit

The success of the project has led to calls for the high support unit in Mountjoy Jail to be replicated across the prison system.

The establishment of the unit in Dec 2010 has led to a significant fall in the use of special isolation cells, according to research.

The European torture prevention watchdog, the CPT, has previously criticised the over-use of these seclusion cells in Mountjoy, including their use for management and punishment.

It said their use was likely to be in breach of UN principles on the protection of prisoners with mental illness.

Research by medical experts from the Central Mental Hospital and the Department of Psychiatry in Trinity College found that 96 prisoners in Mountjoy used the 10-bed High Support Unit in its first year in operation.

Of those referred to the unit:

* 35% reported psychotic symptoms;

* 28% were at immediate risk of self-harm.

* 17% were referred for medical treatments;

* 13% received specialist treatment by the addiction psychiatric team;

* 6% presented with emotional distress;

The research found that 29% were diagnosed with a major mental illness. A fifth required short-term support for crisis intervention, but did not have a major mental illness. A further 10% were deemed to be feigning symptoms to seek refuge in the unit. Some 7% had a personality disorder and 4% had a learning disability.

The researchers said by assessing the risks and needs of the referrals there was a 59% reduction in the seclusion of prisoners in the special isolation cells.

“The success of this project has led to positive comment from the Inspector of Prisons with a recommendation that similar units should be organised from within each of the other prisons,” said the report in the International Journal of Mental Health Systems.

The report, co-authored by Yvette Giblin, said: “Apart from managing vulnerable and mentally ill prisoners in a much more humanitarian environment, there is greater access to care and regular reviews by the prison in-reach team from the National Forensic Psychiatric service [Central Mental Hospital] and the Probation Service. The introduction of the high support unit has achieved the goal of reducing the use of special observation cells and has, therefore, improved compliance with human rights standards.”

The report said prisons remain “unsuitable places” for people with severe mental illness and that while more can be done at remand stage, awaiting trial, only a limited amount can be done once sentenced.

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