Urgent action needed on mental illness in prisons

Increasing numbers of prisoners with a severe mental illness are on a waiting list for the country’s only forensic psychiatric hospital.

While there are psychiatric referral units in all Dublin prisons, as well as Portlaoise and Midlands, there are none in Cork, Limerick, or Castlerea, despite approval for them in 2016.

An Irish Penal Reform Trust (IPRT) report said there are fewer psychologists for prisoners now than three years ago, but that the Irish Prison Service had recruited som recently.

The Progress in the Penal System report raises “particular concern” at the increase in prison numbers since the latter half of 2017, saying it risked reversing the reductions since 2011.

The 116-page assessment, published today, said three issues needed to be “urgently addressed”:

The number of people with severe mental illness presenting in jails;

The increasing numbers of women being detained in prison — with the two women’s prisons being the most overcrowded;

Staffing issues that have resulted in the closure of schools and workshops.

“On a monthly basis in 2018, there were consistently 20-30 prisoners with a severe mental illness awaiting transfer to the Central Mental Hospital,” said the report.

The average monthly number of prisoners awaiting transfer was 20 during 2017, increasing to 23 over the first five months of 2018, hitting a peak of 29 in May.

The report cites CMH estimates of 323 prisoners — out of 4,000 — with a severe mental illness. It said there is a diversion system, involving CMH clinicians, in all Dublin jails as well as Portlaoise and Midlands prisons.

There was no such service in Cork, Limerick, or Castlerea prisons. This was despite HSE approval in 2016, but the IPS said it had not been possible to recruit consultant forensic psychiatrists.

The report said the ratio of psychologists to prisoners was 1:233 in 2015 and had increased to 1:268 in 2018. It said the ratio was 1:78 in Canada and 1:123 in Scotland. It said the IPS has invested in the service since 2017.

The IPRT said only two prisons (Mountjoy and Cloverhill) had high-support units for mentally ill prisoners, even though an inquest jury in 2016 called for one in every prison.

A report last week by the Oireachtas Joint Committee on the Future of Mental Health Care said that prisons were becoming a “de facto” extension of the mental health system.