Conditions experienced by some mentally ill prisoners “might amount to inhuman and degrading treatment”, a European torture watchdog has warned the Government.
The Council of Europe Committee for the Prevention of Torture (CPT) expressed general concern at facilities for inmates with serious psychiatric illnesses and urged authorities to expand the number of beds in community psychiatric facilities for these prisoners.
In a new report on Ireland’s detention facilities, following on from its last inspection in 2014, the watchdog expressed a “major concern” at the rising number of homeless people with severe mental health problems ending up in prison.
It said even where courts are willing to grant these individuals bail, they “languish” in jails because HSE community mental health services won’t take them as they are homeless.
The CPT conducted a visit of selected Irish prisons, Garda stations, psychiatric facilities, and social care settings between September 23 and October 4, 2019.
They included Cork, Midlands, Mountjoy, Cloverhill, and Arbour Hill prisons as well as the Bridewell and Cobh Garda stations in Cork and Store St, Clontarf and Mountjoy stations in Dublin.
It commended progress in prisons, including a significant reduction in committals, an overall reduction in violence and a “marked improvement” in health care services.
But its most stark criticism related to prisoners with psychiatric illnesses.
It said the high support units in Cork, Cloverhill, and Mountjoy prisons are not provided with the appropriate resources to provide a stepping stone to a psychiatric facility.
It said in the D2 Wing in Cloverhill, the largest unit holding mentally ill inmates, authorities needed to “substantially reinforce” the mental health team.
It said the conditions in which two inmates they came across in the wing “might amount to inhuman and degrading treatment”.
The CPT said a “major concern” was the rising number of homeless people ending up in prison, particularly in the D2 Wing, rising by almost 50% in 2019.
“Many of the persons coming to D2 could be granted bail by the courts but because of their homeless status they are excluded from the HSE community health team services so are left to languish in prison,” said the CPT.
“Moreover, their mental health condition continues to deteriorate as they are too ill to consent to treatment.”
It recommended that “urgent steps” be taken, including new laws, to ensure that these prisoners can be transferred rapidly to community psychiatric facilities.
It said an inreach psychiatric service, run by the Central Mental Hospital and the Courts Liaison Service, had identified 100 prisoners in Cloverhill Prison that were “actively psychotic”.
There were 25 prisoners on the waiting list for admission to the CMH when they visited.
It said it received accounts that the new, expanded CMH in Portrane would not result in enough additional beds for mentally ill prisoners — something the Irish Examiner reported on last August.
The executive director of the Irish Penal Reform Trust has described the findings in the report as “deeply disturbing”.
Fiona Ní Chinnéide said that while the trust welcomed publication of the report and recognised the fact that the State engaged openly with the expert inspection team, a number of its findings were “extremely disturbing and upsetting” in particular the treatment of people with mental health issues, particularly those who are homeless and addicted in prisons.
Speaking on RTÉ radio’s Morning Ireland, Ms Ní Chinnéide said the details of the case of a prisoner who had been in a solitary “special observation cell” in Cloverhill Prison for about two weeks without a shower as he awaited transfer to the Central Mental Hospital, were “dehumanising” and “inhuman treatment”.
“We're talking about somebody who is very unwell. It's a damning reflection on us all. It is done in our name, but it's really important to emphasise that prison staff should not be treating these people, they are in an inappropriate facility, they should be in therapeutic care facilities.”
Ms Ní Chinnéide said that the Programme for Government committed to establishing a cross-departmental task force on mental health, addictions and imprisonment, “we welcome this, we understand that Ministers Donnelly and McEntee have met towards progressing this, but it's so important that this is a task force that is focused on short, medium and long term actions and it is not a committee and it doesn't conduct another review.
"We need to see attention paid to changes, to investment in community based mental health services and residential care.” Use of special observation cells was extremely disturbing, she added.
“What we have no sight of in Ireland is the length of time people are held in segregation, in solitary confinement or in the safety observation cells.
“The Irish prison service publishes statistics and figures on the numbers on a given day but there is no transparency around the length of time - beyond 14 or 15 days is considered or identified as prolonged confinement and it can have serious detrimental effects on an individual's psychological integrity.
“We are calling for, if not the inspector of mental health services, then at minimum the inspector of prisons should be notified if people are so held beyond 72 hours. Nobody should be in the central mental hospital for want of suitable facilities in the community - this is calling for this over-arching joined up piece of thinking that must happen between the department of justice and the department of health and a complete overhaul.
“Just under eight per cent of committals to prison in 2019 declared themselves as of no fixed abode, we're seeing increasing numbers of people in prison serving short sentences when it is acknowledged in policy and in law that community service is more appropriate and should be the default option and on top of that we're seeing increasing numbers of remands for public order and social code offences - this has to be linked to the situation of homelessness on the streets.
“Nobody should be in prison for want of shelter in the community,” said Ms Ní Chinnéide.
During their inspection, the European torture watchdog came across a prisoner lying naked in his cell. The cell was smeared with faeces, and there were puddles of urine on the floor.
“There were no blankets in the cell and his poncho [given instead of clothes] lying next to him was soaked in urine,” the CPT said.
This was in a special observation cell (SOC) in the D2 Wing of Cloverhill, the country’s biggest prison unit for mentally ill inmates.
Ten of the prisoners were awaiting transfer to the Central Mental Hospital.
Prison officers explained that the cell door was only opened using the protection of a shield to pass him food.
The CPT said that he had not been provided with a shower within the previous 13 days.
A second man the CPT visited in an SOC was in a “similarly distressed state” and he too had not been afforded a shower or allowed out of his cell since his placement.
Neither of the two men, both on the CMH waiting list, had an individual care and treatment plan.
Nursing staff were unable to engage with them inside their cells as prison officers would not open them.
There was poor recording of any intervention, including if they had taken food.
“In the CPT’s view, such a situation might amount to inhuman and degrading treatment,” the report said.
The High Court bailed one man to a community psychiatric hospital but, 12 days after their visit, he had still not been showered. The second man could not be bailed as the HSE would not accept him as he was homeless.
In other cases, the CPT saw a vulnerable foreign national prisoner with Parkinson's disease in Cork Prison sleeping on a mattress.