HSE commits to plan to divert prisoners with mental illnesses

The schemes are aimed at targeting people at different stages – from those coming to the attention of the criminal justice system for the first time to those in prison, either on remand or serving sentences.

Expanding diversion schemes to remove offenders with mental illnesses into therapeutic settings are among measures the HSE commits to pursuing in the coming years.

The schemes are aimed at targeting people at different stages – from those coming to the attention of the criminal justice system for the first time to those in prison, either on remand or serving sentences.

Multiple domestic and international inspections and watchdogs have repeatedly highlighted the scale of mental illness among a significant proportion of inmates, including those held on remand and awaiting trial, and the limited ability of prisons to provide the necessary therapeutic interventions.

The HSE also plans to conduct a “gap analysis” of the mental health needs of the prison population, with the aim of developing responses. The commitments are contained in the HSE implementation plan 2022-2024 of the Department of Health’s Sharing the Vision - A Mental Health Policy for Everyone, published in June 2020.

Some of the recommendations

Recommendation 55 of the strategy called for funding of diversion schemes for people with mental illness to be diverted from the criminal justice system “at the earliest possible stage” and be treated either in the community or in non-forensic mental health facilities.

The HSE Mental Health Operations is leading its implementation, supported by the National Forensic Mental Health Service, the Prison Service and An Garda Síochána.

The HSE plan commits to setting up a sub-working group of the Taskforce for Mental Health and Addiction Challenges for Persons Coming to the Attention of the Criminal Justice System, which was set up by the Justice Minister Helen McEntee and Health Minister Stephen Donnelly last April.

The plan said this sub-group will review and develop the work of the Prison In-Reach and Court Liaison Service (PICLS) and other diversionary schemes nationally.

The PICLS, which operates in Cloverhill Remand Prison in Dublin, aims to refer people before they appear in court, or earlier, to proper treatment, in situations where their offending is linked to their mental illness. The HSE plan aims to devise a business case for expanding this scheme and other ones nationwide.

Recommendation 54 of the Sharing the Vision strategy states that everyone with mental health difficulties in the forensic system should have access to comprehensive mental health support.

The action plan commits the HSE to conduct a “needs analysis” of the prison population and develop a tiered forensic mental health model, with a phased implementation.

It said this analysis, tasked with identifying gaps in the system, will inform a restructuring of mental health services, regarding alternatives to custody and imprisonment.

Recommendation 56 of the strategy says that the development of further Intensive Care Rehabilitation Units (ICRUs) should be prioritised following successful evaluation of the new ICRU on the Portrane Campus, the new home of the Central Mental Hospital, once it starts operating at the close of this year.

The HSE plan commits to a comprehensive evaluation and review of the ICRU at Portrane and to start the implementation of a national ICRU plan by the end of 2024.