There is a waiting list for prisoners with a serious mental illness to get on another waiting list to access the country’s forensic psychiatric hospital, the prisons' inspector has said.
In a report on Limerick Prison, the inspector said this may have led to a reduction in the numbers of prisoners on the waiting list for admission to the Central Mental Hospital (CMH) as this list does not include those who are awaiting assessment.
A separate inspection report on Cloverhill Prison in Dublin said prisoners with significant mental illnesses were on the CMH waiting list for up to 10 months.
The findings are contained in a series of new reports by the Inspector of Prisons.
In the Limerick report, it said prisoners did not have to wait for psychiatric care inside the prison, adding: "This was due to the 'duty of care' that the psychiatrist had for the patients under his care – 130 to 150 new referrals per year for psychiatric assessment were seen by the psychiatrist.
“In community settings, the average number of referrals to community mental health teams is 50-100 new patients per year.”
It said as there was no cover when the psychiatrist went on leave, he only took small blocks of leave “to ensure that his patients’ needs are addressed”.
The report said: “This resulted in a substantial amount of unused leave.”
The inspector said “additional resources” were required, in particular, additional community psychiatric nursing.
It said access to inpatient forensic mental health services was a challenge: “It would appear that in addition to the waiting list for inpatient care and treatment in the Central Mental Hospital, there was another waiting list for an assessment by a forensic psychiatrist from the CMH.”
The inspector said it was reported that previously any forensic consultant psychiatrist could carry out the assessment, but now they had to be carried out by a CMH forensic psychiatrist.
The report said: “This change in practice may have led to a decrease in numbers of persons on the waiting list for admission to the CMH as it does not include those in custody who are awaiting forensic psychiatric assessment. It would appear that there was a waiting list to get on the waiting list.”
The Cloverhill report said the inspection team met with a number of prisoners in need of “significant mental health intervention”.
It said: “Despite efforts of the Prison Service and the psychiatric team to care for these men, the prison cannot and should not be a holding facility for people awaiting treatment at the Central Mental Hospital.”
The report said one person was on the CMH waiting list for 305 days, another 294 days and a third for 228 days.
Responding, the IPS said the provision of appropriate mental health services to those in custody was "one of the major challenges" to effective healthcare in prisons.
It said imprisonment was "inappropriate for people with severe and enduring mental illness" as prisons were not therapeutic environments.
It said the Irish Prison Service worked with the HSE and the Central Mental Hospital on this issue and was a member of the high level taskforce on mental health and addiction in prison.