People with mental illness who end up in the prison system are often subjected to bullying and intimidation and are victimised and mocked by other prisoners.
A new report published by the Mental Health Commission has said Ireland's justice and mental health systems are failing people in the prison system who are mentally ill.
The report, Access to Mental Health Services for People in the Criminal Justice System, shows longstanding and persistent gaps in the mental health and criminal justice systems in Ireland and said those with mental illness often do not receive the treatment required for them to recover.
According to the report, a lack of diversion services means many with mental illnesses who come into contact with the criminal justice system are not being treated in a psychiatric setting.
This is the latest report by the Inspector of Mental Health Services Dr Susan Finnerty, who under the Mental Health Act has to review a sector of mental health services in the State.
Dr Finnerty visited three prisons, Cloverhill, Mountjoy Men's prison and Mountjoy Women's prison in Dublin and found in her report that there are opportunites to stop people with a mental illness who may have offended (in the context of that mental illness) getting into the prison service.
One of the main findings in the report reveals that unlike other jurisdictions, there are no pre-arrest or diversion teams in the country, which would allow Gardaí to use their discretion to divert individuals suspected of non-violent, low-level offences away from the criminal justice system and towards mental health services.
Dr Finnerty said people with mental illness who end up in the prison system are often subject to bullying and intimidation and are victimised and mocked by other prisoners adding their medication could be taken away from them or they could be asked to try illicit drugs.
The report also highlighted how prison officers are not equipped to deal with the complex needs of prisoners with mental illnesses, while mental health treatment programmes and resources are severely lacking.
It found mentally ill prisoners in Cloverhill were being held in an overcrowded wing, with some cells being occupied by three men.
No therapeutic activities were available for the men along with very few recreational facilities.
No mental health care professionals were based in the area but the report noted that the inreach forensic mental health team had a very active presence in the wing and provided psychotropic medication where a prisoner consented.
The report found that mentally unwell prisoners in Mountjoy's Men's Prison were accomodated in a nine bed High Support Unit (HSU) and progressed to a low support unit when they were well enough which is staffed by prison officers who had a special interest in mentally unwell prisoners.
The inreach team provided a comprehensive mental health service and decided who was admitted or discharged from the unit.
The inspectors were told that mentally ill prisoners were likely to be bullied and abused in the main part of the prison, and the prisoners preferred to be in the HSU when they were feeling unwell.
'This is absolutely fixable but it is about action now to make things better'.— Mental Health Commission Ireland (@MHCIreland) November 15, 2021
John Farrelly on where we go from here after the release of our report on forensic mental health services. pic.twitter.com/bv5MqzDJY1
Mountjoy Women's Prison has a single cell medical unit where women with severe mental illness were located.
During the inspectors visit, there were three severely mentally ill women locked in isolation cells, who both had difficulty articulating their needs due to their illnesses.
The report found there was regular input from the inreach team, but both needed urgent admission to the Central Mental Hospital and appropriate inpatient mental health care.
The report also looked at the Central Mental Hospital in detail following decades of reports stating that the facility in Dundrum was not fit for puropse.
A new building in Portrane will open soon with an increase in beds from 102 to 170, including a unit for children and an Intensive Care Regional Unit.
The report said:
"It is not a sufficient number now and won't be in the future, especially bearing in mind the absence of investment in other areas of general and forensic mental health care.
Executive Clinical Director for the National Forensic Mental Health Service at the Central Mental Hospital, Professor Harry Kennedy, said the report focused attention during difficult and unique times on the numbers of people with severe mental health illnesses passing through the courts and the prisons who need treatment for such illnesses.
Professor Kennedy said more needed to be done rather than placing people in prison or a forensic mental health service, pointing out that there are approximately 4,000 people in prison in Ireland and 10,000 people a year passing through those 4,000 places, adding 3 per cent of them will have a severe mental illness, mostly with a dual diagnosis at any time.
John Farrelly from the Mental Health Commission said prisons are unsuitable locations for those with mental disorders and the negative effects of incarceration on a person with mental illness are profound adding many of these prisoners are accommodated in an extremely restricted daily regime.
"These restrictions amount to inhuman and degrading treatment. The treatment of prisoners who are mentally ill must be addressed as a matter of extreme urgency", he said.
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