Treatment of mentally ill prisoners ‘must be addressed with extreme urgency’

The new and much larger Central Mental Hospital would be full before long because so many mentally ill people were being criminalised and sent to prison where their conditions often worsened, Mental Health Commission chief executive John Farrelly has said.

The treatment of prisoners who are mentally ill “must be addressed as a matter of extreme urgency”, he said, as the State was “failing” them at present.

His remarks came as the commission released a research report into the treatment of mentally ill people across the justice system.

It concludes that while there would be extra capacity in the Central Mental Hospital (CMH) when it moves from its current location in Dundrum, Dublin, to a new building in Portrane in north Co Dublin, it would soon be full because of continued failings elsewhere in the system. The move will see the hospital's capacity increase from 102 to 170 beds.

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Garda members have no options to refer mentally ill people for treatment at any stage before arresting them, the report finds. The courts were “helpless” in trying to find treatment options as the CMH was almost always full and there were few, if any, other suitable facilities.

Resources

There was a lack of “adequate diversion and community resources” in the State coupled with a lack of “intensive care regional units and acute psychiatric intensive care units”. This meant that mentally ill people who committed crimes would continue to be jailed rather than diverted into treatment, and their numbers in the prison system would continue to “accumulate”.

“Increasing numbers of mentally ill people in the prison system will continue to put pressure on the Central Mental Hospital and within a short time the CMH will be at capacity again,” the report concludes.

The findings come 10 days after a research paper carried out by UCD academics with funding from the Policing Authority stated there was an “over-reliance” on the Garda to manage mental-health crises in the community.

As a result, children in crisis were suffering “criminalisation” as they were being arrested as a means of taking them to a Garda station for assessment by a medical professional, it said.

Mr Farrelly said the latest report for the commission made it clear that prisons were “unsuitable locations for those with mental disorders”. The negative effects of incarceration on a person with mental illness were “profound”, he said.

“Many of these prisoners are accommodated on an extremely restricted daily regime,” he said of some prisoners being held in isolation cells while they waited for a bed in the CMH.

“These restrictions amount to inhuman and degrading treatment,” he said, adding that a majority of crimes committed by mentally ill people were “minor and non-violent”.

Delays

Inspector of Mental Health Services Dr Susan Finnerty, who compiled the report, Access to Mental Health Services for People in the Criminal Justice System, said: "Forensic mental health in-reach teams in prison provide an excellent service, but they are under-resourced and there are long delays in obtaining a bed in the Central Mental Hospital."

She added that people with a mental illnesses were “being criminalised” which suggested the need for “systemic change in both the criminal justice and mental-health systems”.

People who should be identified in the criminal justice system as being in need of diversion to mental-health services were instead being sent to prison, she said. However, prison officers were “ill-equipped to deal with the complex needs of prisoners with mental illnesses” while mental-health treatment programmes and resources were “severely lacking”.

“It is clear that resources must be put in place at pre-arrest, arrest and court liaison stages,” Dr Finnerty said.