People with mental illness in criminal justice system failed ‘at every stage’

Findings were described by the inspectorate as ‘disappointing’

Emily Atkinson
Wednesday 17 November 2021 07:16 GMT

The criminal justice system is “failing” people with a mental illness “at every stage”, a major report has found has found.

Thousands of people with a mental illness are entering into the criminal justice system each year, only to be left at the whim of a “broken” system for information sharing, “unacceptable delays” in psychiatric reports and in transferring extremely unwell prisoners for treatment, and a shortage of services and long delays to access them, it said.

The findings of the report, carried out by the Criminal Justice Joint Inspection, were described by the inspectorate as “disappointing” - blaming the “lack of a common definition of mental ill health” for the many failures.

This means nobody has an “accurate picture” of the numbers of people suffering with mental health issues in the criminal justice system or the “needs or risks posed” by these individuals, inspectors said

Chief inspector of probation Justin Russell, speaking on behalf of all six inspectorates involved in compiling the report, has expressed his sadness that “not enough progress” had been made since the last joint inspection in 2009.

He said: “The criminal justice system is failing people with a mental illness. At every stage, their needs are being missed and they face unacceptable delays in getting support. Not enough progress has been made since our last joint inspection 12 years ago to put right these critical shortfalls.

“Police forces, prosecutors, prisons and probation services all assess individuals in different ways, which leads to gaps and inconsistencies. Even when mental health needs are identified, the information is not always recorded fully or used to make effective decisions.

“There are significant problems in the exchange of information in every agency and at every stage of an individual’s journey in the criminal justice system. This part of the system is broken and needs to be fixed urgently.”

Even at the point of entry into the criminal justice system, those with mental illness are met with adversity.

The inspectors found a that a patchwork of systems are used to screen and assess people as they are arrested, charged, sentenced and supervised. As such, incomplete or poor record-keeping mean individuals might not receive appropriate treatment, charging decisions are affected, and there are delays to court proceedings.

Confusion over data protection has also created complications, meaning prosecutors, defence lawyers, judges and magistrates can make decisions without crucial details.

After interviewing a number of police officers, inspectors found many of them were unsure as to when they could share information about an individual’s mental health with the Crown Prosecution Service - despite exemptions for sharing data in the pursuit of justice.

Inadequate information-sharing also impedes the allocation of appropriate support during the transition between prison and probation, the report states.

Mr Russell continued: “Criminal justice agencies need to make major improvements to the way they work with people with mental health issues.

“If someone is charged, they need to understand and be able to participate in the criminal justice process. An individual may need additional support to understand the questions put to them during an investigation or may lack the mental capacity to plead or stand trial.”

Black, Asian and minority ethnic people are both overrepresented at every stage of the criminal justice system and at comparatively higher risk of mental illness. The report found that there was a lack of services made available to people from such backgrounds.

According to the chief executive of the Race Equality Foundation, Jabeer Butt, said, what is more worrying is that there is “scarcely any evidence” to suggest that those working within the criminal justice system are seeking out much-needed specialist services.

He said: “It’s worrying enough that people from Black, Asian and minority ethnic groups are disproportionately represented in both the criminal justice system and in mental health services. But this report also highlights that despite the work done by the Race Equality Foundation to identify some services available to address the mental health needs of ethnic minority people, there is scarcely any evidence that probation leaders are reaching out to source or access specialist services.

“This is perpetuating a cycle in which ethnic minority communities continue to be denied the tailored support that would prevent them from entering the criminal justice system or needing to use mental health services in the first place.”

The report follows figures released in October from the Ministry of Justice that showed a 47 per cent increase in the rate of self-harm incidents per 1,000 people in the women’s estate on the last quarter.

A particularly grim example came out of HMP Bronzefield, after a new report found that there were on average 220 self-harm incidents a month, compared to 91 two years ago. In June 1021 alone, there were 371 instances.

Women in Prison (WIP), a charity providing support to women affected by the criminal justice system, says the increase is evidence of a “deeply worrying continuation of deteriorating mental health for women in prison” as figures surge for the ninth consecutive year.

“This report is yet another devastating reminder of the overwhelming mental health crisis in women’s prisons,” said Dr Kate Paradine, chief executive of WIP.

“Prison is a dead-end that will never be able to meet people’s mental health needs. Women who are severely unwell are being locked away simply because there aren’t enough beds in mental health facilities.”

The inspectorate also found that delays were also found to be common at every stage of the criminal justice system.

In certain circumstances, inspectors found extremely unwell prisoners were often left in prison instead of being transferred urgently to mental health hospitals. Delays were often caused by a lack of medium and high-security beds; the mental health of these prisoners often further deteriorated as they waited, a concern echoed in comments from legal charity INQUEST.

Deborah Coles, the director, said: “This report makes clear what we have long known: that the criminal justice system is systematically failing people with mental ill health at every stage.

“Imprisonment can in fact create and exacerbate existing mental ill health and increase the likelihood of self-harm and suicide. Time and time again, we have witnessed the trauma experienced by the families of people who die in police or prison custody.

“In the short-term, urgent action is needed to ensure that people in custody have access to appropriate mental health support. In the long-term, it is vital that we end the criminalisation of people with mental ill health, radically reduce the prison population, and holistically invest in our communities.”

Last month, the government announced that £3.5bn in funding would be made available to create 18,000 additional prison places - “the biggest prison-building programme in more than a century.” A further £250m was also promised fund an extra 2,000 temporary prison places.

Commenting on the findings of today’s report, Peter Dawson, director of the Prison Reform Trust said the government need to shift their focus from resource, as the much of the failure instead “stems instead from a “failure to work efficiently across departments.”

He said: “The government repeatedly celebrates the fact that it expects to send more people to custody and is spending £4bn to build new prisons as a result. But this hugely important joint report from six different inspectorates shows that many of the people who will fill those cells will be mentally ill. 12 years on from being given a road map to solve these problems, the government’s progress is exposed as inadequate. Austerity provides no excuse.

“Much of what the inspectors describe stems from a failure to work efficiently across departments rather than a lack of resource. But where resource is an issue, governments still choose to spend on punishment rather than treatment.

“A frantic search is underway for ways in which to accommodate the surge in prison numbers expected as courts work through their backlog. That will mean more people spending 23 hours a day sharing Victorian cells in prisons that should be closed. It will mean more people sent to prison as a “place of safety” despite the overwhelming evidence that such prisons cause mental health conditions to worsen, not improve.

“The solutions are still there, and this latest report lays them out. But they require the government to concentrate its attention and resources on their delivery—a task that pointless ‘tough on crime’ rhetoric only seeks to evade.”

The inspectorates have made 22 recommendations following the publication of the report.

They are also urging police forces, the Crown Prosecution Service, prisons and the Probation Service to work with the government and NHS to improve delivery for people suffering from mental illness in the criminal justice system.

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