Mental health problems in the prison population have long been a matter of concern. Suicide rates in prisons in England and Wales are at an all-time high; a record 119 people killed themselves in 2016 – an increase of 29 on the previous year, according to figures from the Ministry of Justice. The rise in prison suicides has been accompanied by a 23% increase in incidents of self-harm, to a total of 37,784.
“It’s a huge issue because lots of people in prison have mental health problems,” says Dr Steffan Davies, consultant forensic psychiatrist and co-chair of the Community Diversion and Prison Psychiatry Network at the Royal College of Psychiatrists. A study by the Prison Reform Trust found that 72% of male and 70% of female prisoners experience two or more diagnosable mental health disorders. Research by the National Institute for Health and Care Excellence found that 7% of male and 14% of female prisoners have a psychotic disorder – 14 and 23 times the level in the general population respectively.
The situation looks set to get worse. In recent years, staff numbers have dropped significantly, budgets and staff training have been cut, the prison population has more than doubled, and the introduction and rising use of new psychoactive substances has contributed to increasing violence.
Jacob Tas, chief executive of the social justice charity Nacro, says: “The overcrowded prison environment is likely to worsen existing mental health problems that are often the key drivers for offenders to commit further crimes or become violent while in prison.”
Davies adds: “It does feel like things are getting worse and I’m hearing it’s hard to recruit people to prison mental health services. People are leaving, and quite a few find it an extremely stressful environment to work in.”
While the general outlook is bleak, projects such as the self-management training programme at HMP & YOI Parc, Bridgend, south Wales, hold out some hope. Developed as a partnership between the Mental Health Foundation and G4S, and funded by Big Lottery Fund Cymru, the aim was to improve prisoners’ mental health through self-management and peer support.
The programme was delivered between September 2013 and December 2016, and involved two to three hours’ training one day a week for four weeks. Up to 10 participants could attend. Training included positive thinking, goal setting and problem-solving.
Fifty prisoners filled in the Warwick-Edinburgh mental wellbeing scale at the start of the course and a month after its completion: the mean score showed a significant increase in the prisoners’ wellbeing.
Lauren Chakkalackal, senior research officer at the Mental Health Foundation, says: “A number of positive stories came from the project. It was an opportunity for people to feel listened to and express how they were feeling.
“A group of prisoners produced resources to better support the mental health needs of new prisoners. The prisoners themselves took ownership of that group.”
Plans are afoot to develop similar models in other prisons and the project is being redesigned to support older prisoners and young offenders.
Signs of hope in the prison mental health crisis
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