WATCH: Mental health services for vulnerable prisoners in NI "far exceeding capacity"

By Q Radio News

A review of health services for vulnerable prisoners at risk of suicide or self-harm has found further improvement is needed for the system that is "under pressure considerable pressure".

In July 2020, Stormont's Justice and Health Ministers commissioned RQIA to review services following criticism of care by the Prisoners Ombudsman. 

An Expert Review Team found some areas of improvement in partnership working and governance arrangements and examples of good practice, such as health and wellbeing work during covid-19, the Towards Zero Suicide Initiative and the Supporting People at Risk (SPAR) Evolution approach to helping those in crisis. 

However, the panel also highlighted the services are under severe pressure with demand greatly exceeding capacity. 

There are long waiting times for mental health and addiction appointments and for transfer to acute mental health beds within a hospital.

A significant lack of psychological support for people with a history of personality disorder and trauma was also outlined. 

While many prison service and healthcare staff are already working with compassion and dedication to improve things for vulnerable people in custody, the review found more of a co-ordinated effort is needed across the Criminal Justice and Health and Social Care Systems. 

The expert panel has made 16 recommendations which could support better outcomes for vulnerable prisoners if implemented. 

They include the avoidance of harm; better prospects for treatment and rehabilitation; reduced reoffending; and reduced risk to wider society. 

Dr Leanne Morgan, RQIA Clinical Lead who was involved in the review, said they spoke with prisoners and prison staff to hear their thoughts on the issue. 

Both the Health and Justice Ministers have welcomed the review. 

Health Minister Robin Swann said, “We welcome the review undertaken by the Expert Panel, and along with the HSC Board, South Eastern Trust, Department of Justice and the NI Prison Service will consider the recommendations arising from this report, and produce an implementation action plan.

"It’s important hat we all continue to collaborate and work together to improve outcomes for vulnerable people in prison.”

Health Minister Robin Swann

Justice Minister Naomi Long added: “This review was jointly commissioned by the Departments of Justice and of Health in response to concerns about how best to keep vulnerable prisoners safe when in the care of the Prison Service.

"RQIA’s report provides an insight into the challenges faced by people in custody and the staff who provide care and support to vulnerable people in
prison on a daily basis.

“While it highlights a need for improvement in how services are planned and delivered, as well as a need for a co-ordinated effort across the criminal justice and health and social care systems, it also recognises the commitment of prison staff as they seek to meet the needs of some of the most complex, challenging and vulnerable members of our society.

"The Department of Justice will take into account RQIA’s findings and recommendations, and we will work with the Department of Health to oversee its implementation.”

Justice Minister Naomi Long 

Commending this review, Professor Siobhan O’Neill, Northern Ireland’s Mental Health Champion said: “I am assured of their commitment to work together to improve the outcomes for prisoners with mental health issues.

"The report identifies the need for a government-led strategy, accompanied by additional funding, to deliver interventions and support for people in the care of the prison system who have suicidal thoughts and behaviours. It is vital that the report’s recommendations are fully implemented.”

Briege Donaghy, Chief Executive of RQIA, concluded: “RQIA is committed to monitoring the care provided to people in custody, as part of its statutory role.

"We will work in partnership with the Criminal Justice Inspectorate, and with the skilled and dedicated staff in the Northern Ireland Prison Service and in the Health and Social Care system to make sure that services are improved for these particularly vulnerable people.”