Thousands of mentally ill people are in prison after being failed by every part of the criminal justice system, a comprehensive multi-inspectorate report has found.
Six regulatory bodies have concluded that people with suspected mental health issues across England and Wales are offered poor support if they are arrested, prosecuted, incarcerated or placed on probation.
HM Inspectorate of Constabulary and Fire & Rescue Services, HM Crown Prosecution Service Inspectorate, HM Inspectorate of Prisons, HM Inspectorate of Probation, the Care Quality Commission and Healthcare Inspectorate Wales found:
Unacceptable delays in psychiatric reports for court and in transferring extremely unwell prisoners into secure mental health hospital beds for treatment.
A “broken” system for sharing information between agencies.
Confusion over data protection rules and incomplete and inaccurate records.
A shortage of services and long delays to access them, made worse by the Covid-19 pandemic.
About a third of people in police custody have some form of mental health difficulty, as do 48% of men and 70% of women in prison.
Inspectors drawing up the 107-page report examined more than 300 cases from six regions, interviewed 550 professionals, and heard from 67 people with mental health problems who had been through the criminal justice system.
Commenting on the report, the chief inspector of probation, Justin Russell, said not enough progress had been made since the last joint inspection by the bodies 12 years ago.
“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,” he said.
Inspectors found extremely unwell prisoners were often left in prison instead of being transferred urgently to mental health hospitals.
Women in particular were placed in prisons as a “place of safety” if they were experiencing a mental health crisis, including suicidal feelings, the report said. “Senior managers at one women’s prison counted 24 such incidents in the previous 12 months; these cases involved extremely vulnerable women being remanded in prison as a last resort, as suitable alternatives could not be accessed. We believe that prisons should not be used as a place of safety – it is inappropriate and inhumane,” the report said.
Delays were often caused by a lack of medium and high-security beds, the report found, while the mental health of prisoners deteriorated as they waited.
The report concluded that a lack of a common definition of mental ill health meant there was an inaccurate picture across the criminal justice system.
Probation practitioners told the inspectors their work was hindered because community mental health services would not allow them to access information, despite the fact these requests are lawful.
The inspection found delays were common at every stage of the criminal justice system. Courts faced long waits for psychiatric reports, used to make sentencing decisions.
The shortage of good-quality mental health provision also led to “unacceptable delays” for individuals accessing services.
Russell concluded: “Criminal justice agencies need to make major improvements to the way they work with people with mental health issues. The inspectorates have made 22 recommendations following our joint inspection. We urge police forces, the Crown Prosecution Service, prisons and the probation service to work with the government and NHS to improve delivery for people with mental health issues in the criminal justice system.”