In its commissioned report in 2005 for the National Offender Management Service (NOMS) and Pathfinder Cymru, Hafal stated unequivocally that ‘people with severe mental illness should not be held in prison at any stage’.
In 2006-07 the Welsh Affairs Committee conducted an inquiry into ‘Welsh Prisoners in the Prison Estate’. It heard considerable evidence on mental health in prison, demands on prison staff and the difficulties in moving people from prison into health units.
Carol Moore, Chief Officer of the North Wales Probation Service, described mental illness as “the invisible part of the system” and other witnesses were clear that individuals with severe and enduring mental health problems should not be in prison, an issue that was acknowledged by the Minister. The problem was acknowledged by NOMS:
In terms of transfers we have been stepping it up so that the proportion of people who are mentally ill, who are transferred out of the prison estate to hospitals has increased by about 24% between 2002 and 2005, but there is still much more to do; we all recognise that.
The All Party Group on Children in Wales told us that mental health services for all prisoners in Wales, both for adults and children, are inadequate and that provision of Child and Adolescent Mental Health Services (CAMHS) in the community had for some time been of concern to the Children’s Commissioner for Wales. Children and young people in custody often have serious and complex needs:
Many children and young people within the young offender institution (YOI) have learning difficulties, require CAMHS service, have a history of child abuse, drug misuse and emotional difficulties and are therefore very vulnerable children. There are concerns about the numbers of young people who have committed suicide in YOI.
The Committee also noted that:
There are high levels of self-harm and suicide in some female prisons, including those that house women and girls from Wales. Seven women have taken their lives at HMP Eastwood Park since 2000 and at HMP Styal the deaths of six women over a 13-month period prompted the Government to commission Baroness Corston to review the adequacy of initiatives to address the problem. Levels of mental distress reflect the vulnerability of many female offenders, the fact that many have children from whom they are separated, and that many are imprisoned a long distance from home.
However, the evidence we heard left us with the impression of a prison system that is poorly equipped to cope effectively with these high levels of need. Despite high levels of self-harm in prisons holding Welsh women and girls we heard from Nacro that there is “limited access to specialist interventions for mental health treatment” and that some mental health practice is inappropriate.
The committee recorded two distinct recommendations on reforming the response to women who offend:
Imprisonment far from home harms both female prisoners and their children. We recommend that new custodial centres for women be provided in Wales of the smaller, community-based type recommended by Baroness Corston. As a minimum, two such units should be established, one in North Wales and one in South Wales. However, the greatest demand for secure accommodation for women is in South Wales and it is here that priority should be given to such provision.
We also recommend the development of a network of locally-based residential women’s centres as proposed in the Corston report, to address the needs of those women serving shorter custodial sentences, those on remand, and those for whom stable accommodation is a condition of sentence. Such centres would also provide resources for women serving community sentences.
The Welsh Affairs Committee concluded its section on mental health thus:
In the context of the outcomes of the review of secure mental health services in Wales we recommend that NOMS works with the Welsh Assembly Government to ensure that arrangements are in place to effect the speedy transfer of Welsh prisoners with severe mental health problems to secure units as appropriate. Where there are cross-border issues for Welsh prisoners held in English prisons which relate to policy or to operational differences in mental health services, these should be resolved as a matter of urgency.