Mental health in prisons

The available evidence suggests that people in prison are more likely to suffer from mental health problems than the general population, though there is no up-to-date data on the number of people with mental illnesses in prison. 

Health services in prisons in England are commissioned by NHS England, with one or multiple providers commissioned for individual prison sites. The Health and Justice budget (covering prisons, secure facilities for children and young people, police and court Liaison and Diversion services and immigration removal centres) is around £503 million. [NHS England, Health and Justice]

Current providers, as commissioned by NHS England, are a mix of private providers and NHS trusts and foundation trusts. Most prisons have a single provider for all healthcare, rather than a particular provider for mental health services. The intention of this commissioning approach is to provide integrated, joined-up services within a prison.  

In Wales, prison healthcare is commissioned by local health boards. Partnership Boards, chaired jointly by chief executives of the boards and governors of the prisons, have responsibility for the governance of prison health services. [NHS Wales, Partnership Working with the Prison Service]

For prisoners whose mental health needs require treatment in hospital, they can be transferred to a secure hospital under powers in the Mental Health Act 1983 (as amended). There is a Government target that prisoners should wait no longer than 14 days for transfer to a secure hospital. As of November 2017, 24% of secure hospital transfers that had taken place since 2016 had taken longer than 14 days. 

Reports last year from the Public Accounts Committee, National Audit Office and the Joint Committee on Human Rights all raised concerns about the mental health of those in prison. The reports highlight a lack of data about those in prison with mental health problems and note the impact of poor prison environments, lack of prison staff and the prevalence of drugs within prisons on prisoners’ mental health.