Northern Ireland news

Co-ordinated effort needed to improve health and social care services for vulnerable prisoners

Briege Donaghy, RQIA chief executive; Robin Swann, Health Minister; Dr Leanne Morgan, RQIA clinical lead; Professor Siobhan O’Neill, NI Mental Health Champion; Emer Hopkins, RQIA director of improvement.

NORTHERN Ireland prisons have "significant lack" of psychological support for inmates suffering personality disorder and trauma, with long waits for appointments and transfers to acute mental health beds.

An expert review team led by the RQIA (Regulation and Quality Improvement Authority) found services "under considerable pressure, with demand greatly exceeding capacity".

They were called in by the Justice and Health ministers in July 2020 following criticism by the Prisoner Ombudsman for Northern Ireland of the care provided to vulnerable prisoners.

Between 2012 and 2019, a number of prison reports highlighted that the care of vulnerable people in custody required significant improvement.

Northern Ireland has a 25 per cent higher prevalence of mental ill-health than the rest of the UK and many prisoners have "a history of adverse childhood experiences, substance misuse and significant mental illness" requiring additional care and support.

Inspectors found evidence of improved "partnership working and governance arrangements" and said there are "examples of good practice".

They single out for praise health and wellbeing engagement work during Covid-19, the Towards Zero Suicide Initiative and the Supporting People at Risk (SPAR) Evolution approach to supporting people in crisis.

However, the team found a need for improvement in how services are "commissioned, planned and delivered".

They highlighted "long waiting times" for mental health and addiction appointments and transfer to acute mental health beds within hospital" and serious gaps in psychological support for vulnerable and traumatised prisoners.

The team praised prison and healthcare staff for "working with great compassion and dedication to make things better for vulnerable people in custody".

But they warned co-ordinated effort is needed across the criminal justice and health and social care systems for outcomes to improve, stressing success depends on "sustained commitment and deepening partnership... recognising that prisons are not `a place apart' but a part of society".

The review makes 16 recommendations which they say if "fully implemented" would reduce harm to vulnerable prisoners and improve treatment and rehabilitation while reducing reoffending and the risk to "wider society".

The recommendations are advised to be implemented within the next six to 18 months.

However, inspectors acknowledge it will be a "considerable challenge in a highly complex system with limited resources".

Health Minister Robin Swann said it is "important that we all continue to collaborate and work together to improve outcomes for vulnerable people in prison".

Justice Minister Naomi Long said the 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".

"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."

Northern Ireland's Mental Health Champion Professor Siobhan O'Neill said the ministers have assured her they are committed to working together, stressing it is "vital that the report's recommendations are fully implemented".

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Northern Ireland news