THE Prisoner Ombudsman says there is a "need to ensure that individuals in custody receive the best possible healthcare" following an investigation into the death of a Co Derry man in jail.
Dr Lesley Carroll raised concerns that "individuals with significant addictions, anxiety and depression find themselves in custody" as she published her report into the death of James Fleck (24) from Kilrea in March 2019.
He died in hospital after being found unresponsive in his cell at Maghaberry Prison, a day after he was remanded into custody. He had a history of anxiety, depression, self-harm and long-standing drug dependency and had been in custody eight times in the last five years of his life.
After being brought to Maghaberry, he was identified as being at risk of self-harm or suicide and during his first night of custody in an observation cell was monitored by prison officers every 15 minutes.
He was moved to a regular cell and observed every 60 minutes with prison staff later increasing the frequency to every 30 minutes.
The following day he was found unresponsive. Medical care was carried out and he was transferred to hospital, but died five days later.
A clinical reviewer found the care provided by prison staff was equivalent to what he would have received in the community and the emergency response was well delivered and in line with resuscitation guidelines.
Speaking on the publication of her report, Dr Carroll said: "I am concerned that individuals with significant addictions, anxiety and depression find themselves in custody.
"The fact that Mr Fleck was in prison is a matter for the courts.
"And yet, he is not alone in returning to prison on a number of occasions while continuing to be medicated for anxiety and depression and in need of addiction services."
She referred to concerns she had raised in August 2020 about adequate information being shared between community and prison healthcare and between services working within prisons.
"We need to ensure that individuals in custody receive the best possible healthcare and to deliver this there needs to be alternative models of care which are informed by the death in custody investigations into Mr Fleck’s death and others," added Dr Carroll.
"I am supportive of the approach taken by the Regulation Quality and Improvement Authority in its 2021 'Review of Services for Vulnerable Persons Detained' in NI Prisons, however, I am deeply concerned that the resources required will not be made available given the current demand on resources and the inertia in decision-making without an Assembly at Stormont."
NI Prison Service Director General Ronnie Armour noted the ombudsman concluded Mr Fleck was assessed as being at risk and received the necessary healthcare support.
Mr Armour added that Dr Carroll also highlighted the addiction and mental health issues many people have when they entire prison.
"In our three prisons we have almost 1,800 individuals, with over 30% having mental health issues and over 50% with addiction issues," the director general said.
He added: "The pressure faced by doctors, nurses, and prison staff should not be underestimated. Collectively we are doing everything we can to support those in our care who are in crisis, but as the RQIA has stated, prison healthcare needs to be properly resourced to meet the increasing demands.”