First steps towards a mentally healthier justice system?

8 November 2023
By Andy Bell

Overcrowding in prisons in England and Wales has brought the justice system back into political focus over the last couple of months. As the number of prisoners rises and reaches beyond the capacity of the estate to cope, it’s become clear that the system is in urgent need of reform.

Nine out of ten people in prison in England and Wales have at least one mental health problem. And according to our research, one prisoner in seven is in contact with a mental health service in England. So a crisis in the prison system is, inevitably, also a mental health crisis. That’s already evident in the large numbers of people in prison who self-harm or attempt to take their own lives, and the numbers of people who are waiting for a transfer to hospital for urgent treatment.

The Government recently announced steps to deal with the crisis, and in the process instigate reform longer term. Justice secretary Alex Chalk set out his plans, many of which are very welcome, to respond to the crisis.

A very welcome first step is to discourage the use of remand or custodial sentences when they are not necessary. Remand prisoners are especially at risk of mental health problems. And short prison sentences can do enormous harm to people’s health and relationships, but without much chance of rehabilitation. While government has fallen short of ending the use of short prison sentences, it plans to introduce a presumption against their use following the King’s Speech, putting a greater emphasis on the use of community sentencing options.

To achieve this, we’re going to need investment in probation services, and alongside them the provision of vital mental health, alcohol and drug services, so that people get the necessary support alongside their community sentence. There is evidence that providing mental health treatment within a community sentence is effective and can make a real difference.

It’s therefore worrying that the Government is also putting more money into extra prison places – spending that cannot then be used to boost community services and that risks further inflating the numbers of people who find themselves in custody. And suggestions of sending prisoners abroad are deeply worrying and risk causing even greater harm.

In response to the current crisis, the Government also plans to release some prisoners early. We know from research that unplanned and unpredictable releases from prison can lead people into a crisis situation. Support ‘through the gates’ makes a big difference to prisoners’ chances of building better lives when they leave.

More positively, the Justice Secretary has pledged to review the legacy of Imprisonment for Public Protection that leaves people in prison well beyond their terms, more than a decade since they were abolished, or on licence at risk of being returned to custody. We know that people on IPP sentences have very high levels of mental distress, many of them ending up in hospital as a result. Action to put the era of IPP to an end cannot come soon enough.

These recent announcements offer a tentative few steps towards a mentally healthier justice system. Bigger steps may yet be needed, however. Too many women still get sent to prison despite presenting little risk to public safety. This causes lasting damage to them and their children. Prisons remain inherently unsafe places, where mental health services struggle to meet high levels of complex need among prisoners. And too many people leave prison facing uncertainty about what life holds for them next.

It is also profoundly disappointing that the Government has chosen not to proceed with reform to the Mental Health Act this year. A new Mental Health Act could have created a 28-day maximum waiting time for hospital transfers and repealed outdated 1976 Bail Act powers to imprison people for their own protection. Failing to take these vital steps will leave vulnerable people in prison when it is not safe or therapeutic for them to be there.

Long-term reform is vital beyond the current crisis. This must include support for robust community sentencing, where it is known that these result in less reoffending than short custodial sentences. Expanding the promising Community Treatment Requirements (optional part of a community sentence) programme needs to be part of this.

Too often people in prison are forgotten and ignored by policymakers unless the system is struggling. This is a chance to make changes that build a more robust, healthy and safe justice system for the future.

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