15 February 2017
Community over custody
Those who end up in custody with mental health issues are often not criminals; they are human beings let down by a failing mental health system. Our work delivering emotional health and wellbeing support across the social welfare cycle only serves to highlight the need to address mental health within our communities from childhood.
School age is when we have a responsibility and obligation to get this right; to support young people to be all they can by recognising difference, understanding how to approach any underlying conditions and, thus, developing a strengths based approach that promotes self-worth and achievement. By doing this from an early age, we can prevent many of the mental health issues we see in the criminal justice system. Where there are existing mental health needs in prisons, there should be a focus on early intervention, building the right and trusted relationships around an offender, and effective multi-agency working within and outside the prison walls.
Joined up working
We believe that prisons should be places of rehabilitation that create social value. At their heart, they should take some of the most challenging people in society and, through judicious use of resources and support, turn them from liabilities into assets. People should be treated as individuals with mental health needs first and foremost, and treated in a community setting where possible. Where custody is necessary, mental health issues should be identified at the outset and appropriate, intensive support provided.
To make this happen, the right kinds of mental health provision need to be implemented throughout the criminal justice process, from pre-sentencing through to release. There needs to be more widespread use of Liaison and Diversion, offenders who are identified as having mental health, learning disabilities, substance misuse or other vulnerabilities can be referred straight away to an appropriate treatment or support service. Rehabilitation does not end at the prison gate and so, when a prisoner is released, there should be appropriate fast track referral pathways from prison to community mental health teams.
The need for relationship based working
The review found that staff shortages impacted on safety and were perceived by staff to be contributing to all of the challenges faced by prisons. Of course, safety and security are paramount but they can only be achieved by creating the right environment and regime, a regime which understands the wider issues and needs surrounding an individual prisoner – particularly mental health. It is not as simple as increasing staff numbers alone.
High prison head-counts coupled with the high turnover of new, often inexperienced, short-staffed and busy officers mean that signs and indicators of self-harm or suicidal ideation go unnoticed. Fostering trusted relationships between staff and inmates is vital to lowering the risk of violence and suicide. But staff challenges are not limited to recruitment, retention and shortages. As the review found, training for nurses and officers alike was lacking. Mental health awareness and first aid should be mainstreamed across prison staff. Prisoners have both diagnosed and undiagnosed issues, as well as dual diagnosis. Specialist Dual Diagnosis Nurses should be able to manage and spot substance misuse and mental health conditions simultaneously when an individual reaches prison.
At Catch22, we believe that the role – and public perception – of the prison officer needs to be reimagined. From being perceived as ‘turnkeys’, prison officers must now be seen as the highly trained, relationship based case workers that they often are. Their role should be to build strong and supportive relationships with the inmates under their care; to understand and unlock their potential, to build a rehabilitative and safe environment through close work. It is through such relationships that subtle changes in behaviour will be noticed as well as potential suicidal ideation amongst inmates.