Figures released today (Monday 8 May) by the Prison Reform Trust to mark the start of Mental Health Awareness Week (8–14 May) reveal that our overcrowded and overstretched prisons are struggling to meet the needs of the high numbers of people in their care with a mental health need or learning disability. Rising levels of self-inflicted deaths and record numbers of self-harm incidents point to the urgent need for the next government, whatever its political complexion, to address the decline in safety and standards in our prisons and to increase support in the justice system for vulnerable defendants.
The latest figures on mental health need and learning disability in the justice system reveal that:

  • 46% of women and 21% of men in prison have attempted suicide at some point, compared to 6% of the general population.
  • 25% of women and 15% of men in prison have symptoms indicative of psychosis, compared to 4% of the general population.
  • 49% of women and 23% of men in prison are identified as suffering from both anxiety and depression, compared to 15% of the general population.
  • 20–30% of offenders have learning disabilities or difficulties that interfere with their ability to cope with the criminal justice system.
  • 7% of prisoners have an IQ of less than 70 and a further 25% have an IQ between 70 and 79. 
The start of Mental Health Awareness Week follows the publication at the end of April of grim official figures which reveal record levels of self-harm incidents and a rising number of self-inflicted deaths behind bars. The latest safety in custody statistics show that:
  • There were 113 self-inflicted deaths in the 12 months to March 2017, up 11 on the previous year. 10 of these deaths were in the female estate.
  • The rate of self-inflicted deaths has more than doubled since 2013.
  • Self-harm reached a record high of 40,161 incidents in the 12 months to December 2016, up 7,848 from the previous year.
  • The number of incidents requiring hospital attendance rose by 21% to 2,740.
Last week, the Joint Committee of Human Rights (JCHR) published a report on mental health and deaths in prison. The report, to which the Prison Reform Trust submitted written evidence, called for a legal framework to be introduced in the next parliament, including a mechanism to hold the Secretary of State accountable for reducing overcrowding, to help ensure the needs of people with a mental illness are recognised and met.
Responding to the JCHR report, Professor Pamela Taylor, Chair of the Royal College of Psychiatrists forensic faculty, called on the next government to bring forward legislation to alleviate “what is now a mental health crisis in prisons”. She said that the courts were repeatedly missing opportunities to divert those with serious mental health problems away from prison, with only 391 people receiving a community-based mental health treatment order last year—nearly half the number 10 years ago.
In his influential 2009 report on meeting the needs of people with mental health needs and learning disabilities in the criminal justice system, the former health minister and PRT trustee Lord Bradley called for the roll out of a national liaison and diversion service in police stations and courts. Liaison and diversion services help people with mental ill health, learning disabilities or autism get the right care in the right place, supporting work between the police and health and social care. They can help ensure fair access to justice, limit the number of court hearings, and avoid costly adjournments and periods on remand. Where appropriate, vulnerable people can be diverted away from the criminal justice system into treatment and care.
With the backing of policymakers and senior figures from across the political spectrum, liaison and diversion services now cover over 50% of the population in England. In 2016, the Conservative government committed to funding the extension of liaison and diversion services to 75% of the population of England by 2018, with anticipated roll out to 100% of the population by 2020, subject to evaluation.
Commenting, Peter Dawson, Director of the Prison Reform Trust, said:
“These grim figures highlight the urgent need for the next government to address the rapid decline in safety and standards in our prisons, and to deliver on the cross-party commitment to provide timely support for people with mental health needs and learning disabilities in contact with criminal justice services, including when appropriate, diversion into healthcare. We hope all political parties will use the opportunity of Mental Health Awareness Week to recommit to this vital task.”