AUDIO: Juliet Lyon speaking at Mental Health and Criminal Justice organised by the Centre for Public Policy Seminars

Mental health policy on care in the community has disintegrated into a lack of practical support and neglect. Prisons have had to fill up with petty offenders with complex mental health needs to take up the slack. There are many men, women and children in prison who need healthcare above all else.

Proper investment in court diversion, mental health and drug treatment in the community and secure health provision for those who need it, would lift the burden off untrained prison staff and put a stop to the cruel and unnecessary punishment of jailing vulnerable people."

The use of prison to warehouse people for their mental illness is a criminal use of our justice system, it makes ill people worse and disrupts the rehabilitative work of prisons. If you had to invent a way to deepen mental health problems and create a health crisis, an overcrowded prison, and particularly the bleak isolation of its segregation unit, would be it.

On the wing there was plenty of evidence of behaviour brought on by  mental distress… one young man only ever wore the same pair of jeans and a green nylon cagoule. He never wore shoes or socks, never went out on exercise, hardly ever spoke to anyone and was understood to have been taken advantage of sexually by predatory prisoners. He was in his early 20s with many years in prison still ahead of him. Another had a habit of inserting objects into his body: a pencil in an arm, matchsticks in his ankles.

(Erwin James, foreword to Troubled Inside: the Mental Health Needs of Men in Prison.)

Many prisoners have mental health problems. 72% of male and 70% of female sentenced prisoners suffer from two or more mental health disorders. One in five prisoners have four of the five major mental health disorders.

A significant number of prisoners suffer from a psychotic disorder. 7% of male and 14% of female sentenced prisoners have a psychotic disorder; 14 and 23 times the level in the general population.

Revised figures, collected by the Prison Service in 2005 show that 597 out of every 1,000 women and 50 out of every 1,000 men harm themselves while in prison.

Research suggests that prisoners are twice as likely to be refused treatment for mental health problems inside prison than outside.

In 2002 there were 39,000 admissions to prison health care centres. The Department of Health estimates that about 30% of these, approximately 11,800, were for mental health reasons.

Prison regimes do little to address the mental health needs of prisoners. Research has found that 28% of male sentenced prisoners with evidence of psychosis reported spending 23 or more hours a day in their cells - over twice the proportion of those without mental health problems.

Mental health issues amongst prisoners are often linked to previous experiences of violence at home and sexual abuse. About half of women and about a quarter of men in prison have suffered from violence at home while about one in three women report having suffered sexual abuse compared with just under one in 10 men.

Half of all those sentenced to custody are not registered with a GP prior to being sent to prison.

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