Dáil Éireann Debate, Wednesday - 11 October 2023
22. Deputy Mark Ward asked the Minister for Justice the efforts being made to tackle waiting times for mental health services within prisons; the funding that has been allocated to this within the budget; and if she will make a statement on the matter. [44104/23]
Amharc ar fhreagraI can advise the Deputy that mental health services within prisons are provided by the Irish Prison Service (IPS) and the HSE/National Forensic Mental Health Service (NFMHS) and there are a range of rehabilitative, therapeutic and counselling services available for people in custody.
The Irish Prison Psychology Service is staffed by qualified mental health practitioners and is the largest body of mental health professionals employed directly by the Prison Service. They provide an integrated service to people in custody, working primarily through a layered care model, providing primary, secondary and tertiary level mental health care. They provide access to a variety of responses, from minimal interventions such as whole population approaches with the Red Cross and primary care mental health interventions, to more specialist mental health and personality disorder treatments. The IPS medical and nursing services also provide a primary care mental health service to this vulnerable population. This includes a comprehensive assessment of individuals on committal to prison with ongoing care and treatment as required.
In addition, the HSE / NFMHS provides in-reach psychiatric services to the Irish Prison Service. This direct service includes dedicated Clinical Forensic Consultants, Community Forensic Mental Health Nurses, Social Workers and administrative staff.
The Prison Service collaborate with the NFMHS to ensure the appropriate provision of psychiatric services to those in custody with a psychiatric diagnosis such as schizophrenia, psychosis and major mood disorder in all closed prisons.
In the case of those in custody who are critically ill and require admission to the Central Mental Hospital (CMH) for appropriate treatment in a medical facility, a waiting list is operated by the NMFHS and is reviewed on a weekly basis.
Over the last three years, the number of critically ill people in the care of the Irish Prison Service on the waiting list has varied between 15-25 patients. It should be noted that all prisoners placed by NMFHS consultants on the waiting list have been clinically assessed as warranting admission to the CMH, which is a tertiary care facility.
While the Prison Service have no control on who is admitted to the CMH, it is expected that the recent opening of the new purpose built facility in Portrane will see admission rates increase over time and I can assure the Deputy that officials in the Prison Service are in ongoing active contact with the CMH to try to ensure that people in prison can access the care they need. It is important to note that patients on the CMH waiting list continue to receive care and treatment from the NFMHS and IPS clinical staff.
It is well known that a significant number of people committed to prison have mental health issues and I can assure the Deputy that I am aware that if we address these issues, in conjunction with appropriate post prison supports, we can help people break the cycle of offending.
The Programme for Government commits to considering the mental health and addiction treatment of persons imprisoned and the primary care support provided on release and a lot of work has been done in this area.
The Deputy will be aware that, in a joint approach with my colleague the Minister for Health, the report of the High Level Taskforce considering the mental health and addiction challenges of people interacting with the criminal justice system was published in September 2022.
In addition, the report on the Health Needs Assessment for the Irish Prison Service, the first comprehensive health assessment undertaken for the Prison Service, was also considered by the Government and published in May this year.
Taken together, these important and comprehensive pieces of work represent a coherent and whole-of-system approach to addressing offender behaviour, providing rehabilitative and mental health supports, and managing the prison population in a considered and planned way.
The Prison Service continually endeavour to provide more effective ways of working to reduce the waiting lists for psychology by proactively reducing the time spent doing assessment, and in turn are increasing the amount of time allocated to intervention. This includes the fast track of prisoners into certain interventions directly from referral based on file review and consultation with the multi-disciplinary team.
It also includes the introduction of rolling groups in order to improve access to psychological therapy.
In addition, the Prison Service have developed 1-day workshops that now run weekly in the Prison schools on specific topics, and workbooks that can be accessed in the Prison school, encouraging more to get involved with Psychology Services.
I can also advise the Deputy that in Budget 2023, additional dedicated funding of €970K was secured to increase the number of psychologists employed by the Irish Prison Service. This year, under Budget 2024, I have secured an additional circa €27 million for the Irish Prisons Service budget. This includes approximately €9m in staffing to provide for increased pay roll costs, recruitment of staff, and for 65,000 additional hours to deal with current pressures.
