Dáil Éireann Debate, Tuesday - 13 December 2022
511. Deputy Mark Ward asked the Minister for Justice if data are collected on the number of persons who have mental ill-health, addiction issues or disabilities, including intellectual disabilities, within the prison system and the Central Mental Hospital; and if she will make a statement on the matter. [61983/22]
Amharc ar fhreagraI have sought the information requested by the Deputy from the Irish Prison Service, however, the information was not available in time. I will write to the Deputy once the information is to hand.
The following deferred reply was received under Standing Order 42A
I have sought the information requested by the Deputy from the Irish Prison Service, however, the information was not available in time. I will write to the Deputy once the information is to hand.
SUBSTANTIVE ANSWER:
I refer to Parliamentary Question No. 511 for written reply on 13th December 2022 requesting
the number of persons who have mental ill-heath, addiction issues or disabilities, including intellectual disabilities within the Prison System and requesting a statement on the matter.
As you will recall, the information you requested was not readily available at that time and the then Minister for Justice, Heather Humphreys T.D., undertook to respond to you as soon as possible with the relevant information.
I am advised by the Irish Prison Service that prison clinical record systems do not collate information in the format requested by the Deputy but relevant information is provided in the narrative and tables below.
The healthcare and psychological records of patients in the custody of the Irish Prison Service are recorded on an individual patient basis on the Prisoner Healthcare Management System (PHMS) and Psychology Case Tracking System (PCTS) respectively. Each prisoner’s individual record is recorded in a narrative fashion and as such it is not possible to extract a global report from PHMS or PCTS to produce a summary of medical or mental health difficulties for which people have received medical or psychological treatment or support.
I am further advised that Mental Health Services in prisons are provided primarily by Healthcare, in-reach psychiatric and IPS psychology services. In-reach mental health services are made available to individuals in custody through collaboration with the Health Service Executive, and the National Forensic Mental Health Service (NFMHS). The NFMHS has confirmed that the current caseload includes up to 350 patients who are ordinarily in the custody of the IPS. The HSE is responsible for the collation of relevant statistical data in this area.
The Prison Service has access to a limited number of beds in the Central Mental Hospital (CMH) for prisoners suffering from a severe mental illness who require residential mental health treatment. A waiting list for the admission of prisoners to the CMH is operated by the NFMHS and is reviewed on a weekly basis. I understand that all prisoners on the waiting list have been clinically assessed by Consultant Forensic Psychiatrists from the NFMHS as requiring admission to the CMH which is a tertiary care facility.
The Irish Prison psychology service is a national service and the largest body of mental health professionals working in prisons, employed directly by the Prison Service. At any one time approximately 2,000 or 50% of the prison population are working with, or on the waiting list for psychological assessment and intervention. In 2021, the psychology service received 1,854 referrals and approximately 66% of these were in relation to mental health (including 268 referrals to the Psychological First Aid help line which was open during Covid-19 outbreaks).
Prison Service psychologists work with people who experience the full spectrum of mental health difficulties, from primary care mental health difficulties, right through to those who meet the criteria for secondary and tertiary care mental health services. Psychologists provide talking therapy rather than medication prescription. Clinical/Mental health presentations routinely assessed and intervened with by the IPS psychology service include: mood and anxiety disorders; personality difficulties; post-traumatic stress disorder (PTSD); complex PTSD; self-harm; suicidal ideation; eating disorders; psychosis and schizophrenia, and addiction. In addition, the service works with people presenting with autism, foetal alcohol syndrome, intellectual difficulties, attention deficit hyperactivity disorder, cognitive decline (including dementia) and traumatic brain injury.
I am further advised by the Prison Service that it provides a health care service for prisoners with addictions in a structured, safe and professional basis in line with international best practice. The Prison Service continues to be committed to, and predominantly involved with, the National Drugs Strategy in partnership with community colleagues and organisations.
The Prison Service advise me that approximately 70% of prisoners who are committed to custody have difficulties associated with addiction to substances. It is the policy of the service that, where a person committed to prison gives a history of opiate use and tests positive for opioids, they are offered a medically assisted, symptomatic detoxification, if clinically indicated.
Patients can, as part of the assessment process, discuss other treatment options with healthcare staff; those treatment options may include stabilisation on methadone maintenance for persons who wish to continue on maintenance while in prison, and when they return to the community on release. I am further advised that while drug treatment services are provided in all closed prisons, the same type of programmes are not offered in open prisons as a condition of transfer to an open prison is that the prisoner is drug free.
The HSE compiles statistics listing numbers of prisoners throughout the prison estate who are in receipt of methadone and records these statistics on the Central Treatment List, the data in respect of the number of prisoners treated in 2022 is provided in the table below.
In line with the National Drug Strategy, the Prison Service has an agreed protocol with the HSE for the seamless transition of prisoners engaging in drug treatment while in custody to community drug treatment settings.
Central Treatment List for period 01/01/2022 to 31/12/2022
|
Prison |
Number of Patients Treated |
|
Castlerea |
11 |
|
Limerick |
74 |
|
Cork |
119 |
|
Wheatfield |
128 |
|
Cloverhill |
204 |
|
Midlands |
207 |
|
Portlaoise |
13 |
|
Dochas Centre |
179 |
|
Mountjoy |
76 |
|
Total |
1,011 |
In addition, the Prison Service engages Merchants Quay Ireland (MQI) to provide a prison-based addiction counselling service. This service includes structured assessments and evidence-based counselling interventions, with clearly-defined treatment plans and goals.
MQI counsellors work to address presenting issues and to explore the underlying reasons for drug use and how this impacts on the prisoner and wider community.
In respect of information on prisoners with disabilities, I can advise that all prisons perform committal interviews, both nursing and medical, to assist in capturing information relating to physical and mental disabilities, including intellectual disabilities. This allows relevant supports to be put in place to help the person adjust to the prison environment. This could include a range of supports as a wheelchair or specific referral to ongoing HSE supports.
Further and related to the recommendations of the High Level Task Force to consider the mental health and addiction challenges of those who come into contact with the criminal justice sector and the implementation of the Department of Health Policy, Sharing the Vision, the Prison Service are currently developing an initiative to capture additional information relating to mental health and addiction across the Irish Prison Service estate. This initiative is being developed in partnership with the HSE and will involve the study of mental health conditions and intellectual disability across the prisoner population.
Statistics as provided by Merchants Quay Ireland for 2022 are as follows:
There were 2,126 unique clients seen in 2022.
|
Counselling Services |
9,017 |
|
Brief Interventions |
2,505 |
|
Group Attendances |
814 |
|
Assessments |
905 |
|
Total interventions for 2022 |
13,241 |
The Deputy may also find the Irish Prison Service Annual Report for 2021 which is published on the Gov.ie website and which covers the Irish Prison Service Psychology Service of interest.
I trust this is of assistance.
______________________
Simon Harris, T.D.,
Minister for Justice
