PRISONERS who are severely mentally ill are sometimes waiting months to be transferred to hospital due to problems such as bed shortages, a report has found.
Inspectors from the Mental Welfare Commission (MWC) Scotland found that one inmate who was "severely and acutely mentally ill" had spent more than 45 weeks in segregation for their own safety, and had been waiting 14 weeks for an inpatient psychiatric bed at the time of their visit in 2021 despite requirements prisoners in this condition be transferred to hospital "without delay".
The MWC said segregation - where mentally unwell prisoners are isolated in their own cell or in a separation and reintegration unit (SRU) to protect themselves and others - should be a "last resort".
It said it "would not expect mentally ill prisoners to be managed in segregation for extended periods of time".
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However, its report, published today, said care had been delayed due to "disagreement between forensic mental health services about the level of security this person required and a lack of available beds in the units where referrals had been made".
The individual was eventually admitted to hospital one month later, and had "significantly improved" within six weeks.
They were one of three prisoners awaiting a hospital transfer at the time of the inspections in 2021, with one other inmate waiting "several weeks for a bed" and a third, who had been referred to medium secure care following more than three months in a segregation unit, had been waiting around a week.
Previous research estimated that the average wait for an urgent transfer is just over 11 days due to factors such as bed availability, disputes between local authorities and health boards over the correct catchment area, and disagreements over the level of security required.
The MWC's 74-page report follows visits to all 15 Scotland's prisons to evaluate how mental healthcare of inmates has improved in the past 10 years.
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Chief executive Julie Paterson said "little has changed" in relation to mental health outcomes for prisoners, with suicide rates nearly three times higher than for the general population.
A majority (77 per cent) of prison staff interviewed for the report said they had concerns about the provision of mental health support within the prison, and almost all said they were worried about the deterioration in mental health among inmates during the pandemic when visits from friends and family were curtailed.
This had led to an increase in self-harm and drug use, they said.
Of the 107 prisoners interviewed, 81 reported having drug or alcohol addictions.
Three quarters (76%) of prisoners had a history of mental illness.
Suzanne McGuinness, executive director of social work for the MWC said: “Scotland has one of the highest rates of imprisonment in Western Europe, and the majority of people arriving at prison reception have a history of mental ill health.
“Suicides in prison remain a serious concern in Scotland.
“While we found some good practice, our overwhelming impression was of a prison population which is under served and under resourced.
"Our key messages of 2011 have not been realised 10 years on, and the anticipated improvements of health care responsibilities being transferred to NHS Scotland have not materialised.”
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A spokesman for the Scottish Prison Service said: "We know that people in custody present higher levels of risk and vulnerability than the general population as a whole and often have complex mental health needs.
"Our front line prison officers and NHS staff work extremely hard every day to provide appropriate care and support to those in our care.
"SPS will give careful consideration to all the recommendations and is committed to working collaboratively with NHS partners and the Scottish Government."
Kevin Stewart, minister for mental wellbeing, said: “This report highlights the importance of mental health support in custodial settings. It contains a number of recommendations that will be given careful consideration.
“Our Mental Health Transition & Recovery Plan published in October last year, backed by our £120m Recovery and Renewal Fund, made clear our commitment to continue to work with partners to seek better support for those with mental ill health within the criminal justice system.
“In addition, we will continue to work with the Scottish Prison Service and other partners to ensure that they receive full support from the Scottish Government in order to fulfil the recommendations and that frontline staff are properly supported.”
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