The Mental Health Services & Supports in Prisons: Service Mapping and Reflections from Lived Experiences report, published yesterday, highlights the need for increased funding to support prisoners experiencing mental health difficulties and addiction issues.

The study draws on survey data, focus groups and interviews with 21 prison staff across nine prisons, including prison officers, psychologists, nurses, and GPs. A total of 12 men across five prisons took part in one-to-one interviews.

Fiona Coyle, CEO of Mental Health Reform, said: “This research sought to better understand the mental health services and supports available to adults in closed prisons, including the pathways to accessing these resources and potential barriers.

“More than 4,500 people are currently detained in the Irish Prison Service. There is a high rate of mental health difficulties among the Irish prison population. Many individuals are severely affected by loneliness, drug misuse and overcrowding.

“Our national mental health policy commits to offering a range of tiered supports to people in the prison system including social supports, primary care, and specialist mental health services. Findings indicate that once accessed, mental health services can be a vital lifeline for prisoners who are experiencing addiction issues and poor mental health.

“The report demonstrates the impact of low-level supports such as psychoeducation workshops and addiction support groups which can reduce stigma for prisoners with mental health needs. Findings also highlight the crucial role of the voluntary and community sector which provides a range of supports to prisoners including listening services, mental health promotion, and addiction counselling.”

She continued: “Despite recent progress in the prison system, individuals still face challenges in accessing mental health care. Staffing shortages, long waiting lists and language barriers can impede prisoners from receiving critical intervention.

“These issues must be addressed with a whole-of-government approach. This will require increased investment and staffing across all mental health services to ensure prisoners receive support at the earliest possible juncture.

“There is a clear need to increase awareness of the voluntary and community sector in the prison system. Sustainable, multi-annual funding is essential to enable the sector to continue providing and expanding key services.

“The government must implement the dual diagnosis model of care to improve treatment for people experiencing both mental health difficulties and addiction. A national clinical programme for dual diagnosis should be resourced and piloted within the prison setting with a view to scaling up the service across the prisons.

“The report also underscores the importance of diverting people with mental health difficulties away from the prison system and into mental health services. Where diversion is not possible, it is crucial to ensure access to tiered mental health services and supports within the prisons.”

The report makes 15 recommendations on how to improve mental health outcomes for people in prison, including:

1. align Irish Prison Service healthcare standards with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD);
2. ensure that legal rights are extended to people in prison, including those afforded to them under the Assisted Decision-Making (Capacity) Act 2015;
3. ensure all prisons are implementing learnings from the Covid-19 lockdown periods;
4. formulate a comprehensive framework for tiered mental health support in Irish prisons;
5. increase resource allocation across all tiers;
6. enhance the role of the voluntary and community sector;
7. implement dual diagnosis model of care in prisons;
8. distribute tailored information booklets in each prison;
9. provide information in multiple languages;
10. provide pre-sentencing guidance on what to expect in prisons;
11. implement a second mental health screening;
12. explore and implement a peer support model within Irish prisons;
13. recruit multi-annual peer-listeners;
14. increase awareness and reduce stigma; and
15. develop population-centric modelling for tailored prison health services in Ireland.