Number of mental health staff in prisons ‘grossly inadequate’, report shows

The shortage of clinical and psychology staff in Irish prisons is of “major concern” and results in staffing numbers that are “sometimes grossly inadequate to meet the clinical needs of mentally disordered prisoners”, a new report has found.

On Tuesday, the Office of the Inspector of Prisons published a report on the provision of psychiatric care in prisons, which highlighted concerns around staffing, overcrowded conditions and long waiting lists.

The inspector found the numbers of clinical staff in prisons is insufficient to meet the needs of inmates with mental illnesses.

“Not only did this hamper the safe care of prisoners but it also significantly contributed to the obvious symptoms of burnout of some clinical staff interviewed,” the report said.

Psychology understaffing is of major concern, the report said, with 38 per cent of psychology posts across the prison service vacant. Even if these were all filled, it would be unlikely to meet current needs, it added.

The Inspectorate team selected seven of the 13 prisons in Ireland for on-site thematic inspection: Mountjoy Men’s Prison, the Dóchas Centre, and Cloverhill Prison in Dublin; Cork, Limerick, Portlaoise and Midlands Prisons.

The inspectorate said this cross section of prisons, which accommodates more than 3,100 prisoners, or over two-thirds of total prison population, was identified because “these establishments were known to have particular challenges in managing prisoners with serious mental illness”.

In Midlands Prison, for example, three of the four staff grade psychologist posts were vacant and prisoners needing therapy were waiting six months for group therapy and two-and-a-half to three years for individual therapy, the inspector found.

The report also criticised the level of overcrowding in Irish prisons, with five of the prisons visited being filled to overcapacity, with cells “doubling” or “tripling” up.

In Limerick Prison, one prisoner with schizophrenia who was distressed, tearful and complaining of hearing voices, and who was on the waiting list for transfer to hospital, was held in a single cell, which had been “doubled” by having a twin bunk installed and then “tripled” by having a mattress placed on the floor.

“The conditions in the cell were far from hygienic, with three prisoners sharing a semi-screened toilet in the corner and, when the men were in their sleeping places, there was nearly no space to stand, with one stepping over another to reach the toilet. Such conditions could be considered as degrading.

The report highlighted the opening of the Central Mental Hospital in Portrane, Dublin in November 2022.

This, the inspectorate said, was intended to address the shortage of high and medium security mental health beds.

However, “the anticipated significant increase in bed numbers and easing of waiting times for the admission of prisoners has stalled due to staff shortages and unopened beds”.

“As prisoner numbers relentlessly increase (including those with severe mental health needs), these concerns are unlikely to diminish, certainly in the shorter term,” the report said.

It made a number of recommendations, including increasing staffing levels, improving “dilapidated” conditions in some cells and reducing overcapacity. The Irish Prison Service accepted the recommendations and put in place an action plan to achieve them.

Fiona Coyle, chief executive of Mental Health Reform, said the findings of the report are “deeply disturbing”.

“It is clear that the State is failing many people in the criminal justice system with mental health difficulties. The inhumane conditions and inadequate care in the prisons indicate serious human rights violations,” she said.

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