Prison Reform (Mental Health)

– in the House of Commons at 12:43 pm on 9th November 2005.

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Photo of Charles Hendry Charles Hendry Shadow Minister (Higher Education and Intellectual Property) 12:43 pm, 9th November 2005

I beg to move,

That leave be given to bring in a Bill to make provision for the mental health and special learning needs of convicted prisoners;
and for connected purposes.

The Bill is specific in trying to address the problems that affect a significant proportion of our prison population. I introduce it because I believe that the way in which our penal system cares for those with mental health needs at the start of the 21st century is a stain on our society.

Daniel Meehan, a young constituent of mine, had always been a troubled young man. He had a history of mental illness and drifted in and out of prison throughout his adult life. Daniel had been diagnosed as suffering from a series of mental illnesses, including the antisocial personality disorder, Tourette's syndrome, from the age of 17. He had spent around half his life in prison but he never received the help and treatment that he needed to tackle his problems.

Instead of rehabilitation, Daniel was left exposed and fell foul of the problems that, all too often, vulnerable people face in prison. He developed a heroin addiction while in jail and started to abuse alcohol. In September last year, on his discharge from prison, he was left homeless, without his medication or even any clothes. He was bailed by the courts to his father's address. When his father was not at home, he looked for somewhere else to stay and, as a result, he was rearrested for breaking his bail conditions and taken back into custody. His mother and sister desperately tried to arrange specialist care for Daniel and eventually arranged for a social worker to visit him in Lewes prison. However, on the same day the social worker was due to visit, he was moved to Her Majesty's prison Weare, a floating prison off Dorset.

Neither the social worker nor Daniel's family had been made aware of the transfer, yet the prison system somehow expected a prisoner with a long history of mental illness to rearrange the appointment himself. Daniel's complex needs were never properly assessed. Alone and without the support he needed, Daniel died at his father's house in January this year, aged 29. The coroner returned an open verdict on the death, but to most of us who had seen his case develop, we have no doubt that suicide would have been the more appropriate verdict.

Daniel's family freely admit that he was a difficult man, but time and again, over almost 10 years, the prison system consistently failed to address his problems. As Daniel's sister, Mrs. Meehan-Bissett, said:

"Prison was not the answer for someone like Daniel, he needed rehabilitation. He died due to neglect. The prison authorities cannot be bothered with someone like Daniel . . . There needs to be somewhere for people like Daniel to go. If you need to lock them up, lock them up, but not without anything to do all day."

The Government response to the Home Affairs Committee report on the rehabilitation of offenders, which was published in January 2005, stated that there were firm commitments that, by 2004:

"All prisoners with severe mental illness would be in receipt of treatment and that no prisoner with a serious mental illness would leave prison without a care plan".

In Daniel's case, it is all too clear that those rules were not followed. Many hon. Members are aware of similar cases from our constituencies, so it is important to understand the extent of the problem.

Last year in a written answer to my hon. Friend Mrs. Gillan, whom I am pleased to see on the Front Bench, the then Under-Secretary of State, Department of Health, Dr. Ladyman said:

"A survey of mental ill health in the prison population of England and Wales, undertaken in 1997 by the Office for National Statistics, showed that around 90 per cent. of prisoners sampled displayed evidence of at least one of the five disorders—personality disorder, psychosis, neurosis, alcohol misuse and drug dependence—considered in the survey. There will, at any one time, be around 5,000 prisoners with a severe mental illness".—[Hansard, 2 December 2004; Vol. 428, c. 247W.]

Similar findings were published in a report by the Prison Reform Trust, supported by the Nuffield Foundation, into the mental health of women prisoners. It found that two thirds of women in prison show symptoms of at least one neurotic disorder such as depression, anxiety and phobias. More than half suffer from a personality disorder. Yet, among the general population, less than one fifth of women suffer from those disorders.

The report found that half the women in prison are on prescribed medication such as anti-depressants or anti-psychotic medicine and there is evidence that the use of medication increases while in custody. Of all women who are sent to prison, a terrifying 40 per cent. say that they have attempted suicide at some time in their life.

Research by Oxford university into suicide rates for younger offenders is even more shocking. The analysis of suicide rates in England and Wales from 1978 to 2003 found that the difference was particularly striking in 15 to 17-year-olds. Offenders in that age group were 18 times more likely to kill themselves than those in the general prison population. Depressingly, the report concluded that

"half those who commit suicide in prison have a treatable mental illness."

If those illnesses were indeed treatable, it means that those suicides could have been prevented.

The problem goes far beyond mental health; there are also too many prisoners who have serious learning difficulties. According to Home Office statistics, the prevalence of poor educational attainment among prisoners is shocking. Fifty-five per cent. of prisoners had a reading ability of level 1 or below—the educational level for an 11-year-old. That proportion rises to 67 per cent. in young offenders—in other words, two thirds of young offenders have the reading ability of an 11-year-old or younger child. In spelling, 79 per cent of prisoners were at level 1 or below, with that figure rising to 87 per cent. in young offenders. In numeracy, those rated at level 1 or below represented 69 per cent. of the general prison population, and 78 per cent. of young offenders, so the frightening truth is that about three quarters of young offenders are illiterate and innumerate. Despite this, however, the average time for education in prison was under six hours a week per prisoner in 2002, and only slightly higher in young offender institutions. As a result, most of them are almost as illiterate and innumerate when they leave prison as when they start their sentence.

This Bill is not about making excuses for those who break the law. One essential pillar of prison is that it should act as a deterrent to those thinking of committing crime and punish those who have broken the law. But prison works only if it also rehabilitates. As one governor said to me:

"We are very good at incarceration, but not at rehabilitation."

A prisoner without rehabilitation is a prisoner who will offend again. So, the mental health and learning needs of prisoners must be addressed if we are truly to have a prison system that meets those two core goals.

The Bill that I am proposing is a simple one. Where it has been established that a criminal has mental health needs, there would be a legal requirement for those needs to be professionally and thoroughly assessed at the start of their sentence. For all prisoners, an assessment would be required of their educational needs. Those with mental health requirements would be detained only in an establishment with specialised facilities, and with staff trained to deal with them. A pathway programme of support would have to be developed to ensure that their mental needs were met. Those needing educational attention would receive a more focused programme of tuition, instead of the haphazard tuition that they currently receive, and it should focus on skills training as well, to give them some hope of employment when they leave. As prisoners with mental health problems are now treated by the NHS, the primary care trust budgets covering this treatment should be ring-fenced to ensure that the funds to finance prisoner care cannot leak away into other areas of health care.

The objective of the Bill is not to create prison asylums surrounded by barbed wire—far from it. The Bill seeks to ensure that prisoners with mental health needs are kept in an establishment in which those needs are addressed first and foremost, and which works to support their rehabilitation. In no way does it undermine the principle that many people need to be kept away from society, for the good of society and for their own good, but it does mean that they will be given the care and medical support that they need.

I have visited a number of young offender institutions. They are the most depressing places I have ever been to, and I certainly do not know how we can rehabilitate someone if we lock them up in a 9 ft by 5 ft cell for 18 hours a day or more. When those prisoners have mental health problems or special learning needs, this becomes a hopeless task unless rehabilitation is at the forefront of the approach. Through specialised and focused rehabilitative methods, the prison system can make major inroads into reducing reoffending, but rehabilitation must be more responsive to the often complex problems of prisoners, which have all too often contributed to their being in prison in the first place, and will have them returning there time and again if they go unresolved.

The case of Daniel Meehan is a tragic one. A young man with profound mental health needs died because he did not receive the help that he needed. At the start of the 21st century, that is something that should shame us all. We have the power to do something about this. I commend the Bill to the House.

Question put and agreed to.

Bill ordered to be brought in by Charles Hendry, Peter Bottomley, James Brokenshire, Annette Brooke, Chris Bryant, Mr. Edward Garnier, Mr. Dominic Grieve, Mrs. Eleanor Laing, Julie Morgan, Mr. Andrew Lansley and Tim Loughton.