My Lords, the noble and learned Lord, Lord Brown, has highlighted, as have others, the unspeakable toll of suicides and self-harm pointing to the distressing rates of mental disorder in prisons. It is that that I wish, as a psychiatrist, to draw attention to today, since overcrowding is both a cause and a consequence of the negative impact of mental illness. I am not going to plough through the statistics, which are already so well known to those speaking here today, but I concur totally with the noble Lord, Lord Wigley, and the noble Baroness, Lady Bottomley, who said we need a totally new cultural and social approach to address the difficulties of crime and the mental disorder that so often goes with it.
The National Audit Office’s excoriating report on mental health in prisons, published in June this year, paints an alarming picture of what prison is for someone with mental health problems. Admirable intentions are not being delivered on the ground and cannot even be measured. We put money into policies and we have no idea whether they are being delivered, simply because we have no way of measuring and there is nobody who can do the measuring. So policy ambitions are not being addressed. Of course, the prison regime is most likely to lead to depression, anomie and disturbed behaviour. Inside prisons the situation is dire. There are long waiting lists for mental health clinics. Dozens of new prisoners arrive every week and spookily disappear just as quickly as they arrive, either discharged on the constant merry-go-round or moved to other prisons on the great train traffic to somewhere else. That totally curtails the ability of psychiatric and mental health services in prison to address the problems. Since we have Spice these days, which is the new flavour of death in prisons, matters are getting worse.
Preparing for this debate today I asked a colleague who works in the forensic service in Birmingham to tell me about a recent visit to prison to see patients there. He said, “When we arrived, so-called recovery worker ‘offenders’ outnumbered the exhausted looking prison officers, who encouraged us to wander between wings unescorted. No one recalled asking us to attend and, as we sat waiting, prisoners came to see us, seemingly unnoticed by prison officers, questioning us about psychoactive drugs and so on. Offenders were friendly enough, but it felt like a phase of pre-anarchy as boundaries were breaking down because of the lack of staff available to deal with what appeared to be a very disturbed group of prisoners”.
My time is up, but it is clear that we cannot continue with this shameful position. Yes, we could have more mental health services but, frankly, it will not make any difference unless we solve the problem of how we are pouring people into the criminal justice system.