Mental Health (Young People Entering and in Custody)

– in the Scottish Parliament on 19th June 2019.

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Photo of Christine Grahame Christine Grahame Scottish National Party

Before we start business, I should tell members that the clocks are running at real time, which has to happen because we are in the middle of stage 3 proceedings. Do not ask me about it; I do not understand it. It means that I will be relying on members to look at the clock to see the time for the purposes of the statement, questions and so on. I also have the time running next to me, to make sure that members do not overrun too much, especially when we get to portfolio question time. Telling you that took only 18 seconds, which is not too bad.

The first item of business is a statement by Humza Yousaf on the Scottish Government’s response to the “Report on an expert review of the provision of mental health services, for young people entering and in custody at HMP YOI Polmont”. The cabinet secretary will take questions at the end of his statement, so there should be no interventions or interruptions.

Photo of Humza Yousaf Humza Yousaf Scottish National Party

Last November, I asked Her Majesty’s chief inspector of prisons for Scotland to carry out an expert review of the mental health support for young people in custody following the tragic deaths by suicide of Katie Allan and William Lindsay Brown at Polmont last year.

I take this opportunity to once again offer my and the Government’s sincerest condolences to their families and to all those who have lost loved ones to suicide. Every death of a young person is undoubtedly a tragedy for them, their families and their friends, and also more widely for Scottish society, which has lost the opportunity of their talent and potential contribution.

The purpose of the review was to consider the arrangements for young people with mental health and wellbeing needs who are entering and are in custody. A fatal accident inquiry is mandatory whenever someone has died in legal custody, and in the cases of Katie Allan and William Lindsay Brown, the Crown Office is undertaking independent investigations in advance of mandatory fatal accident inquiries. It was therefore not the purpose of the review to investigate the specific circumstances surrounding either of those deaths.

The inspectorate of prosecution in Scotland is currently undertaking a follow-up review of the thematic report on FAIs that was published in August 2016. At the Lord Advocate’s request, the follow-up review will consider the scope of the death investigation process when a young person dies in custody and the merits of prioritising it. The follow-up report is due to be submitted to the Lord Advocate this summer.

Separately, the Scottish Prison Service is considering what more can be done to improve the transparency of information about apparent suicides in Scotland’s prisons, pending formal determination by an FAI. Clearly, however, our priority must be to aim to prevent, as far as possible, the circumstances that can give rise to the risk of suicide in prison.

I am very grateful to Her Majesty’s chief inspector of prisons and to Dr Helen Smith, who worked with her to oversee the review, for the comprehensive and robust work that they have carried out.

Both the mental health review and routine inspection report for Polmont recognise the good work at Polmont and highlight the hard work, compassion and dedication of front-line prison and healthcare staff. I am very grateful to the management and staff at Polmont for the open and constructive way in which they have engaged with the review and informed its recommendations.

The review by the chief inspector and Dr Smith is comprehensive and wide ranging, and it makes some important and challenging findings. It highlights the heightened vulnerability of young people who are on remand and those who are in the early days of custody, the damaging impact of social isolation, the vital importance of good information sharing between agencies, and many more issues.

I put on record my appreciation for the staff at Polmont, the overwhelming majority of whom I know care very much about the young people with whom they work. Although there are positives in both the inspection report and the expert review, I intend to focus my remarks and the substance of my statement on the areas of challenge and improvement, as members would expect.

An action group, which includes relevant officials from the Scottish Government, the Scottish Prison Service and the national health service, has been convened to oversee progress on the numerous review recommendations. Some of the recommendations will be taken forward under existing Scottish Government strategies.

When I met the parents of Katie Allan in November last year, I stated my commitment to respond to the concerns that have been raised by the tragic deaths of both Katie and William. On Monday, I wrote to both families to offer to meet them. I very much hope to have the opportunity to discuss the findings of the review with them and I will value their input as we take forward our response. It is clear from the review that the necessary actions extend beyond Polmont.

I turn to the substantial recommendations of the expert review. Nobody who is going through the justice system should be harmed by the failure of agencies to fully share information with one another, where data protection legislation allows it. The health and justice collaboration improvement board, which draws together senior leaders from health and social care, justice and local government, is exploring how public bodies can ensure that decisions are as fully informed as possible. That board is mapping the flows of information in the health and justice systems.

Ministers will work with partner agencies to build on that and consider and take forward actions in response to the recommendations, including immediate action that we can take to improve information sharing between the different agencies that support the care of young people who enter and who are in Polmont. The SPS has confirmed that it will develop a new health and wellbeing strategy, which will include a bespoke mental health strategy for young people.

The review found that the SPS talk to me suicide prevention strategy is “robust”, and that it is generally followed well at Polmont. That strategy—which is relevant when the risk of suicide is deemed to be immediate—is overseen by the national suicide prevention risk management group, which includes representatives from expert partners, including the Samaritans, Breathing Space and Families Outside. The review makes a number of recommendations that are relevant to the talk to me strategy. The Scottish Prison Service will work with the group to consider them, and to ensure that its approach to suicide prevention for young people, including its approach for people who are coming off of the talk to me strategy, is effective. The national group is also developing a self-harm policy and will oversee work to consider lessons from the use of safer spaces in different settings, including secure care, which might allow safer environments to be more supportive and less sterile. Work to address the recommendations that relate to staffing, training and support for staff at Polmont is well under way.

On mental health staffing in prisons, through action 15 in our mental health strategy we have committed to increase access to the overall mental health workforce with 800 additional staff, which will be supported by investment that will rise to £35 million by 2021-22. This month, the Minister for Mental Health wrote to all chief officers of integration joint boards and chief executives of NHS boards to highlight the importance of recruiting additional mental health workers in prisons under that commitment, and to ask them for details of how they will plan recruitment for this financial year.

The review report highlights that those who are young and in the early stages of custody are especially vulnerable to suicide. Everyone who enters prison is assessed for their risk of suicide. Inspectors were impressed by many aspects of the interactive induction at Polmont, highlighting the compassion of the staff who undertake admission and the role of peer mentors. However, we know that the time that people spend on remand is currently largely unproductive. The review report underlines how damaging periods that are spent on remand can potentially be for individuals. The number of young people who are aged under 21 who are held on remand in Scotland has fallen by a quarter over the past five years. Nonetheless, we will continue to ensure that alternatives to remand are available for young people, and to support those young people who are held on remand.

The issue of body searches being part of the regime within prisons was highlighted by the family of Katie Allan in particular. I can confirm today that, as a priority, the SPS will stop the routine body searching of under-18s who are in custody. The Scottish Prison Service will evaluate the impact of those changes after one year. In line with the development of the new female custodial estate, the SPS will adopt a more trauma-informed approach to its searching process for women.

Supporting positive family contact throughout someone’s time in prison has wide-ranging benefits for that individual and their family. It reduces the risk of reoffending and supports positive relationships, which contribute to good mental health and mitigate vulnerability. With a view to supporting that, I can confirm that I have asked the Scottish Prison Service to explore the options for implementing a pilot of in-cell phones across HM YOI Polmont, with necessary controls in place, of course.

At present, prisoners in Scotland can access telephones in communal areas at certain times only. In-cell phones have the potential to contribute to prisoners’ wellbeing by making family contact significantly easier. They also have the benefit of improving access to national helpline services. In addition, technology can offer the potential to develop telehealth services and support for wellbeing in prisons. We will explore the options available as we take forward a pilot, but we will ensure that the Prison Service retains control over the phone numbers that prisoners can access and the ability to monitor calls.

As for monitoring our progress, we remain committed to improving outcomes for young people in the community and in custody. Along with relevant ministerial colleagues, I will hold a round table with key partner agencies before the end of the year to review our progress.

It should not take tragedies such as the deaths of Katie Allan and William Lindsay for services to improve. I am deeply saddened by what happened to those two young people and by any life that is lost in our care. We know that young people who commit offences and become involved in the criminal justice system are often also the young people who have experienced multiple traumas and those who are the most vulnerable. It is our duty to do everything possible to help them rehabilitate where necessary and, vitally, to keep them safe from harm during the time when they are in our care.

The expert review report is substantial, and we will work on the many recommendations contained therein. Our ultimate aim is to oversee the continued fall in the number of young people entering our criminal justice system. It is important that, as a progressive society, we have transparency, a trauma-informed approach and, above all, a compassionate justice system that understands the often complex reasons why people end up in prison and that believes in their ability to rehabilitate.

I will endeavour to keep Parliament updated on our response to the expert review.

The Deputy Presiding Officer:

We have about 20 minutes for the cabinet secretary to take questions on his statement. There is no time in hand this afternoon, so I am relying on members to be disciplined. We will see how it goes.

Photo of Annie Wells Annie Wells Conservative

I, too, offer my sincere condolences to the families and friends affected by the tragic deaths of

Katie Allan and William Lindsay last year. I thank Her Majesty’s chief inspector of prisons and Dr Helen Smith for their work in forming the review, and the Cabinet Secretary for Justice for advance sight of his statement.

Prevention is, of course, key. The SPS has said that it will develop a new mental health strategy for young people. When can we expect to see the strategy? When will the cabinet secretary report back to the Parliament on the steps taken to improve communication across the justice system and to ensure that the risks and vulnerabilities of young inmates are given careful consideration, particularly in the initial three months of custody? Those issues are of specific concern in the report on the review.

The cabinet secretary has highlighted the desperate need to recruit more mental health workers in prisons—I am pleased that that has been included. However, on the basis that, as at the end of April this year, just six additional whole-time equivalent staff had been recruited, what exact steps will be taken to vastly improve that trajectory?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

I thank Annie Wells for her questions and for the constructive manner in which she asked them.

As regards the timeline, the Scottish Prison Service is rightly taking a really informed approach and is talking to partners—some of which I mentioned in my statement—to develop that bespoke mental health strategy for young people. I will ask the chief executive of the Prison Service to write to Annie Wells directly to give her more detail about the steps that the service is taking to develop the strategy and about some of the associated timelines.

I could not agree more with what has been said about remand, and I hope that I highlighted that in my statement. To be very honest and frank, and I am sure that Annie Wells will understand this, who goes to remand—or not—is not entirely in my gift. The judiciary is rightly independent—we all accept the independence of the judiciary and we guard that independence fiercely.

What I can do—to a large extent, this is in the Government’s gift—is work with partners both to create robust community alternatives and to work on alternatives to remand as set out in the Management of Offenders (Scotland) Bill, such as bail supervision and electronic monitoring. The Government will continue to do that.

As for what action is being taken, I mentioned in my statement that the Minister for Mental Health, who is in the chamber, has written to health boards to ask them what they will do in this financial year. We are not waiting around for future years; the minister has asked what is being done this financial year to help recruit more mental health workers for our prisons, and I am sure that she will be happy to furnish Annie Wells with further details, should she require them.

Photo of Pauline McNeill Pauline McNeill Labour

The recent tragic deaths of Katie Allan and William Lindsay Brown highlight deeper problems relating to deaths and suicides in custody, and I associate myself with the remarks of the cabinet secretary and Annie Wells.

We agree that all steps to protect the welfare, including the associated physical health issues, of those who are in custody must be taken. Will the cabinet secretary accept all seven recommendations in the report? I am sure that he agrees that we cannot afford to make the same mistakes again.

How will the cabinet secretary ensure that the talk to me strategy is not simply a tick-box exercise? When will training commence for prison staff who have asked for and need specific training on mental health disorders and on dealing with the welfare of young people? Katie Allan’s family highlighted that many people in custody have mental health problems simply because they are in custody, so it is important to train our staff to be able to deal with such problems.

The case of William Lindsay Brown highlighted the fact that there was a reduction in the number of secure care places in 2016-17, from 90 to 84, which meant that the courts were not able to make the disposals that might have been needed in certain cases. When will the cabinet secretary act to ensure that, when appropriate, young people are placed in secure care, not the prison estate? When will such places become more widely available?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

I thank Pauline McNeill for her questions and remarks.

I reassure Pauline McNeill that the talk to me strategy is about the immediate potential vulnerability of an individual at a particular moment in time. Today, I have confirmed—I reiterated this point in my response to Annie Wells—that the Scottish Prison Service will work on the development of a bespoke mental health strategy for young people. I am sure that, if Pauline McNeill would find it helpful, the chief executive of the SPS would be happy to talk her through how the service will develop the strategy through an iterative process.

I also reassure Pauline McNeill that, as I said in my statement, training is well under way. Again, I can facilitate contact with the chief executive of the Scottish Prison Service if she wants, and I am sure that Colin McConnell would be happy to meet her to give details on how the training is developing and on how the SPS is rolling it out to staff across the prison estate.

Although we are focusing, rightly and understandably, on young people—particularly in the light of the terrible tragedies that have been mentioned—mental health issues also affect the adult population in our prisons. Although I have talked about a bespoke mental health strategy for young people, there will be a mental health strategy for people right across the prison estate.

The Deputy First Minister, who is beside me, and I work closely on wider issues relating to secure care. Action has been taken since the terrible tragedy of the death of William Lindsay Brown. As of today, secure beds in secure units are available. As I have said to Pauline McNeill previously—I know that she understands this—there is a lot of nuance and complexity to the issue. There has been a reduction in admissions from Scotland, and secure units need to have a very high level of occupancy in order for the provision of such services to continue. Therefore, a number of cross-border referrals come in. There are options for the Scottish Government to consider, such as purchasing space, but the issue is complex. I give an assurance that we are working through such complexities, and I can provide Pauline McNeill with more detail on that matter in writing. However, I reassure her that, as things stand, secure beds in our secure estate are available.

The Deputy Presiding Officer:

I appreciate that the matter is very sensitive, but I point out that the first two questions have taken seven minutes. Twelve members want to ask questions, so I ask for succinct questions and answers. I ask members not to miss the point, but to hone it down. I have no doubt that Mr Finnie will set an example.

Photo of John Finnie John Finnie Green

No pressure, Presiding Officer.

I add my condolences and thanks to those of other members. The cabinet secretary talks about a compassionate justice system, and his statement acknowledges that remand is largely unproductive. We talk about ensuring that alternatives are available, and safer spaces and different settings have been mentioned. I ask for some creative thinking to be done, so that safer spaces do not necessarily always mean confinement.

Photo of Humza Yousaf Humza Yousaf Scottish National Party

I could not agree more with John Finnie, who makes his point well. I said in my statement that safer space does not mean a sterile space. That is the thinking that is going on in the Scottish Prison Service. If the member would like to speak to the SPS, it will be able to give him some assurances. He is absolutely right to raise that point.

Photo of Liam McArthur Liam McArthur Liberal Democrat

The tragic deaths of Katie Allan and William Lindsay mean that we must learn lessons. I, too, thank the chief inspector and Dr Smith for a thorough report.

Much that is in the cabinet secretary’s statement is welcome, including the pilot of in-cell phones. More than two years ago, the Scottish Government promised that prisons would share in the roll-out of 800 new mental health workers. At the end of that process, how many of the 800 will be based in prisons?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

I mentioned in my statement, and in response to Annie Wells, that the Minister for Mental Health has written to ask health boards about their plans for this financial year. I will ask her to write to Liam McArthur with the detail of the responses that she receives.

Priority is being given to the matter because we understand the need in our prisons—in particular, among our young people in the custodial estate.

Photo of Rona Mackay Rona Mackay Scottish National Party

I welcome, as the cabinet secretary mentioned, the report’s highlighting of

“the compassion and dedication of front-line prison and healthcare staff.”

I understand that the Scottish Prison Service and its NHS partners have in recent months undertaken a range of actions to improve health and wellbeing support in Polmont. Will the cabinet secretary outline what work is under way?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

Quite a lot of work is under way. I am sure that the Scottish Prison Service can furnish Rona Mackay with details.

However, for example, refresher training on the SPS’s suicide prevention strategy—which is called “Talk to me”—has been delivered to 95 per cent of staff in Polmont. Intensive training in mental health first aid for young people for staff who work in the residential parts of Polmont has also commenced. An additional senior manager was appointed in December 2018 with specific responsibilities for overseeing implementation of the suicide prevention strategy and suicide awareness.

NHS Forth Valley, which is the local health board, has worked closely with Polmont in terms of resources for senior staff who have been appointed to strengthen leadership and support. I do not have time to go into the many other things that have happened, but, if Rona Mackay gets in touch with the SPS, it can give her a lot more detail.

Photo of Liam Kerr Liam Kerr Conservative

I will go back to the cabinet secretary’s remarks on remand. The report notes that young people who are on remand feel that they “struggled to access services”. What will the cabinet secretary do to ensure that young people who are on remand have appropriate access to activities and services?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

I will continue to try to reduce use of remand. That will be our focus.

Liam Kerr is right to ask what we will do for people who are on remand. We will continue to provide funding and we will work with the Scottish Prison Service and third sector providers on services for the young people who are in our care.

It is important to focus on reducing use of remand. Liam Kerr and I have had many discussions about that, and we agree that the proportion of Scotland’s prison population who are on remand is far too high—it is almost double the figure in the nearby jurisdictions of England and Wales. The focus will be on alternatives to remand, including community justice measures, bail supervision and electronic monitoring. I appreciate that all those alternatives must have appropriate safeguards, but the focus must be on reducing the number of people who are on remand. The review has focused on the intense support that is needed in a young person’s first few days on remand and in custody thereafter.

Photo of Angus MacDonald Angus MacDonald Scottish National Party

As the cabinet secretary said, it is clear from the review that the necessary actions must extend beyond Polmont. How will progress on implementing the recommendations be monitored at Polmont and elsewhere?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

I hope that the presence of my ministerial colleagues who are sitting to my right and my left demonstrates the cross-portfolio and cross-Government importance that we attach to the agenda. I reiterate, as I said in my statement, that an action group that will include relevant officials from across the Scottish Government, the Scottish Prison Service and the NHS has been convened to oversee progress on the review’s recommendations. We remain absolutely committed to improving outcomes for young people who are in custody. Alongside my ministerial colleagues, I will hold a round-table meeting with key partner agencies before the end of the year to review our progress.

I mentioned that I hope to meet the families of Katie Allan and William Lindsay—I think that I will meet Katie Allan’s family next week. I would like those families, and others who have been similarly affected, to help us to shape the response. It is hugely important that we listen to their concerns and to people’s lived experience of Polmont, custody and the justice system more broadly, and that people’s views are fed into how we shape the response.

Photo of Monica Lennon Monica Lennon Labour

I am interested in why the inspection report did not look into the culture of bullying that had been highlighted in previous inspections dating back as far as 2003.

The cabinet secretary will be aware that Katie Allan’s death certificate records her cause of death as hanging, but the SPS website has registered the cause of her death as being “Not Determined—Awaiting FAI”. If the incident had happened in England or Wales, under the Ministry of Justice, it might have been recorded as being a suspected suicide that was awaiting an FAI. That does not feel quite right to me. Does the cabinet secretary agree that we need greater transparency? How might we achieve that?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

On Monica Lennon’s first point, she is within her rights to write to the inspector—who is, of course, independent—to ask any questions on the inspection report or the expert review. The inspection report on Polmont is very thorough and says a lot about the workforce. I paraphrase slightly, but I do not think that I am too far off the mark in saying that it describes the workforce as compassionate and committed. I do not doubt that the vast majority of Polmont staff are just that. The inspector carried out close scrutiny of the workforce. If Monica Lennon has questions about the inspection, she would be right to go to the independent inspector and ask them.

I agree with Monica Lennon that we need greater transparency. I said in my statement that transparency is hugely important. I understand the dilemma that the Scottish Prison Service has when a fatal accident inquiry is involved. I know that the SPS feels that it has to be extremely careful about what it says publicly and about what is put in the public domain before the determination is made in an FAI. Notwithstanding that, there are examples—Monica Lennon cited England and Wales—of things that we could do to improve communication, transparency and openness, which are so important for public confidence. That issue is being explored and taken forward as we speak.

The Deputy Presiding Officer:

Emma Harper will be followed by Margaret Mitchell. I am afraid that Margaret Mitchell’s question might have to be the last one, because of the length of the answers. I appreciate why the answers have been longer, given the circumstances, and I hope that members understand, too.

Photo of Emma Harper Emma Harper Scottish National Party

The cabinet secretary mentioned access to in-cell phones for young people. I look forward to following that up. What additional support is available for the families of young people in Polmont, particularly those who are being held on remand?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

We will continue to invest in the prison estate. At the moment, investment is focused on the women’s custodial estate. For example, the new community custody units are designed to help with family support.

The pilot of in-cell phones at Polmont is exciting, and is potentially hugely important for family relations and connections. The prison visitor centres that we help to fund are also really important. They sometimes get negative publicity from elements in the media, which is unfair, but the centres are hugely important in respect of family contact. Family contact and family relationships are hugely important for our young people. Where the Prison Service has not got that right at Polmont, there are plenty of recommendations for us to take forward. That is why we are piloting the in-cell phones in Polmont first, rather than in other parts of the prison estate.

Photo of Margaret Mitchell Margaret Mitchell Conservative

During the Justice Committee’s short inquiry into secure care places and mental health provision in Scotland, the committee heard that the transition between a secure care place and Polmont can be vital. Some young vulnerable people benefit from close personal relationships that are formed in the secure care place, only for those relationships to be broken when the young person is 18 and has to transfer to Polmont. Will the cabinet secretary undertake to look at the transition rules to ensure that they are not so inflexible that they undo months of good work that vulnerable young people have already undertaken in secure care?

Photo of Humza Yousaf Humza Yousaf Scottish National Party

Yes. I will be happy to explore issues to do with transition, with my colleague the Deputy First Minister and Cabinet Secretary for Education and Skills. Margaret Mitchell has raised an important issue.

A related point, on which the review shone a light, is the disappointing nature of information sharing between agencies and services. We are all aware that there are issues to do with information sharing, and the health and justice collaboration improvement board is looking at the matter. The information that flows between the courts, social work, secure care units and the prison estate is vital, so there should be no gaps in that regard.

I assure Margaret Mitchell that we will reflect on what she said about transition. In addition, the key recommendation on information sharing is being taken forward and we will monitor the situation, through the action group.

The Deputy Presiding Officer:

That concludes questions. I apologise to Ruth Maguire, Mary Fee, Fulton MacGregor and Daniel Johnson for being unable to call them, due to time pressures this afternoon.