Prison health 'needs cash boost'

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Mental health services in prisons are not getting the investment they need to provide adequate care, experts say.

Researchers found £300 a year is spent per prisoner on mental health care - a third what is spent on people with severe problems in the community.

The Sainsbury Centre for Mental Health and Lincoln University team also identified regional variations in spending after analysing NHS figures.

Ministers said improvements were needed, but rejected the findings.

Responsibility for prison healthcare across England and Wales passed from the Prison Health Service to the NHS in 2006, in order to bring it up to the standards provided to the general population.

Over 90% of prisoners have at least one type of mental health problem, four times the rate in the general population, and the risk of a prisoner committing suicide is seven times higher than normal.

'Struggling'

Researchers found about 4,700 prisoners got support from mental health in-reach teams, which were set up to help those with severe illnesses.

We need to see a major boost in spending across the country, especially in those areas that are falling behind Sean Duggan, Sainsbury Centre for Mental Health

But this was much less than the one in 12 of the 80,000 population that need them, the report added.

In-reach teams are predominantly made up of mental health nurses, although psychiatrists and psychologists and social workers can also be involved.

They offer assessments and monitoring of prisoners' mental health problems.

The researchers also identified regional variations with spending in London at £416 per head, compared to £182 in the East Midlands or south west - a difference of nearly 130%.

They say there are variations in the needs of prisoners in different regions, but that they cannot explain such a wide gap.

Sean Duggan, from the Sainsbury Centre, said: "Many in-reach teams are struggling to offer a decent service in the face of inadequate funding and very high levels of need among prisoners.

"We need to see a major boost in spending across the country, especially in those areas that are falling behind."

'Long way to go'

But Frances Crook of the Howard League for Penal Reform, said: "Much more must be done to cater for the mental health needs of prisoners.

"Primary Care Trusts (PCTs) must adequately fund mental health care provision in custody.

"Currently, individuals are being released from prison with a likelihood their mental health needs have been exacerbated by their time inside and with an increased risk of reoffending."

Care services minister Ivan Lewis said investment in prison health had risen from £118m in 2003 to over £200m now, and denied there was a postcode lottery.

He added: "The report is weak in its analysis of the number and types of prisons within each area, and the impact that these factors have on the allocation of resources.

"It points out the comparatively low spend in the south west and the East Midlands - but these areas contain no large city male local prisons, whereas London has four large city male prisons and a significantly larger and more challenging prison population.

But he said there was a "long way to go", and that a review of the mental healthcare provided to offenders was being carried out.