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Prison is not the place to manage offenders’ mental health

A long-overdue taskforce has a unique opportunity to influence the future direction of strategy and practice and make a significant contribution to making our communities safer, as well as ensuring help for those who need it

FRI, 09 APR, 2021 - 06:30

The establishment by Justice Minister Helen McEntee and Health Minister Stephen Donnelly of a taskforce “to consider the mental health and addiction challenges of persons interacting with the criminal justice system” is a welcome and long overdue response to what has been acknowledged as one of the most serious challenges facing that system. 

Individual 'horror stories’ that come to our notice through reporting in the national media, of violent crimes or detainees being held in unacceptable conditions, or unable to access appropriate treatment settings, unfortunately represent only the tip of this tragic iceberg, even in terms of the numbers affected. 

On any day, there are about 3,800 people in prison and over 8,000 individuals under Probation Service supervision in the community. 

A substantial proportion of these experiences significant mental health or addiction issues, or indeed a combination of both. 

The establishment of the taskforce, to be chaired by former Minister of State Kathleen Lynch, represents a unique opportunity to address some of the most deep-rooted challenges facing our justice and health systems.

Mental health and addiction issues

The percentage of people subject to penal sanctions such as probation and prison who have mental health and addiction issues in Ireland and internationally, is well above the comparable level in the general population. 

In addition, members of An Garda Síochána are routinely called to incidents involving individuals with significant mental health and/or addiction issues. Offenders in such cases are frequently brought before our courts, who in turn may struggle to identify appropriate referral routes and treatment pathways towards helpful outcomes. 

Those directly affected as a result of all this systemic failure extend beyond those perpetrating the offences in question, to include their family members and wider communities, as well, of course, as the victims of crime.

Justice Minister Helen McEntee and Health Minister Stephen Donnelly have established a taskforce 'to consider the mental health and addiction challenges of persons interacting with the criminal justice system'.  Picture: Sam Boal/Rollingnews.ie

Justice Minister Helen McEntee and Health Minister Stephen Donnelly have established a taskforce 'to consider the mental health and addiction challenges of persons interacting with the criminal justice system'.  Picture: Sam Boal/Rollingnews.ie

The joint ministerial statement around the establishment of the taskforce, and its terms of reference, identify the need to address the mental health and addiction issues of those "coming into contact with the criminal justice system” or “interacting with the criminal justice system", implying clearly that such ‘contact’ or ‘interaction’ may occur at any point of the criminal justice process, from investigation, through prosecution to sanction and beyond. 

Nevertheless, there is a somewhat imbalanced focus in the terms of reference and related statements on prison as the default, as the institution where all the work needs to be done. This should not be the case. 

There must be no less focus by the taskforce on other stages of the justice system, including the roles played by the gardaí, courts and probation, as well as on the role of other bodies, especially the health services. 

Lost opportunity

If there is a narrow focus on prisons, this will be a lost opportunity. The focus on prisons is understandable, given the important and high-profile role they play. 

Yet it is precisely because of the fact that so many people with serious and enduring mental illness are in prison, in the absence of viable alternatives, that we need to move beyond the focus on such custodial options, which are so often in the spotlight for all the wrong reasons.

We must remember that it is better to ensure that as many as possible have access to appropriate services in the community in the first instance, than that we try to "fix" something that is often only made worse by imprisonment. 

One disturbing feature of this dilemma includes those cases where someone ends up in custody specifically for the purpose of accessing treatment that is otherwise not available. 

"No one should have to go to jail specifically for treatment."

It is unlikely, if not impossible, for example, that someone would be sent to prison solely to access physical/medical treatment. 

Why should mental health treatment be any different? In that context, the focus of the taskforce must ensure that, as far as possible, those coming to the attention of the various arms of the criminal justice system are enabled to access appropriate services at each relevant point in the justice process, from contact with the Garda, the Courts and the Probation Service, as well as in prison. 

This will require fine-tuned co-operation and interagency working between justice and health services.

The issues being addressed by the taskforce are by no means unique to Ireland. For example, the Council of Europe has acknowledged the importance of the same issues across its 47 member states, including Ireland. 

The council has recently therefore tasked its working group that develops practice standards for probation and prison services across Europe (the PC-CP) to prioritise the development of good practice standards in relation to mental health issues of those on probation and in prison. 

Lack of adequate data

One of the challenges facing efforts to make positive change in this area of service delivery — whether in Ireland or anywhere else — is the lack of adequate data on the problem. 

Thankfully, this is now being addressed. For example, just last month Ms McEntee published research by the Probation Service on the prevalence of mental health issues among those under its care and supervision. 

Unsurprisingly, that study found the level of mental health issues among those on probation to be much higher that among the wider general population. 

The report also identified the need for improved training for staff and more effective engagement by probation with mainstream mental health service providers, as well as “joined-up strategies and interventions”.

While last week’s ministerial announcement of the taskforce is indeed welcome, what is required if the initiative is to enjoy maximum success and benefit and add most value to a system under strain, includes a need to:

  • Include the voices of all stakeholders (including service users) in the consultation process;
  • Have the taskforce work and report completed on target (by end of 2021);
  • Include a clear action plan, with identified responsibilities and timeline;
  • Harness interagency goodwill and ‘buy-in’; 
  • Overcome entrenched ‘siloed’ thinking and working, particularly between justice and health sectors;
  • Build follow-up actions into existing agencies’ strategic plans.;
  • Be solution-focused, including developing new and practical ways for getting things done. This includes cross-agency practice protocols, communications systems, shared goals, training and practice ‘language’. 

Experience has shown that, while new initiatives to address deeply-entrenched problems may require additional or even redirected resources, by far the most important ingredient for success will be interagency commitment at the highest level. 

Also essential will be a system of adequate reporting on progress, monitoring and evaluation structures inbuilt to the action plan. 

Unique opportunity

Despite being overdue, this taskforce has a unique opportunity to influence the future direction of strategy and practice in this area and thereby make a significant contribution to making our communities safer, as well as ensuring that those in need of help get it, ideally before they need to punished and, where possible, without their having to enter the criminal justice system in the first instance.

Vivian Geiran is adjunct assistant professor at the School of Social Work and Social Policy and a board member of the Irish Association of Social Workers and former Probation Service Director

Read the full article here: https://www.irishexaminer.com/opinion/commentanalysis/arid-40261280.html