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Central Mental Hospital is at full capacity, prisoners with severe conditions wait 120 days for transfer

There are also currently 614 prisoners on a waiting list for an intervention from prison psychology services.

The average waiting time for transfer from the prison to CMH is 120 days.
The average waiting time for transfer from the prison to CMH is 120 days.
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THERE HAS BEEN no improvement in mental healthcare for Ireland’s prison population over the past year and there is particular concern about waiting lists for those due to be transferred to the Central Mental Hospital, according to a new report.

There were 29 prisoners awaiting transfer to the mental hospital in Dundrum, Dublin at the end of April 2019, the Irish Penal Reform Trust’s (IPRT) annual report shows.

Executive director of IPRT Fíona Ní Chinnéide said it is disappointing that there hasn’t been a reduction in the numbers of people in prison with acute mental illness awaiting transfer to the Central Mental Hospital (CMH) over the last three years.

“People with severe mental health issues cannot wait for the opening of the new facility at Portrane in 2020, so it is important that there is a declared commitment, as well as clear accountability in terms of reducing waiting lists for the CMH, and for diverting people experiencing mental illness from the prison system.”

‘Full capacity’

People who have been found not guilty by reason of insanity after a trial, or those in the prison system who have been diagnosed with severe psychological conditions by psychiatrists are transferred to the CMH.

This week a mother who smothered her three-year-old daughter with a pillow was found not guilty by reason of insanity.

Yesterday the court was told the woman could not be committed to the Central Mental Hospital on Wednesday because the facility had reached “full capacity in its quota of female patients”.

A barrister for the HSE told the Central Criminal Court that every effort was being made to secure a bed for the woman and it was hoped that the matter would be resolved by this morning. The judge in the case vacated her committal order and released her on bail until a bed can be made available at the hospital.

In May, a judge in Ennis, Co Clare, criticised the State’s failure to locate a placement for a man who had been found not guilty of arson by reason of insanity. 

At that time, counsel for the State told the judge that there were 48 people waiting for a place at the CMH. 

Twenty-five-year-old Ross Malone was in Limerick prison at the time due to the unavailability of beds at the mental hospital. Judge Gerald Keys said the State is “duty bound under our constitution to provide these facilities and they are not doing it”.

It is not good enough to say that there are no resources. All you have to do is read in the newspaper that we have had €7 billion of a windfall on savings in relation to the exchequer. I get no pleasure having to say these things, but there is frustration just building up all the time in relation to resources in the criminal justice system.

Waiting times

The IPRT report states the hospital is currently operating at 100% of its capacity with admissions “systematically triaged according to the level of therapeutic security required and the urgency of clinical need”.

The average waiting time for transfer from the prison to CMH is 120 days, with a range from seven to 504 days. The IPRT has said the new facility planned for Portrane next year, which will have a maximum capacity for 170 patients, will “not meet demand based on the current and persistent number of prisoners awaiting transfer”. 

cmh3 Figures from the 2016 Census show there were 97 people in the Central Mental Hospital. Source: Health Research Board

General mental health services for prisoners across the country is also an issue of concern, according to the trust. 

A recent Irish Prison Service (IPS) study on self-harm in prisons found there were 223 incidents between 1 January and 31 December 2017. An episode of self-harm was recorded for 4% of the prison population and the majority of these prisoners were male.

Last year an inquest into the death of a man by suicide at Cork Prison heard evidence that 15-minute checks required for prisoners on ‘special observation’ had not been carried out. IPS procedures were changed following the inquest. 

The IPRT said the psychologist-prisoner ratios are “poor for much of the prison population”, with the lowest found in Castlerea (one counsellor to every 170 prisoners) and Cloverhill (one counsellor to ever 431 prisoners) prisons.

“Cloverhill is the main remand facility; as already noted, there is a high prevalence of mental health issues among the remand population, with previous domestic research having shown rates of psychosis to be among the highest for the remand population, at 7.6%,” the report states.

Cross-agency approach

There are currently 614 prisoners on a waiting list for an intervention from psychology services.

“The serious issues of prisoner numbers and access to mental health services while in prison can’t be solved by the Department of Justice and Equality or any one organisation alone,” Fíona Ní Chinnéide commented.

She said a cross-agency approach is needed with input from the judiciary, legislators and multiple departments, as well as the HSE and An Garda Síochána.

“We have been working closely with many of these organisations since the publication of the first Progress in the Penal System report in 2017 and hope that the short-term actions identified in today’s report will be considered and progressed by the relevant stakeholders.

“We all have the same vision: that of Ireland having a world-class penal system and becoming a leading model of international best practice.”

Need help? Support is available:

  • Aware 1800 80 48 48 (depression, anxiety)
  • Samaritans 116 123 or email jo@samaritans.ie
  • Pieta House 1800 247 247 or email mary@pieta.ie (suicide, self-harm)
  • Teen-Line Ireland 1800 833 634 (for ages 13 to 18)
  • Childline 1800 66 66 66 (for under 18s)

With reporting by Gordon Deegan

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