ANALYSIS:While Mountjoy's award is welcomed, the rate of prisoner depression and psychosis is alarming, writes MUIRIS HOUSTON
BECAUSE OF gaps in the wider psychiatric services, it is still relatively common for someone with severe psychological disease to enter the prison system before their condition is recognised. This partly explains the high incidence of mental illness in the prison population.
According to Amnesty International’s report Mental Illness: the Neglected Quarter, those detained in Irish prisons are more likely to suffer with major depression and psychosis than the general population. A 2003 report by Dr Harry Kennedy and his colleagues from the Central Mental Hospital found rates of psychosis were 3.9 per cent among men committed to prison and 2.7 per cent among sentenced men. Women prisoners had a psychosis prevalence of 5.4 per cent. Of note, the rate of psychosis in remand prisoners was much higher than in comparable samples from other countries.
Meanwhile, up to 80 per cent of prisoners had alcohol and drug- dependence problems. The researchers discovered that major depressive illness was present in 10 per cent of male remand prisoners and 16 per cent of female sentenced prisoners. They estimated that as many as 20 per cent of male committals and 32 per cent of female committals needed a psychiatrist.
The high support unit, with its team of trained prison officers, is already proving its worth. Although the need for improved psychiatric services was identified some eight years ago, it has taken strong criticism from the Council of Europe’s committee for the prevention of torture and inhuman or degrading treatment for meaningful change to occur.
In its latest report on the Irish prison system, the council refers to an expression of its concerns to the Government about the use of padded cells (special observation cells) for prisoners with psychiatric illnesses. The report says: “On March 2nd, 2010, the Inspector of Prisons was asked to carry out a review of the use of special observation cells, and in his preliminary findings in relation to Mountjoy Prison he found that these cells were used for a variety of purposes and in the majority of cases not for the uses that they were intended.
“A comprehensive review of the practices and procedures in place, and of the physical conditions of the cells, is under way. The council welcomes the review; it is an opportunity to clearly identify the purpose of the special observation cells and ensure clear operating procedures govern the placement of inmates in them.
“The council would like to receive a copy of the review report and be informed of any measures taken in the light of that report,” it says.
Welcome as the World Health Organisation’s award to the staff of Mountjoy is, establishing the high support unit and changing the practice of isolating people with severe psychological illness in padded cells has taken a long time to implement.
“From a healing perspective, the resulting sensory deprivation and isolation experienced by ill prisoners are completely counterproductive,” it adds.
For the remaining prisoners, the high support unit model must be put in place without delay. It is a budget-neutral initiative so there are no excuses to prevent a proper system of care being made available to all prisoners with significant psychological illness.