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MENTAL HEALTH IN THE CRIMINAL JUSTICE SYSTEM

MENTAL HEALTH IN THE CRIMINAL JUSTICE SYSTEM. The Perspective From The Irish Prison Service Fergal Black Director of Healthcare, Irish Prison Service Association for Criminal Justice Research and Development . Background. Increase in Prisoner Numbers. Healthcare in Prisons.

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MENTAL HEALTH IN THE CRIMINAL JUSTICE SYSTEM

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  1. MENTAL HEALTH IN THE CRIMINAL JUSTICE SYSTEM The Perspective From The Irish Prison Service Fergal Black Director of Healthcare, Irish Prison Service Association for Criminal Justice Research and Development

  2. Background • Increase in Prisoner Numbers

  3. Healthcare in Prisons • 3 main care domains: • Primary Care and Chronic Disease Management • Drug Treatment and Addiction • Mental Health

  4. Primary Care • Model of care through which healthcare is delivered • Healthcare Standards • Care Interventions

  5. Drug Treatment and Addiction • IPS Drug Treatment Clinical Policy • Investment in Responding to Addiction Issues • Increase in number of prisoners treated with substitution therapy

  6. Number of clients Increased Provision Methadone Treatment New 3000 2500 2000 1500 1000 500 0 _2000 _2001 _2002 _2003 _2004 _2005 _2006 _2007 _2008 _2009 Year Number of Prisoners Receiving Methadone Treatment

  7. Mental Health • Significant health deficits among prisoners • Prisoners defined as a special needs group • Prevalence of severe mental illness is significantly worse among prisoners compared to the general population • CMH NFMHS Study – 7.5% of men on remand suffer psychosis; twice the national average

  8. Service Provision • Dublin & Portlaoise Prisons - CMH NFMHS provides 20 consultant-led in-reach sessions • Other Prisons – mental health services are provided by mix of HSE-based and privately contracted psychiatrists • Access to CMH and local mental health services

  9. Number of Prisoners Awaiting Transfer to CMHJanuary – November 2010

  10. Diversion • Vision for Change (2006) • Right of those with mental health illness to receive mental health care, unless subject to legal and cogent rationale • Transfer of persons with significant mental health illness from the CJS to hospital or community treatment setting

  11. Diversions to Community Mental Health Treatment 2007 – 2009

  12. CLIA 2006 • CLIA Amendment Bill • Condition of Discharge: Mental Health Review Tribunal • Community Forensic Settings • Improve throughput and access to CMH beds

  13. Summary • As prison numbers rise, more committals with poor levels of general health, and mental health specifically • Serious mental illness, for a small number, may be a prominent influence in offending • Reasons for increase in numbers of prisoners with mental health issues are poorly understood but include a lack of alternatives to custody

  14. Summary • Public concern and lower tolerance in society for abnormal behaviour • Public pressure to tolerate fewer risks to public safety • Perception that prison is a safer location • Depletion in capacity in community mental health facilities coinciding with the creation of increased capacity in the criminal justice system

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