Mental Health Issues in Irish Prisons
A number of reports on the Irish prison population have noted significant problems with the continuing incarceration of individuals with mental health issues. The types of presented mental illnesses range from affective disorders (depression and dysthymia), psychotic disorders (delusions and hallucinations), anxiety and suicidal behaviour which can be exasperated by the widespread presence of drink and drugs in prisons. The current system for dealing with such prisoners entails a full evaluation of all prisoners on committal after which, if clinically indicated, the prisoner is referred to a psychiatrist who can make proposals for their care. However, in spite of these provisions, successive reports, such as the 2011 European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment highlighted the failure of the system to treat individuals with mental health issues. There are a number of reasons for this including that courts have not sufficiently made use of the ‘not guilty by reason of insanity’ plea as outlined in the Criminal Law (Insanity) Act 2010, persistent overcrowding resulting in prisoners sharing cells and/or being locked up for long periods, and a lack of training among prison staff who often lack basic knowledge about mental illnesses.
How then can this issue be addressed? The Irish government’s pragmatic answer remains the building of new larger prisons such as the often mentioned Thornton Hall complex with a projected capacity of 2,200 inmates. However, the above-mentioned European Committee report has already raised serious misgivings about this project noting that mega-prisons have historically proven unable to deliver the specialist mental health services required. To this author, the key problem is a wider social indifference to the plight of prisoners with mental illnesses. There is no simple short-term solution, such as building larger prisons, as it requires a long-term commitment to up-date and modernize the entire system. It must also be recognized that prisons are not suitable places for individuals with mental health issues and if their illnesses are addressed in the community at an earlier stage, the benefits to the individual, the prison system and society would be substantial.