A report by Cormac O'Keeffe in the Irish Examiner ('Lack of therapy means prisons are turning to pills', Monday 16th July 2012) has revealed a 20% increase in the Irish Prison Service expenditure on pharmaceuticals. The increased spending highlights the vulnerable mental health status of many prisoners in Ireland, the lack of adequate psychiatric healthcare for those prisoners, and the need for more suitable accommodation for prisoners with acute mental illness.
Firstly, increased pharmaceutical spending coincided with, and can largely be attributed to, a significant increase in the numbers of people being sent to prison. In 2004, 8,820 people were sent to prison; in 2010, this had increased to 13,758 people. This 55% increase in prisoners over a six year period saw spending on pharmaceuticals increase 20% from 2.4m to 2.96m.
Secondly, people who suffer mental illness are over-represented in Irish prisons. Recent studies suggest that as many as 27% of sentenced men and 60% of sentenced women suffer from mental illness. Prisoners also suffer high levels of substance or alcohol addictions. Rates of prevalence of psychosis, major depressive disorder, and anxiety disorder are worrying and raise questions about the suitability of a custodial sanction for many offenders. Responding to the Irish Examiner's findings on the increased expenditure on pharmaceuticals, the newspaper cites Prof Joe Barry (IPRT Board member): "If you really want to reduce the cost of the drug bill you need to change sentencing policy and reduce the number of people with primarily mental health issues going to prison. That’s the single biggest take-home message from these figures."
Thirdly, there is a lack of adequate psychiatric care and drug treatment for prisoners. The Inspector of Prisons, Judge Michael Reilly, has previously stressed the urgent need for bed availability in the Central Medical Hospital, as well as adequate counselling and drug treatment programmes in all prisons. In his 2011 Guidance on Physical Healthcare in a Prison Context, Judge Reilly found serious shortcomings in relation to the conditions facing prisoners with acute mental illness.
Finally, mental illness in prisons in Ireland must also be understood in the context of conditions such as overcrowding and ‘slopping out’. Most recent figures indicate that the Dochas Centre women's prison was operating at 50% over its capacity (Nov 2011) and Mountjoy Prison (male) held 710 prisoners when it should hold no more than 517 (March 2011). Most recent figures indicate that 17% of prisoners are 'on protection', which can mean restricted regimes and de facto solitary confinement. All of these conditions lead to an environment wholly unsuitable for the maintenance of health, and in particular mental health.
IPRT is committed to respect for human rights in prison and the use of prison as a sanction of last resort - the issue of prisoner mental health is key to developing a more progressive and effective penal system.