People in prison experience many mental health and behavioral difficulties which are often complicated at a higher rate than people in the community. Mental health services in prison must be equivalent to those in the community in terms of accessibility, quality, and the types and scope of interventions available. Research conducted in the United Kingdom documents the high prevalence of a range of common mental health problems and serious mental disorder, and points to particular vulnerabilities and service gaps for certain groups, including women, young people, the elderly and people in remand. As part of a broader program of health needs assessment, the Scottish Government has commissioned a national assessment of mental health needs among the prison population in Scotland to ensure that future changes to mental health services in prisons are evidence-based and person-centred.
Mapping of mental health services available to individuals in and out of prison
The mapping exercise was conducted to describe the services available to support people’s mental health in Scotland’s prisons. While there have been significant positive developments in multidisciplinary mental health services in prisons in the past decade since the transfer of responsibility for health care delivery in prisons to NHSThe results showed that there are inequalities in some prisons resulting in inconsistent and somewhat arbitrary allocation of service resources that are not closely related to the prison population. The current assignment of NHS Resources necessarily direct support to those with severe mental illness while leaving a large number of people in prison without support from which they can benefit. Service pressures resulting from difficulties in recruiting and retaining employees have been exacerbated by COVID-19 Pandemic and requires action. While there is a role and willingness from non-health agencies to support the mental health and well-being of people in prison, these efforts are hampered by low training opportunities for relevant staff, limited interagency partnership and action and information sharing between justice and health. and third sector organizations.
Understanding the scale of the mental health needs of prison inmates
Strong data on the mental health needs of prison inmates in Scotland are needed to develop services tailored to meet the specific needs of this group. However, data on the mental health needs of people living in Scotland’s prisons is not routinely collected at the national level. Quantitative modeling has been used to estimate the proportion of the prison population in Scotland likely to have mental health needs, using known information about the needs of people in the community. Findings indicate that 15% of the prison population is likely to have a long-term mental health condition, 17% have a history of self-harm, 30% have current alcohol use disorder, 16% symptoms of anxiety, and 18% symptoms of depression over year round. last week. The estimated prevalence of needs was higher among remand inmates, in younger age groups, and in women than in men, except for alcohol use disorder and depression. Data on the use of inpatient forensic services by persons in prison have been examined and indicate that, for prison inmates in Scotland as a whole, these individuals were disproportionately female and on remand. The vast majority were transferred in order to treat a psychotic disorder.
Dealing with professional stakeholders and individuals with live experience
Reflecting on the delivery of existing mental health services and related challenges, professional stakeholders working across justice, health, third sector organizations and other partner agencies called for a ‘cultural shift’ and noted the need for a ‘big change at sea’ for mental health. Health must be more meaningfully supported within Scotland’s prisons. They also highlighted the need for increased resources across the Scottish Prison Service (SPS).SP) And the NHS Mental health teams, improve access to appropriate training for SP Staff to support the implementation of a trauma science approach within prisons.
People with lived experience of acquiring mental health needs while in prison recall a reluctance to share their mental health concerns with prison officers due to a general lack of dignity and respect on the part of officers, or a perceived lack of training to provide needed support.
Conclusions and Recommendations
This needs assessment found that providing the current service to support the mental health and well-being of people in prison places too much responsibility on the individual to participate and to choose to share information with mental health services to obtain the necessary support. Prison mental health services do not equate to the care available to members of the community, and do not adequately address the high levels of needs in this population. A fundamental change is required in the approach to prison care and mental health services in prisons.
Joint and coordinated action from justice, health and social care, and third sector providers is needed to overcome long-standing and structural challenges to supporting the mental health and well-being of people in prison. This can be achieved by developing a formal partnership at the national level, enabling it to address strategic and operational issues, and will provide opportunities for governance, quality improvement and assurance in multi-agency mental health services and support. The findings also emphasize the need for additional resources for mental health services in prisons, particularly in prisons where this is currently limited, in order to achieve consistency across prison holdings. Changes in practice are needed at the operational level to improve the work of inter-agency partnership and information exchange. Relevant mental health training should be mandatory for all staff working with people in prison, in line with the prison-wide approach to supporting individuals’ mental health and well-being.
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