Mental health and criminal justice: current position and what needs to happen in the future Sean Duggan, Joint Chief Executive 13 th November 2010

Mental health in prisons Prison population reached 85,600 on 31 st August 2010 Majority of prisoners have MH problems Over 90% have one MH problem More than 70% suffer from two or more MH problems Many have complex mix of other issues Prison mental health care Improvements in some prisons as a result of mental health in reach teams but picture still mixed Little provision for vast majority of prisoners with common MH problems such as depression Funding no more than one-third of what is needed to deliver policy objective of equivalence

Young people (1) On 31 st August 2010, 11,770 young people (aged 15-20) were in custody High risk of multiple health inequalities and poor life chances One third have mental health needs, often undiagnosed and untreated 8 in 10 young people (aged 16-20) in custody have more than one mental health need; almost all meet criteria for a diagnosis of personality disorder 1 in 5 young people in community and custodial settings meet criteria for a learning disability

Young people (2) Importance of early intervention Conduct problems most common childhood mental health difficulties Estimated 80% of criminal activity attributable to people who had conduct problems in childhood, at a cost of £60 billion a year Programmes aimed at prevention or early intervention most effective Adapting diversion techniques for young offenders Point of arrest pilots ‘Wraparound’ approaches

Police Bradley recommendations on section 136 Transfer commissioning of health services from police to NHS

Diversion All Stages Diversion Model Interventions to address complexity of need

Secure services Around 4,000 people in secure services (compared with an estimated 8,000 prisoners with severe mental illness) Cost the NHS £1.2 billion in 2009/10 Vast majority of places are in medium secure units Growing concern about capacity Excessive delays for prison transfers Recommended 14-day maximum transfer waiting time Need to improve pathways through security levels and between prisons and secure services

Current government strategies (1) NHS White Paper Commissioning: GP consortia; prison health care to be commissioned nationally Health and Wellbeing Boards in local authorities Outcomes framework MH Strategy

Current government strategies (2) MoJ ‘Rehabilitation Revolution’ 3,000 fewer prisoners by 2014 More rigorous and effective community sentences Key role for private sector and voluntary organisations Payment by results and Social Impact Bonds – Peterborough prison pilot Common theme: need to ensure cross- departmental and agency working

Thank you