A prisoner who repeatedly self-harmed spent more than 800 days in segregation, according to a damning report that reveals that jails are using isolation to manage severe mental health needs.
The inmate, who was detained under the imprisonment for public protection (IPP) scheme, is one of dozens with severe psychological issues who have been held for months at a time in isolation, the Independent Monitoring Board (IMB) has concluded.
Observers at a high security prison found that the inmate, identified in the report as “Mr H”, had been diagnosed with a personality disorder and had repeatedly self-harmed.
He was temporarily transferred to a specialist psychological unit but his behaviour deteriorated, and he was returned to a segregation unit again.
Prisoners with severe mental health needs who require care in a secure hospital or psychiatric intensive care unit should be transferred within 28 days, as set out by NHS England guidance.
Mental Health Act reforms were due to make the 28-day transfer target a statutory requirement. However, the bill was not included in the king’s speech in November, meaning it will not be passed in this parliament.
The IMB report, released on Thursday, said the Prison Service too often uses segregation in care and separation units (CSUs) as a way of managing prisoners with severe mental health needs.
It uncovered numerous examples of mentally unwell prisoners being held in isolation. They include a man with autism, a schizophrenia diagnosis and displaying severe ADHD symptoms spending almost nine months in a category C prison’s segregation unit, during which time his mental health dramatically deteriorated.
Another prisoner with complex mental health needs was segregated for 300 days while awaiting assessment for transfer to a secure mental health hospital.
By the time he was assessed and transferred, he had spent more than 550 days in the segregation unit – nearly 20 times the target transfer time.
Elisabeth Davies, the IMB chair, said: “Too often, the Prison Service is using CSUs as the default setting to manage and care for men with severe or challenging mental health needs.
“These units are holding bays for those who face lengthy delays prior to transfer to a more appropriate secure setting, stuck in CSUs because there is simply nowhere else for them to go.”
The report was compiled after surveys of monitoring boards at 30 prisons, which was completed in the spring.
Nearly all of the prisons had held men with mental health needs in CSUs, the survey found.
There was a lack of capacity in prison healthcare units and there were delays in referrals, assessments and transfers, the report said. Some prisoners struggled to cope in residential wings.
Campbell Robb, the chief executive at the charity Nacro, which helps people in prison and on their release, said the policy of holding people with mental health needs in isolation was “completely wrong”, adding: “These are vulnerable people at a moment of crisis – they deserve support, treatment and stability, not to be made to pay the price for our overstretched prison and health services.”
A government spokesperson said: “Segregation is an absolute last resort for those deemed a danger to themselves or others.
“Prisoners are entitled to the same care as they would receive in the community, which is why we guarantee the most vulnerable individuals are able to access mental health support tailored to their needs.”
