Recommendations
42 items
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Annual, mandatory training should be given to frontline staff to ensure they adopt a person-centred and trauma-informed approach to providing support to individuals under their care. Detention settings should adopt OHID’s working definition of trauma-informed practice.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Staff training on responses to mental health crises should involve input from people with lived experience and families bereaved by suicide. Staff themselves should be given the opportunity to inform training content as well.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Detention settings should draw on learning from community postvention initiatives and the postvention initiative in prisons being developed in collaboration with the Samaritans to ensure people in detention and staff are supported when a death does occur.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Safety impact assessments should be introduced across detention settings to ensure that all policy proposals include assessment of their likely impact on the health and safety of detainees and the staff charged with their care.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
The transfer of information between different teams in individual custodial institutions, as well as with external agencies and organisations across the criminal justice system, needs to be improved. This should include the revision of robust memorandums of understanding between relevant teams and organisations.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Mental health services need to be universally available to individuals in detention and properly resourced.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Greater resource is required to ensure more hospital beds are available to ensure transfers from prisons or IRCs to hospital for individuals with severe mental health needs requiring hospital treatment are done within the 28-day limit proposed in the draft Mental Health Bill.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Tailored, multidisciplinary support is needed to address the often complex and diverse needs of female prisoners.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Release planning for detainees should be improved to prevent post-custody deaths. This should always involve input from core services, such as health, housing, and addiction treatment. Services should ensure each establishment has staff with clear responsibilities for making sure arrangements to support individuals ahead of release are taking place.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
End-to-end systems of support should be put in place for people leaving all forms of detention. This is particularly important for individuals deemed at higher risk, such as those leaving police custody accused of child sex abuse and indecent image offences. Evaluation of interventions is needed to understand which are most successful and to ensure forces are not simply relying on signposting.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
More health-based places of safety are needed to ensure individuals detained and transported under Section 135 and 136 of the Mental Health Act can be managed safely and in a timely manner.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
DHSC should lead work with the Home Office to ensure targeted resources and improved systems are in place to make sure mental health professionals, not police officers, are the first responders to individuals experiencing a mental health crisis.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Detention staff involved in care planning processes should make sure that non-clinical risks, such as negative parole outcomes and a lack of social visits, form part of self-harm and suicide prevention conversations and actively inform interventions.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Safety interviews and assessments should always take place in private to encourage detainees to share information about their mental health, wellbeing, and any concerns they may have openly and honestly.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Risks should be recorded in one place to enable easy and quick access to up-to-date information on detainees’ vulnerabilities and needs. This should include healthcare information. Plans contained within the Prisons Strategy White Paper to create a single digital prisoner record should be fast tracked.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Detention settings should review processes to ensure a multidisciplinary approach is taken to supporting the mental health needs of detainees. Healthcare staff should be involved in self-harm and suicide prevention processes to ensure support is not fragmented.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Information on the Rule 35 process should be translated into a variety of languages and be readily available for detainees in immigration detention. An independent review of Rule 35 should be commissioned with the importance of protecting those at risk of suicide and self-harm, as recommended by the ICIBI. This review should involve health partners.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Individuals in immigration detention placed on an ACDT should be automatically referred for a mental health assessment.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Self-harm and suicide prevention processes should be used at an earlier stage than when the detainee is at the point of crisis in order to maximise the efficacy of interventions.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Leadership in individual prisons should take responsibility to ensure peer support programmes, particularly the Samaritans Listener scheme, are in place, supported, and prioritised.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Where appropriate and with consent, families should routinely be involved in ACCT reviews and care planning processes for individuals identified at risk of self-harm or suicide. Staff must facilitate this and respond promptly to issues raised.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Consent to contact families about mental healthcare concerns should be sought from individuals early on during their detention and kept under review.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Places of detention must have working, adequately resourced phone lines to ensure families can promptly escalate concerns about prisoners’ wellbeing. A dedicated phone line for families should be introduced across all detention settings.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
In-cell telephony should be rolled out across the prison estate. In the interim, a flexible approach should be taken by staff to ensure vulnerable prisoners can contact their families as a means of support.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Individuals in IRCs without close family ties should be empowered to access support provided by charities supporting detainees.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Where possible, individuals should be detained close to their homes, families, and communities to ensure they have access to support. Where this is not possible, schemes to facilitate visits, such as help with travel costs and accumulated visits, should be amplified as well as video-calling facilities offered as an alternative.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Proactive steps should be taken to review and remove ligature points in accommodation across all detention settings.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Physical conditions across detention settings should be improved to benefit good mental health. For instance, examples of good practice are already taking place across several police forces which should be shared with and embedded across all forces as well as other detention settings where appropriate.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Alternative provision is needed to ensure custodial settings can reduce inappropriate use of segregation. Its use should not be a means to prevent self-harm and suicide.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
The provision of care suites for individuals in crisis should be rolled out across the immigration detention estate.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Out of area placements for individuals detained under the Mental Health Act should be eliminated, as outlined in the Five Year Forward View for Mental Health, to enable patients to receive care closer to their support networks.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Alternatives to remand and non-custodial sentences should be prioritised, where possible. Sentencing decisions should be informed by high-quality pre-sentence reports. Training for staff is needed to improve the quality of, and thereby increase judicial confidence in, pre-sentence reports.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Indeterminacy for patients detained under the Mental Health Act should be minimised. Where possible, they should be given a clear timetable for their discharge. Similarly, information should be given to detainees in IRCs on the process of their release in a language they can understand.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Detention settings should invest in interpretation services to ensure detainees are able to access information and support and can communicate their emotions and concerns.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Prisoners should be given access to daily activities which promote their sense of purpose and wellbeing. Staff recruitment and retention, to facilitate purposeful regimes, is a key aspect of this.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
An independent body with an investigative function, similar to that carried out by the PPO and IOPC, should be established to investigate deaths under the Mental Health Act.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Departments should consider the establishment of a function to monitor Article 2 compliance to ensure learning from investigations and inquiries is fully acted on and shared.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Staff shadowing opportunities should be made available across detention settings to facilitate sharing and embedding of learning and good practice.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Places of detention must be open to and facilitate research on self-inflicted deaths to develop an evidence base for interventions.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Research should focus on diversity within detention settings, factoring in the different experiences of, for example, women, young people, and ethnic minority groups.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
Research in detention settings which have a lower incidence of completed suicides should focus on ‘near misses’ and attempted suicides.
No response text is recorded for this recommendation.
Addressed to: Department of Health and Social Care · Open
Recommendation · source text
DHSC should produce high-quality, disaggregated data on deaths of people detained under the Mental Health Act to enable an in-depth understanding of deaths across different population groups.
No response text is recorded for this recommendation.