Mental health access for alcohol addiction

HMP Eastwood Park, a women's closed local prison, maintained a population of 351 against an operational capacity of 395. The report highlights ongoing challenges with an extremely high rate of self-harm (4,479 incidents) and 235 assaults on staff, although no deaths in custody occurred for the second consecutive year. Significant concerns include the detention of mentally unwell women awaiting hospital transfers, persistent staffing shortages exacerbated by vetting delays, and a restrictive regime for the general population due to the management of segregated prisoners.

HMP Wakefield is a high-security prison for men, reporting an operational capacity of 744 and a population of 793. The Board noted significant improvements in staff recruitment and key worker sessions, as well as the delivery of healthcare and a varied education curriculum. However, it raises serious concerns regarding prisoner safety, including drone incursions and increased violence. Longstanding issues with delays in mental health transfers to hospitals, inadequate physical infrastructure, and insufficient purposeful activity opportunities for prisoners remain critical areas for development.

HMP/YOI New Hall operates as a closed prison for women, holding 313 prisoners against an operational capacity of 376. The report highlights several positive developments, including effective reception processes, successful key worker implementation, and improved chaplaincy services. However, significant concerns remain regarding inadequate mental health provision and lengthy transfer delays for acutely unwell prisoners, a 50% increase in healthcare complaints, and ongoing issues with regime limitations and prison maintenance.

HMP/YOI Bronzefield, a local female prison, effectively managed the initial COVID-19 lockdown, maintaining a nearly virus-free environment, but the sustained restricted regime led to a significant rise in self-harm and mental health concerns. Key issues included a high proportion of prisoners released without stable accommodation, persistent challenges with timely mental health transfers, and a shortage of cell keys affecting prisoner property security. Despite these, the Board noted positive developments in food quality, key worker implementation, and effective education provision during the pandemic.

HMYOI Feltham's report (Nov 2019-Aug 2020) highlights a challenging period dominated by COVID-19 lockdown. While staff were commended for their dedication and a reduction in violence and self-harm was noted, concerns persist regarding the long-term impact of extreme confinement on prisoners' mental health. Significant issues include deteriorating accommodation, delays in mental health transfers, and insufficient purposeful activity for young adults.

The IMB report for HMYOI Cookham Wood covers 1 August 2019 – 31 August 2020, focusing heavily on the impact of the COVID-19 lockdown. While staff are commended for their caring approach and efforts to maintain safety and welfare, particularly during initial lockdown, the severe and protracted regime resulted in boys being locked in their rooms for over 23 hours a day, raising significant concerns about inhumane treatment, especially for those in segregation or with mental health issues. Key challenges include the unfit Phoenix segregation unit, national shortages of mental health beds, delays in transferring young adults, and an increasing remand population, all exacerbated by the lack of IT capacity during the pandemic.

The COVID-19 pandemic significantly impacted HMP Hewell, leading to a full lockdown, 23.5-hour cell confinement, and cessation of most activities. While staff are commended for averting a direct catastrophic impact from the virus and improving cleanliness, concerns remain regarding prisoner welfare, mental health, and rehabilitation. The prison saw leadership changes and continued a journey of improvement after years of poor performance, with some areas showing progress despite ongoing challenges in safety, healthcare provision, and regime delivery.

This IMB annual report for HMP Channings Wood (September 2019 – August 2020) highlights the significant impact of COVID-19 restrictions. The Board commends staff for maintaining a safe and well-run prison, noting reductions in assaults and ACCT cases, and improvements in education and complaint handling. However, key concerns persist regarding the detrimental effect of COVID-19 on prisoners' mental health and self-harm, unacceptably long delays in mental health transfers, the poor condition of the prison estate, and inefficient management of prisoners' property during transfers.

In 2020, Brook House IRC faced significant challenges due to the COVID-19 pandemic, a contract change to Serco, and a compressed charter flight programme for Dublin Convention removals. The Board found the centre unsafe for vulnerable detainees in the latter months, marked by a dramatic increase in self-harm and suicidal ideation, and inhumane treatment of detainees due to Home Office policies. Delays in Rule 35 assessments, inadequate inductions, and issues with property and communication from the Home Office were key concerns, despite a welcome increase in staff numbers and some improvements in facilities.

The IMB report for Heathrow IRC (Jan-Dec 2020) highlights that the Centre generally maintained safety and humane treatment, successfully minimizing COVID-19 spread and sustaining services during lockdowns. Key concerns remain regarding the detention of individuals with severe mental health issues, inadequate detention gatekeeping, and the presence of illegal substances. Delays in police response, issues with remote DET engagement, and long periods of detention for some individuals are also noted as significant challenges.

HMP/YOI Downview operated under severe Covid-19 restrictions, leading to a significantly reduced regime with prisoners largely confined to cells for 22.5 hours a day. Despite these challenges, the Board found Downview to be a safe prison, with staff highly commended for their efforts in maintaining safety and humane treatment. Concerns persist regarding mental health provision, the impact of prolonged lockdown on prisoners' well-being, and the limited availability of purposeful activity and external support services.

HMP/YOI Bronzefield operated under severe Covid-19 restrictions, impacting prisoner well-being and regime delivery, exacerbated by staff absences. Despite these challenges, the prison managed the pandemic effectively, improved mental health transfers, and achieved Hepatitis C elimination. However, concerns remain regarding escalating self-harm incidents, a high number of prisoners released without accommodation, the prison's use as a 'place of safety' for mentally unwell women, and persistent drug ingress.

This report covers a year dominated by the Covid-19 pandemic at Aylesbury YOI, which saw a reduced prisoner population of around 209. Despite a severely curtailed regime and poor education provision, the prison maintained stability, low infection rates among prisoners, and provided daily showers and exercise. Key concerns include the lack of mental health beds, the weakening of the key worker scheme, and the risk that post-pandemic priorities will shift from prisoner outcomes to risk management as population numbers increase.

This report highlights HMYOI Wetherby's effective management of the Covid-19 pandemic and positive staff-prisoner relationships, alongside significant improvements in facilities and family contact. However, it raises serious concerns, particularly the chronic shortage of secure mental health beds, delays in transferring young adults, and persistent issues with maintenance. The Board also notes challenges in staffing stability, ACCT application, and high levels of violence, urging action from the Minister, Youth Custody Service, and Governor.

HMP Guys Marsh, a Category C training prison, navigated a challenging year (Dec 2020 – Nov 2021) under a restrictive "red regime" due to COVID-19. While recording no deaths in custody and a 20% drop in self-harm, concerns persisted regarding a significant increase in staff assaults, high mental health transfer waiting times, and problems with key working and purposeful activity due to staffing pressures and regime restrictions. The Board highlighted the need for improved staff retention, better IT systems, enhanced resettlement provisions, and a more consistent application of incentive schemes.

HMP Berwyn, a category C resettlement prison, experienced its first period near full operational capacity during a reporting year largely impacted by the Covid-19 pandemic. Despite restrictions, the IMB found the establishment safe with generally good staff-prisoner relationships and efforts made to provide education and essential work. However, significant concerns persisted regarding infrastructure defects (heating, paint), lengthy healthcare waiting times, and delays in transferring prisoners with mental ill-health or those eligible for Category D.

The 2021 report covers the first year of the combined Gatwick IRC (Brook House and Tinsley House) under merged IMB oversight and Serco management, with the year dominated by Covid-19 restrictions, unprecedented Channel crossing arrivals through Tinsley House, and ongoing Home Office case management failures leading to prolonged and often unnecessary detention. While Serco staff generally treated detained men with respect and compassion, systemic failings in mental health support, access to legal advice, property management, and Home Office communication remained serious and in many cases repeated concerns.

The IMB report for Heathrow IRC (Jan-Dec 2021) identifies generally safe conditions but raises serious concerns regarding the management of Short-term Holding Facility (STHF) detainees, particularly South Coast Arrivals (SCAs), which compromised safety and humane treatment. Significant issues include the inappropriate detention of individuals with severe mental health needs, a critical lack of engagement from the Detention Engagement Team (DET), and unacceptably prolonged detention periods for many. The Board calls for urgent policy reviews, capital investment in infrastructure, and improved communication and service provision to address these systemic problems.

HMP Leicester maintained its status as a well-run establishment during the reporting year, demonstrating strong leadership and staff commitment despite ongoing Covid-19 restrictions. Safety remained a high priority, with reductions in violence and self-harm, improved security, and good management of Covid cases. However, the Board raised significant concerns regarding the long waits for mental health transfers, the management of IPP prisoners, and the impact of a high remand population on resettlement, alongside persistent issues with staff recruitment and retention.

HMP Nottingham operated under pandemic restrictions for most of the reporting year, gradually easing, with effective governance despite management flux. While self-harm incidents decreased, violence between prisoners increased significantly. Key concerns include the ongoing situation for IPP prisoners, the lack of separation for remand and convicted prisoners, and inadequate mental health facilities, alongside regime restrictions and low education attendance.

HMP/YOI Moorland, a Category C resettlement prison, reported a population of 915 against a reduced operational capacity of 964 for the year ending February 2022. The report noted positive trends with reduced self-harm and violence incidents but highlighted significant concerns regarding the treatment and progression of IPP prisoners and persistent delays in mental health transfers. Staffing shortages affected key worker provision and programme delivery, while long waiting times for dental care were also an issue.

HMP/YOI Low Newton provides a generally safe and humane environment with good staff-prisoner relationships and a supportive regime, despite Covid-19 challenges. The Board commended staff commitment to safety and highlighted positive outcomes in education and various support initiatives. However, significant concerns remain regarding the national shortage of secure mental health places for women, the effectiveness of resettlement accommodation, and the consistent implementation of key worker schemes and use of body-worn cameras.

HMP Send is a closed prison for adult women with an operational capacity of 191, holding 182 prisoners at the end of the reporting year, including 63 ISPs. The Board considers Send a safe prison but highlights a significant increase in self-harm incidents (837) and one death in custody. Key concerns include the need for specialist mental health provision for prolific self-harmers, slow progress on digital in-cell technology, and persistent staffing shortages.

HMP Peterborough operated under significant Covid-19 restrictions, impacting regime and staffing, yet saw a welcome continued decrease in violence and self-harm incidents. Concerns persist regarding the adequacy of healthcare services, resettlement provision post-CRC transition, and the length of time some remand prisoners are held. The prison demonstrated strengths in staff commitment, SEN provision, and resettlement accommodation outcomes, while acknowledging ongoing challenges in staff retention and property management.

HMP Peterborough (Women) navigated a challenging year with Covid-19 restrictions, managing outbreaks and staff shortages while still making improvements in safety and achieving its accommodation on release target. Despite this, prisoner dissatisfaction with healthcare services remained high, alongside concerns about the effectiveness of the key worker system and the impact of probation service changes on resettlement. The Board noted the prison's strong commitment to prisoner welfare and its proactive efforts in communication and SEN support.

HMP Stocken generally provides a safe and humane environment, with strong efforts in safer custody and no deaths in custody this year. However, the Board highlights significant challenges including chronic understaffing across various departments, persistent delays in staff vetting, and a critical shortage of secure mental health provision, leading to unsuitable placements within the prison. Issues with prisoner transfers, including incomplete assessments and uncontrolled property, and a lack of category D prison places continue to hinder progression and resettlement efforts. The performance of the education provider is also a key concern.

HMP Wakefield, a high-security prison for men, is generally considered safe but experienced increases in assaults and use of force. Key concerns include persistent issues with mental health transfers, a lack of robust healthcare complaints processes, and the absence of in-cell telephony. The Board also highlighted unsatisfactory property management and insufficient purposeful activity for prisoners.

HMP Usk and Prescoed are considered effective, well-run prisons with low levels of violence and self-harm, successfully navigating Covid-19 restrictions while maintaining humane treatment. Challenges include reduced education funding, inadequate mental health and probation staffing, and persistent issues for men serving IPP sentences. The Board commends the cooperation between staff and prisoners, and the impressive rate of successful resettlement via Release on Temporary Licence.

HMP Leicester is well-led, maintaining a relatively safe environment with reduced self-harm and assaults on staff, and improved reception facilities. Despite generally good physical and mental healthcare, significant concerns persist regarding long delays for mentally ill prisoners awaiting transfer, which can result in inhumane segregation. Staffing shortages have severely impacted key working and the regime on weekends, while aging infrastructure requires substantial capital investment, particularly for the gym. Resettlement efforts are hindered by a high proportion of men released without accommodation and underdeveloped substance misuse services.

HMP Northumberland generally provides a safe and humane environment, with improvements in regime and education post-Covid, and promising employment initiatives like The Recruitment Junction. However, significant challenges persist concerning mental health support and transfers, unreliable healthcare provision, and poor resettlement outcomes, especially regarding post-release employment and housing. These issues, particularly mental health and homelessness, remain areas of repeated concern for the Board.

HMP Littlehey is a Category C training prison for men convicted of sexual offenses, holding 1,171 prisoners. The Board commended the prison for its generally safe environment, compassionate end-of-life care, and excellent PE regime. Key concerns include persistent overcrowding due to shared cells, long waiting times for specialist healthcare, and significant issues with managing prisoner property transfers between prisons. The report also highlights the over-representation of Black and Muslim prisoners in adjudications and use of force incidents, and ongoing problems with heating infrastructure and the use of temporary freezers.

HMP Lincoln, a Category B prison, experienced a decrease in self-harm incidents and drug finds during the reporting period, alongside generally positive staff-prisoner relationships. However, significant concerns persist regarding the length and quality of maintenance work by Amey, and the inadequate access to specialist mental health facilities. Other key challenges include the impact of increasing operational capacity, difficulties for transient prisoners accessing education, issues with property transfers, and unsuitable infrastructure for vulnerable prisoners.

HMP Usk and Prescoed maintained good relationships between staff and prisoners and effectively restored regime activities following Covid-19 restrictions. While safety levels were low for assaults and self-harm, concerns persist regarding understaffing in mental health and probation services, and issues with prisoner property transfers. The prisons continue to demonstrate success in purposeful activity and resettlement, including high rates of first-night housing on release.

HMP Swansea is generally considered a safe and humane prison by the Board, with notable improvements in education, purposeful activity, and resettlement support. However, significant concerns persist regarding the inadequate mental health provision and the challenge of securing accommodation for prisoners on release. Other key issues include delays in cell refurbishment, poor disability access, and inconsistent reporting of segregation decisions to the Board.

HMP/YOI Foston Hall has shown positive developments in regime provision and some safety initiatives, yet it continues to grapple with persistently high self-harm rates and increased use of force. Staffing shortages have impacted key work and overall experience levels, while healthcare faces challenges with recruitment, missed appointments, and inadequate facilities. The Board highlights significant concerns regarding accommodation decency, delays in parole and mental health transfers, and a lack of analytical focus on protected characteristics, affecting fair treatment and access to services.

HMP Gartree maintains a calm and ordered environment with positive staff-prisoner relationships, though faces significant challenges with its ageing infrastructure and an increase in use of force incidents. While basic healthcare access is good, mental health services and purposeful activity require improvement. The Board highlights key concerns regarding building repairs, drug infiltration, fire safety, and adequate provision for vulnerable prisoners, while acknowledging efforts in staff recruitment and regime development.

HMP Leicester, a busy local prison, continues to be well led despite the challenges of old buildings needing investment and high prisoner churn. While staff-prisoner interactions are positive and resettlement planning is a strength, the Board remains concerned by rising self-harm incidents, delays in mental health transfers, prisoners leaving without accommodation, and deteriorating cell conditions. Key working remains insufficient, and the substance misuse unit is not delivering its full therapeutic regime.

The IMB finds HMP/YOI Low Newton a reasonably safe and clean environment with generally good staff-prisoner relationships. However, the Board is concerned about the increasing number of women with severe mental health issues being sent to prison, impacting self-harm and assault rates. Delays in accessing healthcare and mental health support, along with the negative effects of custodial transport and staffing shortages leading to lockdowns, remain key challenges.

HMP/YOI Downview experienced significant population pressures and a more complex demographic during the reporting year, leading to an unsettled environment and increased safety incidents. While healthcare saw some positive working relationships and good mental health support, there were critical delays in transferring acutely unwell women to psychiatric units and persistent issues with medication distribution. The Board raised concerns about the accuracy of education attendance data, the inconsistent key worker system, and a decline in library services.

HMP Nottingham, a Category B adult male and YOI establishment, has an operational capacity of 950. The reporting year saw increases in self-harm incidents (898), prisoner assaults (296), staff assaults (114), and use of force (760), with two deaths in custody. The Board raises concerns about restricted time out of cell, particularly for vulnerable prisoners, persistent healthcare staff shortages impacting provision, and insufficient capacity for mental health transfers. Positive developments include improved food quality, a new neurodiversity lead, and reduced IMB applications.

HMP Hewell, a local Category B prison, faced significant challenges in the reporting year, including persistent crowding and a high remand population. Despite these pressures, the IMB noted dedicated efforts by staff to maintain a safe and humane regime, introducing positive initiatives like 'here to help' mentors and a prison council. Key concerns remain around increased self-harm and violence, the lack of IT for prisoners, and inadequate mental health and family contact provisions, many of which are recurrent issues.

HMP/YOI New Hall, a closed category prison for women, held 365 residents against an operational capacity of 381. The Board noted positive developments in reception, staff-prisoner relationships, and the introduction of a drug recovery wing. However, significant concerns persist regarding the inadequate funding and suitability of the prison environment for women with complex mental health needs, leading to unacceptable delays in transfers to secure units. There was also a notable increase in healthcare-related applications to the IMB and issues impacting access to Release on Temporary Licence (ROTL).

The Independent Monitoring Board at HMP Doncaster reports a generally fair and humane treatment of prisoners, with good staff-prisoner relationships and improved education attendance. However, the prison faces significant challenges, primarily due to severe overcrowding and population pressures, leading to inhumane double occupancy of cells and restricted regimes. Key concerns include extended waits for mental health transfers, a problematic reception and induction process, and insufficient community support for released prisoners.

HMP/YOI Eastwood Park, a closed local prison for women, faced significant challenges in the reporting year, particularly concerning high levels of self-harm and use of force incidents. While staffing shortages and the concentration of complex prisoners strained the regime, efforts were made to improve healthcare, purposeful activity, and resettlement support. The Board highlighted concerns regarding mental health transfers, estate development, and the overall impact of managing complex individuals on staff and the general prison population.

HMP Northumberland, a Category C prison, experienced a challenging year due to RAAC issues impacting various areas, including education and reception, and contributing to spikes in self-harm and violence. Despite these challenges, the Board noted significant improvements in accommodation, healthcare provision, and progress in securing housing for prisoners on release. Key concerns remain around the inadequacy of mental health support and the effectiveness of education and vocational training in preparing prisoners for employment.

HMP Cardiff, a Category B local training prison, maintained a 'Good' HMIP rating despite significant population pressures, with the IMB noting positive staff-prisoner relationships and cell refurbishment efforts. However, the Board expressed serious concerns over rising self-harm, violence, and use of force incidents, alongside persistent overcrowding leading to inhumane eating conditions. Key challenges included inadequate mental health staffing at weekends, a doubling of medication complaints, and poor key worker scheme delivery.

HMP Leicester, a busy local male prison, continues to be well-led despite the challenges of an aging Victorian estate and high prisoner turnover. The reporting year saw a positive 33% reduction in self-harm incidents and no deaths in custody, alongside effective intelligence work to intercept illicit items. However, concerns persist regarding an increase in violent incidents, significant delays in mental health transfers, a lack of accommodation for 33% of prisoners on release, and the persistent availability of drugs.

HMP/YOI Low Newton is a women's closed prison that has seen improvements in culture and regime under new leadership. While safety is prioritised, challenges remain with a high number of self-harm incidents and significant mental health needs among the population, often leading to the prison acting as a place of safety. Efforts are being made in purposeful activity, resettlement, and healthcare, with strong staff dedication noted.

HMP Lewes saw improvements in its regime, leading to increased time out of cell and a fall in prisoner-on-prisoner violence. Healthcare provision also improved, with reduced waiting times for routine appointments. However, significant challenges persist with the prison's heating system, gaps in mental health services, and a worrying increase in self-harm and assaults on staff. The Board highlighted ongoing concerns regarding disproportionality in the use of force and adjudications against certain prisoner groups.

HMP Lancaster Farms, a Category C resettlement prison, continues to provide a largely safe environment for its 560 prisoners, with positive initiatives like the complex care unit and CrossFit program. However, significant concerns persist, particularly around healthcare provision, including long waiting times and issues with medication and data transparency. The Board also highlights problems with property management during transfers, a rise in prisoners on the restrictive basic regime, and continued challenges in placing prisoners with complex mental health needs in specialist facilities.

The Minister should continue to liaise with other Ministers to ensure a coordinated approach to the humane incarceration of prisoners with poor mental health, addressing the national concerns about their increasing numbers.

The Board remains concerned as to the mental health service offered to prisoners within HMP Swansea.

Can the Minister take action to prevent prisons being deemed a place of safety for women with serious mental health issues?

Can the Minister work with the Department of Health and Social Care to ensure women with serious mental health issues in the criminal justice system are directed to an appropriate pathway?

Despite efforts by management and staff at Parc to support those prisoners serving an Imprisonment for Public Protection (IPP) sentence, not knowing when they will be released is a cause of anxiety impacting on the mental health of those affected. We urge the Government to put in place a process where IPP prisoners’ sentences are reviewed, and a single sentence …

The Prison Service is aware of the inhumane length of time some prisoners have been in the CSU at HMP Liverpool whilst waiting for transfer to an appropriate mental health establishment. What will the Prison Service do to ensure that prisoners at HMP Liverpool are not waiting for inhumane periods of time for such transfers?

The numbers of people experiencing mental health issues are increasing at Heathrow IRC. It is important that external mental health beds in the community are made available to detained people who present with a severe mental condition, that cannot be managed within Heathrow IRC.

People with severe mental health problems should not be detained in the CSU for extended periods of time. Detained individuals with severe mental health issues should be treated in a mental health setting external to the Heathrow Detention Centre. The Home Office should reduce the use of CSU for those who do not wish to share a room with another …

The Board is very concerned about the deterioration in the mental health of many detained people and too many detained people are resorting to self-harm. It is imperative that appropriate support, care, and mental health services are promptly provided to individuals grappling with mental health vulnerabilities.

More work is required to consider different ways of dealing with those who have mental health problems. There should be an increase in external mental health beds for people in detention who display increased or increasing levels of mental health problems. A clear mental health pathway should be made available to those with mental health difficulties, the detention centre is …

The Board consider Rules 40 and 42 are being misused. There were several instances in 2023 where Rule 40 and 42 have been used for prolonged situations. It is imperative that Rules 40 and 42 are used for the shortest possible time and as a means of last resort. It should not be used to hold mentally ill detained people …

The Home Office has a duty of care for those with mental health problems and to ensure that they are safe in the community they are released into. Robust support is required for detained people with mental health people who are released on bail.

How does the Minister plan to work with colleagues across Government to increase the provision of specialist secure mental health services for offenders with serious mental health problems?

The procedures followed in the detention gate-keeping process should be reviewed to ensure that the processes in place to protect those with severe mental health issues from being detained in the Immigration Estate are robust and effective.

The policy which results in people with severe mental health issues being held in IRCs should be reviewed.

The IMB is concerned about: the ‘short-term’ closure of the mental health office to facilitate the demolition of A and B wings, which by November had extended into three months, causing acute problems for the delivery of mental health services

The IMB is concerned about: staffing pressures in healthcare and mental health, impacting on services provided.

The Board notes that the prison experienced significant delays in being able to transfer men to more appropriate establishments and settings, especially those relating to mental ill-health. The Board considers that this lack of secure mental health facilities needs to be addressed as a matter of urgency.

We urge the Minister to heed the CPT’s request for rapid transfer of people with serious mental illness to appropriate mental health settings, and to put in place sufficient funds to enable this to happen.

As the population of the prison continues to increase inevitably some of the additional prisoners received will have addiction issues. How does the prison plan to support these additional prisoners with their substance misuse needs? What plans are in place to prevent the ingress of these substances?

Provision should be made in appropriate secure specialist mental health facilities for the small number of very challenging women with highly complex mental health needs. These are often a result of traumatic lives and manifest as prolific self-harm. Prison is a totally inadequate ‘revolving door’ for these prisoners (4.2).

In our 2021 annual report, we urged the Minister to review the policy which results in people with severe mental health issues being held in IRCs. The Board repeats its recommendation: The role of the Home Office Gate Keeper and accountability for their decisions, in particular, needs to be urgently reviewed.

We believe that there would be significant benefits in the co-location of healthcare and mental health services and are disappointed that this has not yet happened.

Will the Minister speak to colleagues in the Department for Health and Social Care to improve prisoners’ timely access to specialist mental health facilities, where required?

Will the Minister speak to colleagues to seek to ensure that there are sufficient beds in secure mental health hospitals to speed up the transfer of prisoners and support their rehabilitation?

Will the Minister advise on the progress of the Mental Health Bill which offered remedies for concerns raised in our annual report last year? Our concerns about the lack of appropriate services for prisoners with complex mental health needs remain and are growing.

The IMB would support broader use of the Colnbrook Care Suite for short term respite, particularly for detained people with deteriorating mental health conditions. We also urge the Contractor to replicate the Colnbrook Care Suite facility in Harmondsworth.

Work with other Ministers and agencies to increase mental health support for the prison and to ensure resources are in place to facilitate the timely transfer of prisoners with serious mental health conditions?

Will the Minister work with colleagues in the Department of Health and Social Care to consider how to address the mental health needs of prisoners, many of whom require specialist care alongside their punishment and rehabilitation?

To make mental health provision available in the evenings and at weekends.

To develop mental health provision.

The Board continues to believe that the continued detention of IPP prisoners is unfair and inhumane.

The Board remains concerned that there is no centrally directed, long-term solution to the injustice of the IPP (imprisoned for public protection) sentence and its impact on the mental health and wellbeing of affected prisoners. The IMB has raised this for a number of years, but since the rejection of the Justice Select Committee’s recommendations, there does not seem to …

What plans do you have to improve prisoner access to healthcare & mental health support?

Why are so many prisoners who present with severe mental ill health and personality disorders continuing to be sent to prison?

Can the Governor work with healthcare commissioners and the provider to ensure that the healthcare unit provides a more holistic, therapeutic regime for prisoners who are seeking to reduce their substance misuse?

The Board reiterates that the needs of complex individuals with multiple mental health issues are not served well in prison. Such prisoners also take up a disproportionate amount of staff time (4.2) (6.2).

The prison has successfully maintained an almost COVID-19-free environment, in contrast to the situation in the community. What steps are the government taking to end the current severe lockdown restrictions in prison, taking into account the impact on the mental health of the prisoners (see section 8)?

Additionally, during the year the prison had to deal with a prisoner experiencing difficulties associated with an eating disorder. However, no facility existed that could provide specialist services for this individual. As a result, the prison was forced to manage the situation without specialist support. This constitutes a service deficit (see section 6.3).

Can you facilitate access to appropriate room allocations, so that the mental health, substance misuse and other teams can deliver their full range of programmes effectively?

Nationally, there is still a pressing need for more specialist facilities that can be easily accessed, particularly psychiatric units.

Limited access to Listeners, resulting in a significant increase in phone calls to the Samaritans (see paragraph 4.2.4)

Given concerns expressed above, to invite Department of Health colleagues to work with the minister to review the capacity of provision of mental health services and provide more secure mental health provision across the prison estate for those prisoners with severe and enduring mental illness.

What will the Minister do about the impact of transferring prisoners from secure hospitals to an already full and stretched prison?

The Home Office should improve the time scales for those that wish to return to their home country voluntarily. Any Delays to voluntary returns can acerbates anxiety and mental health issues for detained people.

Will the Minister work with his colleagues in the Department of Health and Social Care to find further ways mental health provision can be extended into the Prison Service in order to avoid lengthy incarceration in isolation of troubled prisoners and those with challenging behaviour?

What long term strategy is in place to address the chronic shortage of suitable mental health provision?

How does the Minister plan to work with colleagues across the Government to increase the provision of specialist secure mental health services for prisoners with serious mental health problems?

The Board recommends the Health Board review the level of weekend cover in the mental health team in view of the significant demand for mental health support within the prison.

To increase the range of activities for women, with a view to better supporting those with anxiety or mental health issues.