Human Rights and Prisons - Rethinking Crime and Punishment
Human Rights and Prisons - Rethinking Crime and Punishment
Human Rights and Prisons - Rethinking Crime and Punishment
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Applications for the compulsory assessment or treatment of prisoners, or their<br />
hospital detention, must meet the requirements of the Mental Health<br />
(Compulsory Assessment <strong>and</strong> Treatment) Act 1992. The Mental Health Act<br />
1992 notes that it is an offence for a person concerned with the care,<br />
oversight <strong>and</strong> control of mentally disordered people to neglect or ill-treat them.<br />
Responsibility for mental health provisions are split between the Department<br />
of Corrections (for primary care) <strong>and</strong> District Health Boards (for specialist care<br />
through Regional Forensic Services). The Ministry of Health guides strategic<br />
direction.<br />
Issues<br />
Recently, good-practice initiatives have included the opening of a 13-bed „At<br />
Risk Unit‟ at Hawkes Bay Prison in 2008. This Unit is staffed by on-site<br />
registered nurses with mental health training as well as a forensic nurse from<br />
Hastings DHB. Prisoners can also access a psychiatrist on a weekly basis.<br />
This Unit, like others, is a useful tool for short-term stays.<br />
In addition, it is clear that certain practices – such as the use of Forensic<br />
Mental Health Services (FMHS) to work with those with serious mental illness<br />
– provide very good service delivery. As Simpson et al (2006) have identified,<br />
these services are costly but offer very good outcomes in terms of lowering<br />
offending rates. Their study, of 105 patients (many of whom had psychotic<br />
disorders <strong>and</strong> a history of violent offending), demonstrated that at the end of<br />
the study, half were in independent living <strong>and</strong> half were in employment. Only<br />
five were reimprisoned. This illustrates that committed mental health services<br />
can produce high level outcomes. This is something that is not evidenced in<br />
other forms of care.<br />
Despite these advances, there remain a range of concerns about provision for<br />
those with mental illness within the prisons:<br />
<br />
<br />
Capacity – Over recent years, forensic services have been operating at<br />
full capacity (<strong>and</strong> beyond). Still, many prisoners do not receive the<br />
treatment they need in a timely manner <strong>and</strong> prisoners who require<br />
urgent treatment for mental illness often have to remain in prison <strong>and</strong><br />
wait for an available bed. This puts pressure on prison services, that<br />
are already stretched through prisoner numbers, to look after disturbed<br />
individuals (Brinded et al, 2001; Fennell, 2006; Office of the Auditor-<br />
General, 2008; Simpson et al, 2006). The Office of the Auditor-General<br />
(2008) detailed the situation of 59 prisoners on the Auckl<strong>and</strong> prison<br />
waiting list (between July 2006-June 2007). Of the 59 prisoners, 34<br />
waited ten days or less, 10 for 41-80 days, 15 waited longer than 80<br />
days, <strong>and</strong> 10 prisoners waited more than 100 days for treatment.<br />
Limited funding for Primary or Preventive Care – There are few<br />
services for prisoners with mild to moderate mental health illness.<br />
More basic treatment options, such as counselling or therapeutic<br />
treatment, are not available (Office of the Auditor-General, 2008). The<br />
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