Foreword
Mental illness is a significant health issue, with considerable direct and indirect costs. Prisoners have a high need for mental health services. Responding to mental health issues in prison can help prisoners and staff by improving health, creating a better environment in prison, and potentially reducing reoffending.
Responsibility for prisoners’ mental health services is split between the Department of Corrections (primary mental health care), the Ministry of Health (strategic direction of mental health services), and district health boards (provision of specialist mental health services for those in the criminal justice system). District health boards deliver these services regionally through Regional Forensic Psychiatric Services.
The systems for providing mental health services are under significant pressure from increasing prison musters and a high demand for inpatient beds. The needs of prisoners with severe mental illness are generally well catered for but timely access to inpatient beds can be an issue. Service responsiveness is more limited for some groups. These include those with mild to moderate mental illness, women, those with personality disorders, and Māori.
I acknowledge that the agencies involved in providing mental health services to prisoners have committed resources to identify gaps in services, address these gaps, and improve services overall. I was pleased to see that work is being done to better identify prisoners with mental health issues. Service planning and obtaining adequate data for service planning is a difficult area for the agencies involved, and I encourage the Department of Corrections and the Ministry of Health to work closely to improve this.
There are challenges and constraints that come with providing health care in the prison environment, and the staff involved in managing prisoners with mental health needs often do so in difficult circumstances. I thank staff in the Department of Corrections, the Ministry of Health, and the district health boards for their assistance during my audit.
K B Brady
Controller and Auditor-General
11 March 2008