What steps are the Minister and his department taking to ensure that mentally ill inmates or those with addictions are given appropriate help

2.13   Deputy  M. Tadier of the Minister for Home Affairs regarding the treatment of mentally ill inmates or those with addictions:

What steps, if any, are the Minister and his department taking to ensure that mentally ill inmates or those with addictions are given appropriate help and are not simply in prison?

Senator B.I. Le Marquand (The Minister for Home Affairs):

I am going to ask my excellent Assistant Minister if she would answer the question, as she deals primarily with matters relating to the prison.

Deputy J.A. Hilton of St. Helier (Assistant Minister for Home Affairs -

rapporteur):

The healthcare needs of every prisoner are assessed on admission to the prison. The prison employs 3 full-time professional drug and alcohol counsellors and prisoners are able to access considerable support in this area. In regard to mental health, a consultant forensic psychiatrist visits the prison on a weekly basis to carry out assessments and provide professional care and support. The prison also benefits from the services of a community psychiatric nurse who attends one day per week to manage a prisoner case load. Most of those with a history of mental illness are kept stable by the administration of appropriate medication. There are some prisoners who would clearly present to the lay person as being mentally unwell but who are not deemed to be suffering from treatable mental illnesses. They are not eligible for a place in a mental health facility and, yet, seem to be misplaced in the prison. Myself, the Prison Governor and the Minister met with the previous Minister for Health and Social Services to discuss the management of such individuals and I plan to seek an early meeting with Deputy Anne Pryke to explore the issue further.

1. Deputy M. Tadier :

My underlying concern is not simply about prisoners who may be mentally ill and end up in prison but is about the steps which are being taken to avoid that happening in the first place. I know, certainly, from personal experience in my constituency, that people who have had a history of mental illness and also a history of addiction are simply being treated as ordinary criminals and not being given the appropriate sentences which may not always end up in a prison sentence. So what steps is the department taking to ensure that these problems are picked up by the police and the Honoraries before they get to court?

Deputy J.A. Hilton:

I feel that I can only answer with regard to prisoners who have been convicted. I

agree that there is a problem and both the Minister and I, who have been involved in the criminal justice system for many years, are well aware of the merry-go-round that appears to be happening at the moment with certain prisoners and we are both extremely concerned about that.

2. Deputy S. Power:

Would the Assistant Minister agree with me that there is, in our society, those that do have personality disorders, brain injuries and mental illness who are given custodial sentences because of this and it is beholden on States departments such as Social Services, Social Security, Housing, Education, Sport and Culture and Home Affairs to get together under the Chief Minister's Social Policy Review Panel to solve this problem once and for all - sentencing people to La Moye - when there may be a more appropriate way forward?

Deputy J.A. Hilton:

The Social Policy Group met last Thursday afternoon and I was there in place of the Minister who was away from the Island and, indeed, Deputy Power did produce a paper which he had done in conjunction with Deputy Green for that meeting that afternoon, and it is the intention to pass that paper to an organisation called

M.A.P.P.A. (Multi-Agency Public Protection Arrangements) which is made up of professionals from various departments who are trying to deal with this problem.  As I said in my answer previously, it is a matter that both the Minister and I have very significant concerns about and we do intend to address the issue of prisoners currently in the system who, we believe, should not be in the system and are not receiving appropriate treatment. To that end, we will be working with the Deputy of Trinity , the Minister for Health and Social Services and I do sense that we are pushing against an open door in that regard.

3. Deputy A.E. Jeune :

I fully accept what the Assistant Minister says in that she and the Minister are very, very concerned about the current situation for offenders with mental illness. However, currently, with 3 persons with experience in drugs and alcohol and a C.P.N. (Community Psychiatric Nurse) attending weekly, does the Assistant Minister consider this anywhere near sufficient and surely they ought to be considering having experienced nurses with forensic psychiatry?

Deputy J.A. Hilton:

Prior to the 2 additional members of staff being taken on, the prison was operating with one counsellor as Members will be well aware, from what the previous Minister Senator Wendy Kinnard used to bring to the House about the concerns surrounding funding for prison. Now, since the Prison Improvement Plan was approved by the House, obviously additional funding was put in place which did enable us to employ a couple more counsellors to help with the problem. Currently, approximately 50 per cent of prisoners do have issues with alcohol or drug dependency. We could spend any amount of money on trying to address these issues. The staff that we have at the prison are excellent, professional staff who carry out their jobs in a very professional way but, yes, we could do with more funding but I suppose the same could be said of many different services provided by all States departments. I think we provide a very good service with the resources we have available to us.

4. Deputy M. Tadier :

I appreciate the Assistant Minister may not have been prepared for the angle of my last supplementary, so I would be happy to discuss it perhaps informally with herself and the Minister but my last question would be, to what extent is the problem a practical one, in that there is no satisfactory alternative facility for housing mentally ill offenders?

Deputy J.A. Hilton:

The great majority of prisoners with mental health issues are being handled satisfactorily at the moment but we are very aware of the small number who have been in the system for a very, very long time, and it is that small number that the Minister and I are going to be working very hard towards obtaining what we believe is the appropriate treatment for them. As in all small jurisdictions, there is always going to be a problem of funding a unit specifically for the needs of maybe just 2 or 3 people, so one has to weigh-up the cost of possibly providing that unit within the Island or whether those people are best treated away from the Island.

The Greffier of the States (in the Chair):

Question 13 falls away in the absence of Deputy Pitman, so we come to question 14 which Senator Syvret will ask of the Attorney General.