Mental Health Bill [HL]

Committee (5th Day) (Continued)

Amendments 150 to 160 not moved.

Amendment 160A

160A: After Clause 50, insert the following new Clause— “Review: impact of this Act on the prison estate(1) Within 12 months of the day on which this Act is passed, the Secretary of State must publish a review of the impact of provisions in this Act related to the treatment and care of mentally disordered persons on—(a) under 18s in youth offender institutions,(b) IPP prisoners,(c) female prisoners, and(d) any other such persons they deem appropriate.(2) In the review, the Secretary of State must assess whether, in their view, the Act provides adequate support for ongoing treatment and care of mentally disordered persons in a prison setting.”Member’s explanatory statement This amendment requires the Secretary of State to publish a review of the impact of the provisions of the Act on prisons and to assess whether the Act provides for adequate support for ongoing treatment and care in these settings.

My Lords, after all that excitement, I fear I may be a bit of an anticlimax, but I will carry on regardless—and let people walk out. My Amendment 160A calls for a review of the impact of the Act on the prison estate and the ongoing treatment and care of mentally disordered people in a prison setting a year after the Act passes. We have all welcomed the Bill’s commitment to ending the use of prison cells as so-called places of safety, but as some of us noted in the debate on an earlier group, the promise of, for example, a transfer to hospital for prisoners facing acute crises within 28 days is widely viewed by criminal justice stakeholders as unlikely to happen. We need to review whether such cynicism is merited, because the prison reform aspects of the Bill are not minor. They should not be treated as Cinderella clauses: they are, to my mind, crucial.

We cannot pass this Act and leave prisoners who ought to be in hospital beds abandoned in squalid conditions in jails. Additionally, it is not fair to prison staff because, to quote Andrew Neilson from the Howard League:

“Our overcrowded prison system that has been asked to do much, with too little, for too long, is ill-equipped to help people who require intensive support for their mental health”.

I recently visited Five Wells prison in Wellingborough with my Academy of Ideas hat on. The new leadership team at Five Wells is doing some fantastic work on purposeful rehabilitation activities, and we hope to do a joint project of Debating Matters Beyond Bars with it there. I chatted more generally to the team members, who have worked in a variety of prisons over the years, and they all noted that the time and emotional strain on staff when dealing with psychotic and very poorly prisoners—they gave gory examples of prisoners eating their own faeces or making very bloody attempts at self-harm, et cetera—have been totally demoralising for officers. It may have been one of the reasons for the use of the segregation units I talked about earlier. But these things have also had a destabilising and frightening impact on other prisoners. Sharing space with those with paranoid delusions and who present a violent threat to themselves and others is no joke; it makes prison difficult for everyone. So it is crucial that we get this right in the context of an overstretched prison crisis, and a specific view would focus minds.

So, surely—this is the reason I raise this—we need to ensure that this Bill does not lead to such misinterpretations, with tragic unintended consequences. When I asked the Minister how the findings of the Calocane investigation would impact on this law, her answer seemed unclear in terms of timings, but if “lessons will be learned” is to be more than a placating evasion, perhaps this amendment or something more precisely worded would give the Government a chance to review the impact of the Act on criminal justice and mental health in general. The whole dispute about prison versus hospital for the most serious cases could then, in fact, be dealt with.

We will also need to review exactly how the Act will interact with the actual prison estate, not an imaginary one. Regardless of the 28-day rule, seriously mentally ill people will still be incarcerated in prison. One complication is that some prisoners are likely to deteriorate in jail, so much so that they arrive at an acute crisis phase. In some instances, this is because of the inadequacy of mental health service provision in prison.

One evidential marker of this relates to recent revelations that four out of 10 prisoners who have taken their own lives in custody in recent years did so because they were denied adequate healthcare before their death. Here I give huge credit to the journalism of Amy-Clare Martin of the Independent. Amy has recently exposed the scale of neglect, showing that 104 out of 233 self-inflicted deaths investigated by the prisons watchdog between 2020 and 2023 show failings in mental health care in jails.

I will focus on just a couple of cases to illustrate the point. The coroners’ court heard of one prisoner who took his own life at HMP Risley, 37 year-old Jason McQuoid, who did not eat or sleep for three days and begged for help after being put in one of those infamous segregation units that we discussed earlier. Jason’s family repeatedly warned that he was going to take his own life, but he still was not seen by any mental health clinician in the 72 hours before his death. No wonder they described his treatment as “medieval”.

Similarly, at another inquest in December, it was found that neglect and a failure to procure basic medical attention contributed to the death of Haydar Jefferies. Haydar took his own life in HMP Coldingley in February 2023. Shortly before his death, he was observed naked on all fours in his cell, barking like a dog, in the throes of severe depression and suffering acute psychosis, yet staff did not provide him with any medical attention. That is, of course, shocking, but perhaps more shocking is that Mr Jefferies’s mental health rapidly deteriorated after he was recalled to prison, having successfully rebuilt his life on the outside. The recall, based on an unproven and later withdrawn allegation, was under the terms of that discredited and abolished sentencing regime, IPP. What is more, the coroner noted that the postponed parole hearings—plural—

“more than minimally contributed to the development of psychosis, due to the psychological stress”.

Complaints about the inequities of IPP sentences are familiar in this House and to the Minister, yet the state still incarcerates 2,600 people indefinitely. Although, brilliantly, there has been reform of the draconian IPP recall regime, there is still a whole body of evidence to suggest that mental distress is one of the most pervasive and intrinsic factors associated with IPP sentences. That is not because of pre-existing mental health issues but is a distinctive characteristic of the specific sentence itself, over and above the general experience of imprisonment. The way the sentence is psychologically toxic is well documented in the literature, assessed invaluably in UNGRIPP’s report Making Sense of the Mental Health of People Serving an IPP Sentence by Donna Mooney and Sophie Ellis.

Pertinent to our discussions of this Bill, IPP prisoners are often very frightened to disclose their mental health problems or ask for help from prison staff, because poor mental health is regularly cited as a reason to knock back their parole. This can lead to untreated illnesses becoming more acute and in need of the provisions of this legislation. It also suggests that some of these IPP prisoners are, in effect, being detained by the state because of their mental health challenges, without that being acknowledged, and this could be seen as a sort of section by the back door.

These Catch-22 situations for IPP prisoners are illustrated by the harrowing plight of Thomas White, the father who has spent 13 years in prison for the street robbery of a phone, which I raised at Second Reading. Two medical reports last year laid bare the toll of his IPP jail term on the 42 year-old Mr White, warning that his lengthy incarceration had created “impermeable barriers” to his recovery. Recently, Thomas set himself alight in his cell in desperation, and, since then, the latest news from his family and his Member of Parliament is just awful. He is now totally disengaged and has lost hope. The cause is the denial of a hospital transfer, a very key part of this Bill. Thomas’s sister, Clara White, explained the dilemma. She said:

“If I took him to A&E and sat there for three hours he would be admitted to hospital”—