Prisoners have a high need for mental health services. The Ministry of Health (the Ministry) estimates that prisoners are three times more likely to require access to specialist mental health services than people in the general population. Providing treatment for mental illness in prisons can deliver significant benefits not just for prisoners but also for prison staff and people in the wider community.
Delivering mental health care to prisoners is a complex and challenging area. There are constraints that come with operating in a prison environment. Delivering services is complicated further by the high level of health need among prisoners and the transfer of prisoners within the justice system.
Responsibility for meeting prisoners' mental health needs is split between the Department of Corrections (the Department), the Ministry, and district health boards’ Regional Forensic Psychiatric Services (RFPS). We refer to these organisations as "the agencies" throughout our report.
We conducted a performance audit that focused on the effectiveness of the agencies’ systems for delivering mental health services to sentenced and remand prisoners (prisoners). The audit looked at three areas – service planning, service delivery, and service monitoring and evaluation.
The system is subject to a number of pressures, such as increasing prison musters, high demand for inpatient beds, and, for some groups, a lack of services to meet their needs. We found a number of areas where mental health services for prisoners could be improved. However, the agencies were aware of their service issues and they were at various stages of identifying and introducing improvements. Where this was the case, we have noted that this work was under way. We support and encourage the introduction of the improvements. We make eight recommendations to supplement the agencies’ work.