§ Mr. Worthington
To ask the Secretary of State for Scotland what proposals he has to reduce the number of mentally ill people in prison.
§ Lord James Douglas-Hamilton
The initial disposal of individuals on remand or sentence is a matter for the courts. There is now a wide range of disposals, other than prison, open to the courts in dealing with individuals who may be mentally ill or mentally handicapped. In addition, the courts can decide to obtain a psychiatric assessment, in a mental hospital or in a penal establishment, before deciding on the most appropriate disposal.
A number of schemes have been developed locally under which offenders may be diverted to psychiatric assistance rather than to prosecution in the courts. The largest such scheme is in Glasgow and the operation of this scheme is being evaluated in a research study funded by the Scottish Home and Health Department.
The courts have powers to remand individuals, in appropriate cases, to hospital rather than to prison pretrial or awaiting sentence. The powers to remand untried individuals to hospital have existed in Scotland for many years. A new "interim hospital order", appropriate to certain convicted offenders, was introduced in 1983 and is regularly being used by the courts. Decisions on individual cases, however, need to be taken on the evidence and reports available to the court.
For those individuals who are sent to prison either on remand awaiting trial or sentence or after sentence, appropriate medical care, including the services of visiting consultant psychiatrists, is available. Visiting psychiatrists will advise the medical officer of the establishment on any cases which are drawn to their attention and the facilities or treatment which might be available elsewhere.
The process of transfer from prison to a mental hospital depends on clinical judgment in individual cases. Closer liaison has been developed between the Scottish prison service and the State hospital Carstairs, and with other mental hospitals on cases where transfer to such a hospital might be appropriate.
There are many forms of short-lived emotional stress or more persistent behavioural disorders which would not necessarily benefit from transfer to a mental hospital. Any individual who has a mental disorder which appears to require assessment or treatment ina psychiatric hospital will be carefully assessed. All requests to transfer a prisoner to psychiatric hospital are now monitored centrally to see whether there are recurrent difficulties or any general issues which need to be addressed.
In 1986, 63 inmates in penal establishments were diagnosed as suffering from psychosis. In the same year there were 35 transfers of prisoners to mental hospitals, 18 of these to the State hospital, Carstairs and 17 to other mental hospitals. This is a significant increase in the number of transfers which took place in 1985 and earlier years as a result of the closer liaison which has been developed in the assessment and consideration of individual cases.