Mentally ill prisoners face months-long waits for hospital transfer

Prisoners with severe mental health problems are waiting up to six months to be transferred to hospital to get treatment, a Guardian investigation has found.

Government guidelines in England and Wales stipulate that prisoners who are acutely mentally ill should be transferred to a hospital within 14 days of the first medical recommendation. But according to an analysis of Ministry of Justice data, hundreds of prisoners a year are being left awaiting adequate treatment.

The data shows that in some cases prisoners with mental health problems wait for six months from officials receiving an application for transfer of a prisoner to the prisoner’s eventual admission to hospital.

An analysis of self-inflicted deaths in prison also reveals that at least six prisoners have killed themselves since 2014 while being considered for or waiting for transfer to a hospital.

In one report into a prisoner’s death, Nigel Newcomen, the prisons watchdog, noted that even though the prisoner was assessed as suitable for transfer to a hospital, the prisoner “had been waiting for over seven weeks when he died”. In a report on another prisoner’s suicide, Newcomen wrote that “at the time of his death he was waiting for a transfer to a secure hospital, but sadly, no bed space was available before he died”.

Of the six cases, two prisoners waited over two weeks to be transferred to hospital. In one case, a prison psychiatrist requested an assessment to determine whether a prisoner should transfer to a secure hospital, but specialist commissioners did not receive the initial referral so the mental health team manager re-sent it several weeks later. The prisoner was still awaiting assessment when he died.

In 2011, the government introduced guidelines in England and Wales stating that a second medical opinion and all administrative tasks should be completed within 14 days.

But in England and Wales in 2016-2017, 66% of transfers from prison to hospital took longer than 14 days, and 7.1% took 140 days or longer.

Data released from the Ministry of Justice, through a parliamentary question asked by MP Barbara Keeley, revealed it takes an average of two weeks for one crucial stage of the process, from when the ministry receives an application for transfer to the actual date of admission to hospital.

The Ministry of Justice noted it sometimes receives incomplete applications so some of the time between receipt and admission would be spent awaiting essential information.

The total number of transfers to hospital has reduced 12% over four years. In 2014, there were 1,061 transfers from prison to hospital, but this dropped to 936 in 2017.

Graph of prisoner transfers to hospital

Keeley, Labour’s shadow minister for mental health, said: “This data has exposed the hidden scandal of poor access to mental health treatment in England’s prisons, a scandal which has tragically claimed the lives of prisoners who desperately sought help for their mental ill health.

“Labour is calling for an urgent investigation by Tory ministers into the scale of the prison mental health crisis and the barriers facing those who try to access services in prison.

Peter Dawson, director of the Prison Reform Trust, said: “Prison is no place for people who are acutely mentally ill. These shocking numbers graphically show the harm that is done to the most vulnerable of patients while two overstretched services argue over who should care for them.

“The government needs to be taking action now to meet its responsibilities towards individuals completely at its mercy.”

Abdi Gure, a community organiser for Mind who works to transfer mentally ill BAME prisoners to hospital, said there are significant institutional failings.

“There’s a failure at every step,” he said. “We have cases where black people, who have been in the mental health system for many years, become unwell and commit a crime, the police pick them up, treat them as genuine criminals, take them to the police station, and they charge.”

Related: Families of prisoners who killed themselves express their anger

Deborah Coles, director of Inquest, said: “The prolonged delay in transferring people from prison to mental health settings, when they are recognised to be in crisis, is deplorable and is costing lives. Prisons are harmful, unsafe and dangerous environments that exacerbate distress and mental ill health.”

A government spokesman said: “We take the mental health of prisoners extremely seriously, which is why we have increased the support available to vulnerable offenders – especially during the first 24 hours in custody – and invested more in mental health awareness training for prison officers.

“But we recognise that more can be done and continue to work in partnership with NHS England among others to improve the mental health of offenders at all points of the criminal justice system.”

• In the UK, Samaritans can be contacted on 116 123 or emailjo@samaritans.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.