Thinking beyond incarceration – Justice and the mentally ill

February 26, 2013 3:20 pm

By Sundar Thavapalasundaram

In Britain today mental illness significantly increases one’s chances of imprisonment and impacts disproportionately on the most vulnerable.

A paradigm shift in Labour justice policy is needed, moving away from policies of containment to preventing the mentally unwell citizen drifting into this lifestyle to begin with.

With the mentally ill currently constituting over 90% of the UK prison population is justice best served within the current judicial framework or does  it inadvertently discriminate?

Citizens expect criminals to serve their sentence and return seamlessly to society. This is predicated on the assumption that incarceration causes desirable changes in behavior and is not supported by high re- offender or re-imprisonment rates.

The prisons, police and judiciary lack the resources and skills needed to care for people with mental health problems. Furthermore, navigating the legal maze is complex and places the mentally ill at a disadvantage.

Politically, labeling criminal behavior as ‘illness’, risks being seen as ‘soft’ on crime. Labour must challenge preconceived ideas and champion reform in this area. The fact that most offenders with mental health problems are not dangerous and better treated outside the prison system must be highlighted and supported by strong moral and fiscal arguments.

It is morally wrong to incarcerate persons suffering with mental illness, particularly when competence is in doubt. Illness requires medical treatment and protection from the arduous nature of prison life. Placing vulnerable persons in this environment is an abdication of the state’s duty to protect its citizens.

Fiscally, the successful identification and treatment of mental illness, reduces re-offender rates and ensures convicts receive good mental health care. This may reduce the £11bn currently squandered on re- offenders, while alleviating the growing challenge of prison overcrowding.

Systems for identifying and diverting the mentally ill out of prison and into secure community treatment programs are needed. Reviewing sentencing and encouraging hospital and secure community care orders to be considered routinely is called for. As is mandatory mental health training for the judiciary, legal, police and prison services.

The judicial process needs to be supported by enhanced mental health services, with better coordination between prisons, secure units, NHS Mental Health Trusts, commissioning groups and community care providers. This would allow greater flexibility and individually tailored care solutions.

Re-examining the legal test for fitness to stand trial is important to ensure defendants facing prosecution are competent and therefore accountable for their actions. Used in conjunction with early psychiatric screening, this would allow ‘at risk’ defendants (facing possible custodial sentences), to be identified early. Judicial process might then be ‘reasonably adjusted’, to ensure fairness.

Conservative austerity measures are fermenting inequality, breeding criminality and eroding mental health services. Labour must respond to this if it is to build a truly fair society. Incarceration is an expensive, failed approach to justice and a progressive prison reform agenda is needed. What form this takes in fiscally challenging times will be the acid test for Labour policy makers engineering victory in 2015.

Dr Sundar Thavapalasundaram is a General Medical Practitioner & Member of the RCGP Health Inequalities Standing Group

  • aracataca

    Really good piece. Perhaps the best aspect of this article is its highlighting of the sheer scale of mental illness among the incarcerated population in the UK and the necessity of facing up to this in policy terms.

  • Daniel Speight

    Dr Sundar you may be swimming against the flow with the present Labour leadership. The likes of Yvette Cooper have been playing the hang-em-high card for quite some time.

  • Sundar Thavapalasundaram

    Hi Guys. Thank you very much for your feedback.

    Daniel- I don’t know what the party leaderships official stand on this one is, but at Conference last year Sadiq Khan MP spoke about this issue in his conference speech on Justice. I got the impression he was keen to explore policy options in this arena moving forward.

    Aracataca- Thanks for the you compliment. I think if this piece makes people aware and gets them talking, then were one step closer to putting it onto the agenda as a serious policy issue.

    Best wishes
    Sundar

Latest

  • Comment Labour can change the false narrative with a reality check

    Labour can change the false narrative with a reality check

    A false narrative has developed about Labour that must be rejected comprehensively by a party aiming to govern in six months. It claims that Labour has become alienated from virtually the entire electorate. Our response to date has been ineffective. Here are some suggestions for how we may succeed in future. Franklin D. Roosevelt said: “the only thing we have to fear is fear itself”. We should take heed and refuse to be cowed by something as illusory as a […]

    Read more →
  • News Labour consider selling off central London buildings to help pay off debts

    Labour consider selling off central London buildings to help pay off debts

    The Labour leadership say they would consider selling off QEII Conference Centre and the Civil Service Club – alongside two other buildings in London – to help pay off the country’s debt. They say they selling off these government-owned buildings could raise up to £100m, and would be part of a “fairer way” of reducing the deficit. Alongside selling off the QEII conference centre and the Civil Service Club, Labour are also thinking about selling Marlborough House, which is near Buckingham […]

    Read more →
  • Featured Gordon Brown to announce departure as an MP “within days”

    Gordon Brown to announce departure as an MP “within days”

    Former Labour leader and Prime Minister Gordon Brown is set to resign as MP for Kirkcaldy and Cowdenbeath “within days” according to a report from the Sunday Mirror. Brown, who played a key role in the Scottish referendum campaign this year – giving a barnstorming speech on the eve of the vote that defined the case for the union. Brown’s rumoured departure follows his long-time ally Alistair Darling’s decision to quit Parliament in 2015. The Sunday Mirror reports: “Gordon Brown will […]

    Read more →
  • News Scotland Findlay says information going to party members for leadership vote is “insulting”

    Findlay says information going to party members for leadership vote is “insulting”

    Neil Findlay MSP, who is running to be leader of the Scottish Labour Party, is calling on the Labour Party to clarify what information will be given to members with Leadership ballot papers. At the moment it looks as though the booklet with candidate statements in it only lists the nominations each candidate received from Parliamentarians and not from Constituency Labour Parties, trade Unions or socialist societies. In response to this, Findlay has released the following statement: “Over the last […]

    Read more →
  • Comment It’s Ukip that offends working class sentiment

    It’s Ukip that offends working class sentiment

    After this week’s Twitter row at the Rochester by-election, I am using my keynote speech to the Labour East Regional Conference today to say that it is UKIP who truly offends working class sentiment and represents a party which is fundamentally un-British. Today I am lucky to serve as a Euro MP but, like many in our movement, I grew up on a council estate living in poverty, so don’t need any lectures from UKIP about snobbery. First, we can’t counter UKIP […]

    Read more →