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 The tennis match that reveals the Tories’ re-election strategy

    The tennis match that reveals the Tories’ re-election strategy

    David Cameron’s fundraising takes place in secretive opulence amongst the world’s super rich. This week we saw the extent of his reliance of those who operate in a different world to hardworking families concerned with paying their bills. The Conservative Party has taken a reported £1 million from Russian backers since David Cameron has been leader.  In 2008 David Cameron said, ‘Russian armies can’t march into other countries while Russian shoppers carry on marching into Selfridges’, and yet as Russian […]

    Read more →
  • Comment Keeping childcare high on the agenda

    Keeping childcare high on the agenda

    Recent headlines that childcare will be a key battle ground in the General Election will come as no surprise to those of us who have been knocking on doors and speaking with mums and dads in our communities. Time after time, when I’m listening to families on the doorstep, the cost of childcare comes up as a reason for why they are struggling to afford to work. As the summer holidays start, this is particularly true. Research from the Family […]

    Read more →
  • Featured We are the only people who can stop Murdoch’s power growing

    We are the only people who can stop Murdoch’s power growing

    After the parliamentary inquiries, Leveson, and the criminal trials, it sometimes feels like nothing has changed at Rupert Murdoch’s News UK. The grim case of Tulisa Contostavlos shows that Murdoch’s people will still fit up a celebrity if it sells papers. When I read Mazher Mahmood’s Sun on Sunday drugs sting, I thought of poor Sean Hoare. Sean was a brave man. He was the first former News of the World journalist to have the guts to admit to phone hacking. He was an […]

    Read more →
  • News Independence? UKIP can’t even spell it

    Independence? UKIP can’t even spell it

    Slow clap for UKIP, who have put out a leaflet in Blackpool in which they’ve managed to spell their own name wrong. Proudly proclaiming themselves as the “UK Indepencence Party”, the leaflet has been delivered to voters for the Clifton by-election taking place today. Maybe their campaigning against “Eurocrats” has just been a typo all along.

    Read more →
  • News Company pulls out of workfare scheme days after Osborne visit to promote it

    Company pulls out of workfare scheme days after Osborne visit to promote it

    A business in Bristol has pulled involvement with the Government’s controversial workfare programme, only days after Chancellor George Osborne paid them a visit to publicise the scheme. Byteback IT Solutions welcomed Osborne earlier this month for an opportunity to publicise the Help to Work programme, where long-term unemployed must work on placements in order to receive their benefits. However, after campaigners took to Byteback’s social media sites to protest, they decided to terminate their involvement, saying they had been “ill-informed” […]

    Read more →