‘Beds shortage’ sends mentally ill patients to prison

Jul 13, 2015
Mental health patients are being held in South Australian prisons, such as Yatala (pictured).

Mental health patients are being held in South Australian prisons, such as Yatala (pictured).

Forensic mental health patients are being held in prison because under-pressure services do not have the resources to meet growing demand, InDaily can reveal.

Public Advocate John Brayley told InDaily eight forensic mental health patients – who had been found not guilty of a crime, or unfit to plead because of mental incapacity – were being held in prison without appropriate psychiatric care last month.

Each suffers serious mental illness or intellectual disabilities, including those resulting from brain injury.

“These people are patients, not prisoners,” said Brayley.

“The people concerned are patients who should be receiving care and treatment.

“It is not uncommon for people to spend many months in Yatala or other prisons waiting (for treatment).”

Brayley said the problem had grown over the past several years, and “is more significant both in the number of patients kept in prison and also the length of time they stay”.

“In the past, we would hear of a couple of people from time to time kept in prison, but now because of a lack of beds it has become a regular part of the system,” he said.

He said that a lack of capacity in forensic mental health services had flow-on effects, including exacerbating overcrowding in hospital emergency departments.

Public Service Association Senior Industrial Officer Simon Johnson told InDaily: “the continual housing of mental health patients within the prison system puts the safety of correctional officers, as well as those individuals who require appropriate support and care, at risk”.

“It is inappropriate for correctional officers to be required to provide such support, which is clearly outside their scope of employment.

“Correctional officers are not mental health nurses or psychiatrists.

“The issue is further exacerbated by an overcrowded prison system.”

Principal Community Visitor Maurice Corcoran said holding forensic mental health patients in prison was a violation of their right to treatment.

“It’s an issue of human rights, especially for those people … who have an intellectual disabilities, a brain injury or autism who are (in) the correctional services system at Yatala,” he said.

“How are we going to be judged as today’s society in 10 years’ time for how we’ve treated people?”

SA branch chair of the Royal Australasian College of Psychiatrists, Dr Michelle Atchison, said “a number” of forensic mental health patients “should be receiving in-patient mental health care, but remain in the general prisons” because of “capacity issues” at secure mental health ward James Nash House.

She said the demand for forensic mental health care had “grown far beyond the current capacity of the forensic service”.

Brayley said forensic mental health services were struggling to meet demand “both in absolute bed numbers (and) the ability to manage patients who are very complex, with higher needs”.

“According to our calculations … we need at least 60 beds, plus the step-down beds and also some extra stand-alone disability beds,” he said.

“We, however, have been very pleased that the government has expanded the beds number from 40 to 50.”

In May last year, the State Government opened 20 psychiatric beds at the new Kenneth O’Brien Rehabilitation Centre at James Nash House.

However, 10 of those beds remain unstaffed.

A spokesperson for SA Health said the beds were expected to be operational by September this year.

“Following 10 new forensic beds coming online at James Nash House in September, this will bring available forensic beds in South Australia to 60, and above the national average for forensic beds per person,” the spokesperson said.

Meanwhile, SA Health has commissioned an external inquiry into forensic mental health services in Adelaide’s north – including James Nash House – led by interstate psychiatrists.

A spokesperson said that “following the opening of a new rehabilitation facility at James Nash House in May, SA Health invited interstate psychiatrists to visit and share contemporary models of practice, with the aim of ensuring our consumers receive the best level of care”.

Atchison said the College of Psychiatrists supported the review.

She said the system was struggling to cope with increasing demand, both from forensic mental health patients (found not guilty or unfit to plead) and from increasing numbers of convicted prisoners suffering mental illness.

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