UK’s mentally ill people more likely to be found in jail than hospital

Each decade in Britain appears to contain a symbolic, heinous murder – a crime so awful that it reflects a nation’s pathologies as well as its fears. In the 1990s, the death of James Bulger, a two-year-old who was abducted from a Merseyside shopping centre before being tortured and killed, led to the age of criminal responsibility being changed.

The next decade began with the case of 10-year-old Damilola Taylor, who bled to death after being assaulted on a south London stairwell, presaging years of concern over the rise of such attacks.

This month has seen a gruesome case which again holds up a mirror to the state of Britain. The events that led to Matthew Williams, found eating the face and eyeball of a 22-year-old woman he had lured into his room at Caerphilly’s Sirhowy Arms hotel, can be used to give a diagnosis of one of society’s most visceral ills: that prisons, not hospitals, are the place to find the mentally disturbed.

There are about 16,000 mental health beds in the NHS, while the Centre for Mental Health estimates that about 21,000 people behind bars – a quarter of the total prison population – have bipolar disorder, depression or personality disorders.

Prisons also disproportionately house those who have the most serious mental illnesses. About a quarter of women and 15% of men in prison reported psychotic episodes. The rate among the general public is about 4%.

Williams, who had had paranoid schizophrenia since he was a teenager, had been released from jail two weeks before the attack. He appeared to be a man lost, prey to delusions and hallucinations that had haunted him for years.

It’s certainly what his mother, Sally Ann Williams, thought. Interviewed by the BBC days after the murder, she claimed her son had been unable to access the medication he needed to keep his condition in check. She argued that her son, who died after police fired a Taser at him to try to force him away from his victim, should have been in hospital rather than living with little or no supervision in the community.

None of this surprises Jeremy Coid, professor of forensic psychiatry at Queen Mary University of London. He points out that less than 25% of prisoners who screen positive for psychosis subsequently received an appointment with a mental health professional after release. In a paper last year he said that failing to effectively screen prisoners’ mental health inevitably led to tragedy.

He told the Guardian: “Our work, which looked at 1,000 cases, showed released prisoners with schizophrenia are three times more likely to be violent than other prisoners, but only if they receive no treatment or follow-up support from mental health services.”

It did not have to be like this. In the dying days of the last Labour administration, ministers produced the Bradley report – a blueprint for reform of the criminal justice system and healthcare to ensure that prisoners did not languish behind bars without help. Ministers had been spurred into action by a series of hard-hitting warnings from charities such as the Prison Reform Trust, which pointed out that a third of prisons frequently saw prisoners who were too ill to be in jail.

However, the Bradley report was shelved by this government, which instead has brought about huge upheavals in the prison service and the NHS.


In the US we are using our prisons almost like psychiatric hospitals. They make the prison inmates who need it take anti-psychotic medication. The prisoners don’t like taking them. One reason for this is that the med’s make the people who take them physically weak. I saw one inmate on tv saying, “I can’t take these, I have to be able to defend myself.” Also, almost half the people who live on the street are diagnosable as schizophrenic. Appropriate mental health treatment is a huge problem in the US. Any dollars directed towards the problem are stretched thin. We are going to have to do some soul searching and set priorities in treating this problem,

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This is a serious problem in Canada as well.


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Very sad story

This is the biggest issue with mental illness - lack of treatment.

I wonder whether in developed countries the issue is as much access to treatment as not seeking treatment because either you or your parents don’t see that you have a problem.