Prisoners with mental health concerns and intellectual disability were significantly over-represented in staff assault incidents.
In 180 staff assault cases, the prisoners were recorded as having some form of psychiatric illness identified by Departmental health staff. This constitutes almost 40 per cent of all assaults. In contrast, people identified by the Department with psychiatric illness, constitute only 14 per cent of the daily average prisoner population. More than a quarter of 180 staff assault cases were women (27%) and over half were Aboriginal (51.7%). There were only 121 distinct prisoners involved in the 180 staff assaults, with 30 prisoners responsible for two or more assaults.
There were 69 staff assault records where the prisoner was identified as having an intellectual disability. Only 2.6 per cent of the prison population is recorded with an intellectual disability yet these prisoners were responsible for 15 per cent of all staff assaults.
The combined effect of these figures is stark: 55 per cent of assaults were committed by prisoners formally identified with a mental health condition or an intellectual impairment, even though this group only makes up 16.6 per cent of the prisoner population.
These findings accord with the both international and local experience. A recent review by this Office found that people held in prison under Criminal Law (Mentally Impaired Accused) Act 1996 with a cognitive impairment learn a variety of negative institutionalised behaviours such as violence and victimisation through the modelling of peer group behaviour. It also found that mental illness can be exacerbated by the unfamiliar and threatening prison environment. Prisoners with mental illness are at risk of self-harm, suicide, aggression, assault and behavioural disturbance; their presence can affect the entire prison and poses an increased burden on custodial officers who generally have little or no specialist training.
For a whole range of reasons, including the correlation between mental health / intellectual disability and staff assault, consideration should be given to ways to better manage these prisoners. In an ideal world, people with serious mental health conditions would not be held in a prison environment but this is unlikely to happen in the near future. In 2001, in acknowledgement of the high prevalence of mental health issues in UK prisons, the Department of Health and HM Prison Service developed a strategy for developing and modernising mental health services in prisons. This strategy acknowledged that despite the best efforts of health care staff, prisoners were receiving no or inappropriate treatment from staff with the wrong mix of skills in the wrong kind of setting. Rather than solely advocating for the removal of mentally unwell people from prisons, the strategy focussed on greater use of day care and wing-based treatments. The intention was to allow the lives of these prisoners to be made more normal, with greater opportunities to participate in a purposeful regime and other activities.
The UK strategy acknowledged that if prisoners with mental health problems are to be managed appropriately, all staff must be trained so they have ‘sufficient competence to know what to look for and what to do if they have concerns’. This Office has frequently raised concerns about the limited mental health training available to prison officers, despite the obvious need and the desire of staff to undertake such training.
Female prisoners are committing staff assaults at twice the rate of their general number in the prison population and the rate of assault at Bandyup Women’s Prison is vastly higher than any other facility in the state. This corresponds with a rate of mental health issues present amongst female prisoners. Departmental research indicates that 39 per cent of incarcerated women had some history of mental health illness and 28 per cent had specifically identified mental health ailments. Of those women who have assaulted staff members, almost 60 per cent were medically assessed as requiring psychiatric care compared with 35 per cent of male assaulters. Additionally, more than 15 per cent of women who assaulted staff were assessed by the Department as having an apparent intellectual disability.
The unequivocal link between assaults and issues of mental health and cognitive impairment on the part of all prisoners, and especially women, adds impetus to the need for a fundamental reappraisal of the way this state is tackling these issues in its prisons. A number of reviews are underway but action, training and new strategies are needed.