24th May, 2001
Dr. Henry: I hope the Minister of State noticed the recent report of the Irish Penal Reform Trust on an investigation of the use of padded cells in our prisons. These padded cells are strip cells and should be eliminated from prisons because if such facilities are not in place they cannot be used. It is not the staff in the prisons who want such facilities to be in place.
The survey by the Irish Penal Reform Trust shows that more than 80% of those who were put in padded cells were put there for psychiatric reasons. As a doctor, I have not heard of a recommendation that patients should be put in padded cells, such as those that are in our prisons, for the improvement of their mental health.
It has been said there are padded cells in hospitals but they are different and few in number compared to the dark, stark, frequently unpadded apartments into which these people have to be put. Frequently the walls are made of cement which means that such patients can injure themselves. There are still slopping out buckets in some of them, so there the dreadful situation can arise where a patient who is ill may smear the place with his or her faeces.
Much has been said about the psychiatric services in the prisons and the lack of them. On the last occasion the Minister for Justice, Equality and Law Reform was here, he agreed there was a serious deficit in psychiatric treatment for people who would come within the prison system. While the opening of Clover Hill Prison has made a big difference in that remand prisoners go there fairly rapidly, we must have a system whereby these people either go straight to the Central Mental Hospital or, if they are not considered dangerous, to psychiatric institutions. Having these padded cells only serves as a holding situation.
The White Paper on Mental Health recommended in chapter seven that there should be mental health courts, but unfortunately that chapter was omitted from the composition of the Mental Health Bill, which will come before the Seanad next week, and it is difficult to understand why. Separating before the courts and in custody people who are mentally ill and dealing with them differently has been found to be very successful in other jurisdictions. We should try to progress like that rather than leaving the situation the way it is. If the Department of Health and Children will not deal with these people, as it obviously is not, the Department of Justice, Equality and Law Reform, will have to make a better effort to try to ensure they get treatment rather than incarceration.
Dr. Valerie Bresnihan, the chairperson of the Irish Penal Reform Trust, visited three prisons and was shown the records for a year of those who had been put in these cells. If one was in the best of health, one would find the incarceration there very difficult. The adverse effect it must have on people who are mentally ill is dreadful.
Ireland has signed but not implemented the United Nations Universal Declaration of Human Rights, article 5 of which, I am sure the Minister of State is aware, states that no one should be subjected to torture or to cruel, inhuman or degrading treatment. It is difficult not to feel that such a manner of dealing with these people is not a cruel, inhuman and degrading treatment of people. Because we have not ratified the treaty, it means we can delay in doing anything about it. We should ratify the treaty at once, but while we are doing that the very least we can do is shut these cells so that we cannot be used.
The patients are in solitary confinement. Recently I was approached by a man who works abroad who told me the following sad story. One of his daughters who is here became mentally ill and was arrested for a breach of the peace and brought before a court in the Dublin area by the gardaí. He could not say enough in support of the gardaí or the court. There were problems in finding his daughter's identification, so she was brought to Mountjoy Women's Prison where for three days she was kept in solitary confinement in a padded cell, got no treatment and wore only an unshredable nightdress because some of these patients have to be kept naked in case they make an attempt on their life. This position is totally unsuitable. When the man heard of the plight of his daughter and came back to Ireland the girl was transferred with the co-operation of the prison staff, the gardaí and the courts to a mental institution and all charges were dropped. This is the type of thing that is happening and I do not think anyone wants it. Our prisons would be better without these facilities for the sake of the prisons' staff and the prisoners.
Mr. Cullen: I am happy to reply on behalf of the Minister for Justice, Equality and Law Reform. Under rule 78 of the 1947 Rules for the Government of Prisons, the governor may have a refractory or violent prisoner detained in a cladded-padded cell for his or her protection. Similarly, the prison doctor may authorise the detention of an offender in the cladded-padded cell for medical observation or for the offender's own protection if he or she has suicidal tendencies. Obviously, while undesirable, it is a matter of practical necessity to put some prisoners in a place of safety within the prison system when they prove difficult to manage among the general prison population.
Padded cells are sometimes used in such instances as they provide a secure, safe place where prisoners can remain under special observation, with minimal opportunity to cause damage to themselves or to other prisoners. Prisoners may be confined to such cells as may be approved by the Minister for Justice, Equality and Law Reform, but only on the authority of the governor or other officer in charge, and for as short a period as necessary. The guidelines in place for the use of padded cells require all such placements to be reported to prison service headquarters and the early involvement of the prison doctor where accommodation in one is deemed necessary. On many occasions, placement in a padded cell is at the prisoner's own request.
Senators will be aware that the Irish Penal Reform Trust recently published a document, Out of Mind, Out of Sight, which called for the elimination of the use of padded cells within the prison system. I would like to make a few observations on that report. Apparently, the finding in the report that 78% of prisoners placed in padded cells are suffering from mental illness is based exclusively on the comments and observations in prison registers regarding the use of such cells. Most of these entries, which are brief and situation-related, are made by prison officers who would not have a professional qualification in assessing or diagnosing mental illness. The classification by the trust's report of such cases as exhibiting "mental illness" is unscientific. The decision whether a prisoner is in need of treatment for a psychiatric disorder is a matter for the medical personnel in our penal institutions. Such a decision can be taken only following medical assessment and diagnosis.
I am informed that the Irish Penal Reform Trust report does not differentiate between strip cell usage and padded cell usage. Padded cells are used for the protection of the prisoner as opposed to disciplinary or good order purposes. The Irish Penal Reform Trust report does not make this clear and instead gives the impression that "punishment" is the rationale for such use.
The Minister for Justice Equality and Law Reform, however, accepts that there are indications that an increasing number of vulnerable and mentally disordered people are being committed to prison. In this regard, there is a risk that prison may be used as a refuge of last resort by the courts for some mentally disordered people who may be charged with offences of a public order nature that are by-products of their illness. It would obviously be beneficial if such minor offenders could be given medical treatment, either on an outpatient basis in the community or, in extremis, in a hospital, until their conditions stabilise. In this regard, there are reviews under way of both prisoners' medical care arrangements and on the future service role of the Central Mental Hospital. The Minister is awaiting the outcome of these reviews.
Successive Governments have held that if a prisoner is psychiatrically assessed and in need of psychiatric treatment, that treatment ought to be provided in a psychiatric hospital. That policy conforms generally to the policy in other European jurisdictions and to that advocated by the relevant organs of the Council of Europe. However, all the recommendations contained in the Irish Penal Reform Trust report will be carefully considered. The Director General of the Prisons Service, in this context, met a deputation from the trust last week to discuss at some length its report and recommendations.
The Seanad adjourned at 5.25 p.m. until 2.30 p.m. on Tuesday, 29 May 2001.
