Mentally ill patients at risk without treatment in overcrowded jails
Mentally ill patients are increasingly being held in overcrowded jails and unable to get the treatment they need because of a lack of beds, adding to the risk of self-harm, death, or reoffending.
With Premier Daniel Andrews under pressure over community safety, the government has been warned of yet another escalating crisis: the growing number of severely unwell prisoners being locked up in mainstream jails because forensic psychiatric hospitals are full.
Public watchdogs including the Ombudsman and Auditor-General have urged successive governments to act for years, but some now say the problem will worsen unless a new secure psychiatric facility is built to take pressure off hospitals such as Thomas Embling in Fairfield.
Such concerns were recently raised by health services expert Stephen Duckett, who told the government as part of a review into hospital safety: "It has been 13 years since the Victorian Institute of Forensic Mental Health identified that demand for forensic psychiatric beds has outstripped availability … Since then, the problem has worsened and concerns have continued to be raised, but without redress."
This week, Public Advocate Colleen Pearce also weighed in, saying she was "very concerned that there are prisoners receiving inadequate or no treatment for their serious mental health issues, and that they may be released back into the community still unwell and at risk of reoffending".
Thomas Embling has 116 beds, housing patients from Victoria's criminal justice system, including murderers and other dangerous offenders, who have been ordered by the courts into high-security psychiatric care. It also has forensic patients who are found not guilty or unfit for trial; or people who are unable to be managed in the community and need treatment in a highly secure environment.
However, the mental health system has been at capacity for years, leading to many patients being detained for too long in the Melbourne Assessment Prison; the increasing risk of violence against staff; and the likelihood that some people are being treated too quickly when they get to the hospital in order to free up beds.
Figures from Forensicare show that, at any given time in 2015, an average of 10 men were held in the Melbourne Assessment Prison awaiting transfer to Thomas Embling. A further 10 prisoners were on the waitlist for a bed at Forensicare's acute assessment unit, and there were sometimes "in excess of 90 prisoners at the prison on the highest level of psychiatric risk rating".
- The average number of days between prisoners being certified for compulsory treatment and their admission to Thomas Embling Hospital has jumped, from 5.3 in 2009-10 to 22.2 in 2013-14.
- Longer waiting times are leading to patients turning up at hospitals more unwell, partly because of an increase in acutely disturbed prisoners who are kept in their cells on "lockdown" for up to 23 hours a day.
- The Health and Community Services Union has been lobbying the government for a second facility and better safety measures, particularly after a doctor was stabbed by a patient at Thomas Embling in October 2015.
Asked if the government had plans for a new facility, a spokeswoman for Mental Health Minister Martin Foley said: "The government has invested in an expansion of forensic mental health services to help people get well and stay well and keep them out of the criminal justice system. We are aware of the ongoing pressures Forensicare are experiencing and we are actively working with them on short and long-term solutions. We will have more to say soon."