Closure report: mental health in Scotland's prisons in 2021

Covering statement

When NHS Scotland took over the role of providing mental health services in Scotland’s prisons over 10 years ago, the reason for making that change (previously this was the responsibility of Scottish Prison Services) was to make improvements to services for prisoners. 

We’d published a report on how mental health services were working in prisons before that change, and last year we published a follow-up report looking at how this was working in 2021. We found that little improvement had taken place and we described mental health services in Scotland’s prisons as underserved and under resourced. 

We called for urgent action and made 10 recommendations for change – nine to both NHS Scotland and the Scottish Prison Service, one to the Scottish Prison Service , and one overarching recommendation to Scottish Government, asking that they monitor delivery and work with Scottish Prison Services and NHS Scotland to resource and deliver the changes needed.

This closure report summarises responses to our report at the 12 month point of a 12 to 24 month timeframe we gave for our recommendations to be actioned. We gave a two year timeframe because we recognise the two separate systems – NHS and prison services – attempting to achieve the one objective of improving mental health care for prisoners.

Nevertheless, at the midpoint stage, this closure report finds considerable variation across the prison estate in meeting our recommendations. 

The process by which Scottish Government will monitor the overall delivery of our recommendations has been established and is in the process of identifying some of the key priorities to monitor over the coming 12 months, and beyond that.  

We remain committed to ensuring that, this time, action is taken to make much needed improvements, and we believe that Scottish Government, the Scottish Prison Service and NHS Scotland wish to see those improvements too. We hope that by sharing this report with those three organisations now they can work closely and actively together to ensure that by this time next year all of our recommendations have been met, and that mental health services for prisoners are substantially improved. 

Whilst we understand the complexities, we will not lose sight of the need for fundamental change and we will report again on these recommendations next year.