Prisoners needing clinical care are not able to access it
The majority of referrals to the Frankland Centre for clinical mental health treatment do not result in a placement. Even after multiple referrals a third of people never access the centre. These people are reliant on clinical care being provided within the prison, but the ability to provide services in these environments is poor. There are no designated therapeutic units and in-reach services fall well short of need. Most management of people with mental health conditions is carried out by custodial staff who have limited training in managing mental health issues and do not have access to full information about the person’s needs.
The problems of not accessing care are well known and getting worse, but no action has been taken
The number of beds at the Frankland Centre have not increased since it opened in 1993 when the prison population was a third of the current population. Multiple agencies, including this Office, have drawn attention to the shortage of beds for well over a decade but no change has occurred. The prison population has continued to rise and the volume of people requiring a mental health assessment when they initially come to court also continues to rise. Clinical and judicial decisions are being compromised by the lack of beds, with unwell people being released early from the Frankland Centre and unwell people not being sent for assessment from court.
Staff are making the system work as best they can despite the severe limitations
Custodial and clinical staff are continually adapting and applying band aid solutions to make the severely under-resourced system provide as much support as they can. Goodwill, perseverance, and good intent are driving service delivery. While this is commendable, it is inefficient and vulnerable to staff movements. Policy and written guidance is lacking, particularly for custodial staff who are mostly responsible for managing prisoners with mental health issues.
Transport between prison and the Frankland Centre is mainly safe, but areas of concern are impossible to track
Most prisoner transfers to the Frankland Centre have been conducted safely and without incident. Almost all transfers between prisons and the Frankland Centre are conducted as a direct transfer between the two facilities with only one person in custody in the vehicle.
However, the reporting of critical incidents during transfer is insufficient and movements of people with mental health conditions, prior to their transfer to the Frankland Centre, are largely impossible to track. The two case studies which triggered the review were not initially reported as critical incidents, with one still not considered an incident. Substantial improvement in recognising and appropriately reporting incidents is needed by both the Department and transport contractors. Safety can also be improved by including specialist vehicles for medical transports in the secure fleet and reducing transports to the Frankland Centre late in the evening.