Experts urge overhaul of mental health care in New South Wales prisons

Dr. Ian Korbel, chair of the RANZCP NSW branch, emphasized that “safe cells are a custodial response rather than a health response.” He stated the need for close support from nursing staff, psychologists, and psychiatrists, potentially including medication, and ideally, shared accommodation rather than solitary confinement.

Forensic psychiatrist Dr. Kerri Eagle previously proposed that Justice Health, a division of the NSW health department, should take the lead in managing the mental health of incarcerated individuals. She argued that Corrective Services’ focus on security and law enforcement makes them unsuitable for handling these complex health conditions. Dr. Eagle made this statement as a private practitioner, despite being a clinical director at Justice Health.

Currently, assessments of at-risk inmates involve a team of two CSNSW staff and one Justice Health worker, with guards responsible for monitoring those placed in safe cells. Dr. Korbel supports shifting assessment and monitoring responsibilities to health professionals, acknowledging that while many correctional officers are caring, they lack specialized psychiatric training.

Similar calls for health department oversight are emerging in Victoria, as recommended by the Yoorrook Justice Commission, with a focus on Aboriginal community-controlled health organizations.

An ABC report last week revealed 48 NSW coronial inquests since 2015 have identified shortcomings in the care and supervision of individuals with mental illness, including 14 involving the deaths of Indigenous people. This includes interim findings related to the case of Tammy Shipley, a 47-year-old Aboriginal woman with schizophrenia who died from water intoxication after 10 nights in a monitored safe cell. This followed the death of Daniel Turnbull, a 35-year-old man with schizophrenia, who also died in a safe cell just two months prior.

The RANZCP is also advocating for increased diversion of individuals with severe mental illness from the justice system into treatment programs. A 2019 UNSW study found that NSW prisoners with psychosis who received court treatment orders instead of sanctions were less likely to reoffend.

Giancarlo de Vera, CEO of BEING Mental Health Consumers, attributes the mental health crisis in prisons to years of insufficient investment in community-based care, citing NSW Health documents indicating a $600 million annual shortfall for frontline mental health staff. “We are treating the justice system and prisons as a de facto mental health system,” they said.

Premier Chris Minns recently defended the current system, stating, “It may be not reasonable in all circumstances for a prisoner in psychological distress to be seen by a psychiatrist, at least initially.” He added that initial interactions often occur with prison staff and Corrections officers.

A Corrective Services spokesperson previously stated that the department “adheres to strict legislative and regulatory frameworks to safely, securely and humanely manage people within its facilities.”,