In a new report it highlights the lack of available beds in specific units in Scotland’s mental health facilities and raises critical questions about missed opportunities with early intervention, pathways from prison to the community, and the revolving door of prison.

In October 2018 the European Committee for the Prevention of Torture (CPT) visited prisons and police facilities in Scotland. The report of their visit raised issues across the estate but specifically raised serious concerns about five women with mental ill health in Cornton Vale, including concerns about segregation for extended periods and the conditions in which the women were held.

The UK government’s response, including the Scottish government’s, was published in October 2019. While action is being taken to build new facilities at Cornton Vale and a review of forensic mental health services has reported, the serious nature of the CPT’s findings drove the commission to carry out this retrospective detailed review of the prison health records of the five women whom the CPT had raised concerns about, and to broaden this review to include four further women who were in the prison between 2017 and 2020.

The commission said that examination of the records revealed a distressing and disturbing picture, much in line with the CPT’s findings. A number of women experienced a significant deterioration in their self-care in the context of their mental disturbance.

A significant concern was women’s access to medication and the recording of this. There were gaps in the dispensing of medications for physical and mental health in individual cases, which amounted to significant gaps in treatment.

The commission found examples of repeated inequalities, with women in prison being unable to readily access intensive psychiatric care unit (IPCU) beds or secure forensic female beds due to bed pressures in local services and a lack of provision of female medium secure facilities.

Claire Lamza, senior manager (practitioners) at the Mental Welfare Commission, said: “This document opens a window on the lives of some of the most marginalised women in society. It gives some insight into the irreparable damage that is being done to those individuals, and we can only imagine the wider impact on their families and communities.

“We hope this detailed review will be read and acted upon by those who are examining Scotland’s future approach to the best ways to care for mentally unwell people in prison.  While changes are being made at Cornton Vale, the wider situation needs to be addressed, and Scotland as a society needs to do more.

“We agreed with the CPT on many issues, particularly related to the environment of the segregation and reintegration unit.

“Our review also raises critical questions about missed opportunities with early intervention, pathways from prison to the community, and the revolving door of prison.”