Prison survey – for Health Managers

INTRODUCTORY TEXT

The National Audit Office (NAO) is conducting a value for money study to establish whethergovernment is meeting its objectives relating to the mental health needs of offenders in prison. This report will not make a judgement on the performance of individual prisons, but rather on how the system operates as a whole. As part of our study, we are conducting a survey of all Prison Governors and Health Managers at prisons and YOIs across England and Wales. This is your opportunity to contribute to our work, but if you have additional comments which are not covered please do contact the team on the email address below.

We would be grateful if you, or an appropriate colleague, could answer the following questions and submit your responses by XXXX. You may start the survey and save your responses as many times as you wish using this link, and the responses will only be submitted once you have clicked on “finish” at the end of the survey. We have also attached a PDF with the survey questions which you can print and/or read through in full, if needed.

Most of this survey asks for your opinion, or judgement, but there are some factual questions for which you may want to have information to hand when completing the survey. These include:

  • The clinical services available in this prison
  • The caseload for clinical mental health services
  • The number of healthcare staff and vacancies you have in this prison

Should we wish to refer to an individual prison, for example to illustrate good practice, we would check the factual accuracy of this with you before publication.Please be aware that all information held by the NAO, including responses to this survey, could potentially be requested under the Freedom of Information Act 2000 or audited as part of our quality assurance processes.

Should you have any questions regarding this survey, please send an email to xxxxx.

Identifying and addressing the mental health needs of prisoners

  1. With regards to your prison, to what extent do you agree with the following statements?

Strongly Agree / Agree / Neither agree nor disagree / Disagree / Strongly Disagree / Don’t know
Prisoners receive an equivalent mental health service to thatavailable to the general population
**I think that there are prisoners in this prison who should be receiving clinical help for mental health problems but are not.
I have a good understanding of the different types ofmentalhealth problems faced by prisoners
**This prison has effective screening procedures to detect prisoners’ mental health issues on arrival
This prison has effective procedures in place to identify mental health issues which develop during the course of a prisoner’s sentence
Prison Officers make appropriate mental health referrals to healthcare professionals
There is an adequate range of clinical services to meet the needs of prisoners with mental health problems in this prison
The clinical services available to prisoners have enough capacity to meet the needs of the prison population
There is an adequate range of other services to meet the needs of prisoners with mental health or wellbeing problems in this prison (e.g. listener and chaplaincy services)
**We are able to take appropriate action to address the mental health needs of offenders within this prison
I have a good understanding of how factors such as the prison environment regime, exercise and purposeful activity affect the mental health of my prisoners
Prisoners in this prison experience improvement in their health and
wellbeing in respect of recovery from substance misuse
Prisoners in this prison experience improvement in their health and
wellbeing in respect of their mental health
The current regime in this prison supports the mental wellbeing of prisoners

**: An answer prompts further open box questions:

You disagreed with the statement “My prison has effective screening procedures to detect prisoners’ mental health issues on arrival”.

What are the barriers to having an effective screening process?

You agreed with the statement “I think that there are prisoners in this prison who should be receiving clinical help for mental health problems but are not”

Why, in your opinion, are these prisoners not receiving clinical help for their mental health problems?

You disagreed with the statement “We are able to take appropriate action to address the specific mental health needs of offenders within my prison”.

What prevents you, if anything, from taking appropriate action to address the specific mental health needs of your prisoners?

  1. What, if anything, would help you to have a clearer understanding of mental health needs within your prison?
  1. If you have taken specific actions to address the mental health needs of offenders within your prison, please provide brief details of these actions below (for example, specific services, training, etc..)(max. 1000 characters)
  1. Which of the following services are available in your prison?

Type of services / Available to all prisoners in need / Available to some prisoners in need / Not available / Don’t know
Personality disorder service
Primary care services
Mental health in reach services
On site hospital wing
Clinical psychology
General psychiatry
Occupational therapy
Other clinical therapeutic sessions
Substance misuse services
Groups or classes to help manage behaviour or anxiety
Alternative therapies (like art or music)
Chaplaincy
Listeners or other prisoner led services
PIPE (Psychologically Informed Planned Environments)
Transfer to secure hospital
Other (please specify)

Staffing and workforce

  1. How many full time equivalent clinical staff, or other qualified healthcare professionals, are currently employed to work in this prison?

Number of FTE staff
  1. How many full time equivalent vacancies do you currently have for clinical staff, or other qualified healthcare professionals, in this prison?

Number of FTE staff vacancies
  1. To what extent do you agree with the following statements?

Strongly Agree / Agree / Neither agree, nor disagree / Disagree / Strongly Disagree / Don’t know / not applicable
Healthcare staff are able to access information about individual prisoner, that might inform their care, as and when they need it
The information recorded for individual prisoners is accurate and up to date

Access to services

  1. Approximately how much did the health services within your prison spend on addressing offender mental health during the financial year 2015/16?

£______

It is not possible for us to make this estimate

  1. To what extent do you agree with the following statements?

Prisoners in this prison currently:

Strongly Agree / Agree / Neither agree, nor disagree / Disagree / Strongly Disagree / Don’t know / not applicable
Have sufficient opportunity to partake in purposeful activities
Have sufficient association and domestic time
Have sufficient time out of cell
Have sufficient opportunities for physical exercise
Have a balanced diet
Have good relationships with prison staff
Live in conditions which do not exacerbate mental health problems
Continuity of care between custodial settings
Continuity of care
between custody and community
  1. To what extent do you agree with the following statements?

Strongly Agree / Agree / Neutral / no opinion / Disagree / Strongly Disagree / Don’t know / not applicable
Drug use in prison has a negative impact on prisoners’ mental health
We have seen an increase in mental health issues due to NPS

Referral to health services and treatment

  1. Approximately what proportion of the offenders referred to you with mental health concerns have had:

% of referred offenders
Mental health problems above the clinical threshold?
Mental health problems below the clinical threshold?
No diagnosable mental health problems?
  1. To what extent do you agree with the following statements?

Strongly Agree / Agree / Neither agree nor disagree / Disagree / Strongly Disagree / Don’t know / not applicable
Prisoners above the clinical threshold for intervention are able to get access to services they need
Prisoners below the clinical threshold for intervention are able to get access to services they need
The most mentally unwell prisoners are able to get access to the services they need
  1. How many patients are currently on the healthcare caseload for:

(Individual patients may be included in more than one category)

Number of patients on caseload
Depression
Psychoses including Schizophrenia
Personality Disorders
Bi-polar disorder
Anxiety disorders
Obsessive compulsive disorder
Phobias
Organic brain disorders such as dementia
Alcohol and drug misuse
Somatoform disorders
PTSD
Eating disorders
Perinatal disorders
Self-harm behaviours
Neurodevelopmental conditions
Other mental health issue (please specify)
Total number of patients on the caseload for mental health
Total number of prisoners on the caseload of substance misuse
  1. How many primary and planned secondary appointments were available to prisoners, and how many were not attended between 1 September and 30 September 2016?

Number of appointments available / Number of appointments notattended
Primary care
Planned secondary care (mental health)
  1. What do you think is the main reason that prisoners do not attend appointments?

Looking to the future

  1. To what extent do you think the following aspects pose acurrentchallenge to delivering effective mental health services in prison?

High risk / Some risk / No risk / Don’t know / not applicable
Too few clinical / qualified healthcare staff
Limited funding for prisons
Limited funding for healthcare in prisons
Over-crowding
Buildings that are not fit for purpose
Prison facilities and maintenance
An ageing prisoner population
Drugs and NPS
The prison regime
The smoking ban (if operating in this prison)
Gangs
Violence
Funding for health services
Availability of beds in secure hospitals
Other (please specify)
  1. How do you expectthese things will change over the next five years?

Get better / Stay the same / Get worse / Don’t know / not applicable
Too few clinical / qualified healthcare staff
Limited funding for prisons
Limited funding for healthcare in prisons
Over-crowding
Buildings that are not fit for purpose
Prison facilities and maintenance
An ageing prisoner population
Drugs and NPS
The prison regime
The smoking ban (if operating in this prison)
Gangs
Violence
Funding for health services
Availability of beds in secure hospitals
Other (please specify)

Concluding remarks

  1. Is there anything else you would like to tell us which is not covered in this survey, or any further comments you would like to add?