Serious healthcare failings and the overuse of seclusion at Scotland’s national women’s prison are causing “irreparable damage” to mentally ill inmates, according to an independent report.

The Mental Welfare Commission says the situation at Cornton Vale prison is “distressing and disturbing”, warning of missed opportunities for mental health support and prisoners deteriorating after lengthy spells of isolation.

The Scottish Prison Service said it took the mental health of all prisoners very seriously, but admitted it would always be difficult to manage women with acute mental health problems in a prison environment.

Mental Wellbeing Minister Kevin Stewart said the report would be given “careful consideration”, adding that new facilities for women prisoners would be open by 2022.

Scotland has the second largest female prison population in Northern Europe, with around 400 women in the system on any given day.

There is a long history of concerns being raised about Cornton Vale, which has been slated for closure since 2015.

In 2012 Dame Elish Angiolini described the institution as a “miserable place” with “antediluvian and appalling” conditions.

Years later the Council of Europe’s Committee for the Prevention of Torture visited the prison and warned of an “emergency” situation. Some women there “clearly were in need of urgent care and treatment in a psychiatric facility, and should not have been in a prison environment," they said.

This damning report prompted the Mental Welfare Commission to analyse the health records of nine women who were mentally unwell while in prison custody between 2017 and February 2020.

The watchdog uncovered a raft of issues, including ‘significant concern’ around access to medication, ‘significant gaps in treatment’ and ‘unacceptable’ delays transferring prisoners to hospital.

Further criticism is directed at the Separation and Reintegration Unit (SRU), where several women who were acutely unwell with psychosis were locked alone in a cell for up to 22 hours a day.

‘The severity of women’s symptoms and level of their behavioural disturbance appeared to worsen in this environment, as did their self-care and the opportunity for any meaningful interaction with others,’ the Commission’s report states.

More broadly the Commission takes aim at the support before and after entering prison, with missed chances to flag up where mental health care was urgently needed in police custody.

Many of the women in the prison are repeat reoffenders often dealing with histories of abuse, mental health problems and addiction, the report says, and custody offers ‘little benefit’ in breaking this cycle.

A series of recommendations have been made to the Scottish government, Cornton Vale Prison and the wider prison service, including improvements to medication processes and hospital transfers, while all women should have at least two hours of meaningful human contact a day.

Claire Lamza, from the Mental Welfare Commission, said the report "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."

She added: "While changes are being made at Cornton Vale, the wider situation needs to be addressed, and Scotland as a society needs to do more."

In a statement, the Scottish Prison Service said it takes the mental health of all those in its care very seriously.

“We recognise that women in custody have complex needs and our staff, along with our NHS colleagues, work hard every day to support them.

“Decisions on whether someone should be in hospital is a clinical decision, and not one for the Scottish Prison Service.

“The plans for our new custodial estate for women sees the creation of a gender specific and trauma informed therapeutic environment, but even in those circumstances, supporting women with acute mental health problems will continue to be difficult to manage within a custodial setting.”

Mental Wellbeing Minister Kevin Stewart said the Scottish government was working to improve support for mental ill health in the criminal justice system, including specific help for women and girls. 

He added: "...We continue to work with the Scottish Prison Service and other partners to ensure that frontline staff are properly supported. This includes the development of a new custodial estate for women in Scotland, scheduled to open in 2022 and filling over 41 whole time equivalent mental health roles located across the prison estate including the female estate.”

Read more: “Indefensible” to send Scots women to England for care; Watchdog: Low security patients need appeal rights; 28-day drug therapy roll out follows prison success

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