An evaluation of mental health in prisons shows the government is spending approximately £400m on prison healthcare in England despite failing to collect “enough, or good enough, data” about mental health in prisons.
This, the NAO concluded, makes it hard to plan services and monitor outcomes.
The report states: “The data on how many people in prison have mental health problems and how much government is spending to address this is poor.”
The review notes that rates of suicide and self-harm in prison have risen dramatically in the last five years.
Between 2012 and 2016, self-harm incidents increased by 73% reaching 40,161 in 2016, the equivalent of one incident for every two prisoners
There were 120 suicides in 2016, the highest number on record and nearly twice as many as occurred in 2012.
Meanwhile, funding for the National Offender Management Service reduced by 13% between 2009-10 and 2016-17, and staff numbers in public prisons have fallen by 30% over the same period.
The NAO urged the government to address the problem of suicide and self-harm as a matter of urgency.
Amyas Morse, head of the NAO, said: “Improving the mental health of those in prison will require a step change in effort and resources.
“The quality of clinical care is generally good for those who can access it, but the rise in prisoner suicide and self-harm suggests a decline in mental health and wellbeing overall.”
He called on the government to improve its collection of data without which he concludes “it is hard to see how government can be achieving value for money”.
Peter Dawson, director of the Prison Reform Trust, said the problem of mental ill health in prison was being exacerbated because vulnerable people were being locked up when they should be getting specialist care in the community.
He said: “It is futile to expect to improve their situation while prisons are overcrowded and thousands of people are spending a few weeks inside each year simply because there is inadequate community provision.
“The government must grip the issue of who goes to prison so that the system can care properly for the minority who really need to be there.”
