Mentally ill prisoners in peril due to hospital bed delays

HMP Pentonville prisoners with mental health needs can be left waiting for a hospital bed for up to six months.
General view of the centre of Pentonville Prison, London (Anthony Devlin/PA)
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Mentally ill prisoners are being put at risk due to delays of up to six months in finding them a hospital bed to receive treatment, a coroner has warned.

Sarah Bourke, an assistant coroner in Inner North London, said delays are “extremely common” when inmates at HMP Pentonville are in need of psychiatric help.

She raised the alarm after the suicide of a 20-year-old prisoner, Abdullah Popalzai, whose mental health declined during nearly two months waiting for a hospital bed.

“Prisoners who are acutely psychotic and refusing treatment that requires transfer to hospital under the Mental Health Act are being left untreated and at risk of further deterioration due to a shortage of suitable psychiatric hospital bed spaces becoming available in a timely way”, wrote Ms Bourke, in a Prevention of Future Deaths report.

She said she had heard evidence prison psychiatrists that the target of transferring a patient to hospital within two weeks of an appointment is “seldom met”, adding: “I was also told that significant delays in beds becoming available were extremely common and delays of up to six months were not unheard of.”

Serious concerns about overcrowding in HMP Pentonville (Victoria Jones/PA)
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The coroner’s warning comes after a damning report into conditions at the overcrowded HMP Pentonville, with inmates going for days without a shower and sometimes spending up to 22 hours a day in their cells.

Mr Popalzai was an Afghan asylum seeker who was assessed as needing mental health treatment while at Barkingside magistrates court on an assault charge, and he was remanded to HMP Pentonville in September 2019.

He was held on the in-patient wing of the prison, and was “acutely psychotic”, said the coroner, noting he “was aggressive and most interactions with psychiatrists, healthcare staff and prison officers took place through the cell door”.

He refused to take medication, and threatened to take his own life on multiple occasions.

A psychiatrist determined on October 9, 2019 that Mr Popalzai should be detained under the Mental Health Act, but it was not until late November that a bed became available.

Mr Popalzai was found dead in his cell on November 29, the day after he had been told the transfer was about to take place.

The coroner found that Mr Popalzai needed to be taken to hospital as his anti-psychotic medication could not be administered against his wishes in prison.

“Mr Popalzai’s mental health deteriorated in the time that he was waiting for a psychiatric bed to become available”, added Ms Bourke.

An inquest jury also found there had been failings within the prison, allowing Mr Popalzai to be able to take his own life.

A government spokesperson said: “Our thoughts remain with Mr Popalzai’s family and friends.

“People in prison are entitled to the same standard and range of health and social care services as they would receive in the community, including mental health.

“NHS England is working to make sure vulnerable offenders can access specialist treatment in a timely manner, and has set out clear guidance for the transfer and remission of patients from prison to hospital.

“We will continue to work to improve pathways for offenders with mental health needs.”

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