This Report sets out progress on a range of actions being taken to address mental health and addiction needs of people in prison. It is the second report from the Steering Committee which was established between the Department of Health and the Department of Justice to monitor implementation of recommendations in the High-Level Taskforce report, published in 2022. The committee’s first report is also available. 

Key areas of progress over the period covered in the report from September 2023 to September 2024 include the roll-out of Mental Health First Aid training to An Garda Síochána members nationally, the launch of the Community Access Support Team (CAST) pilot project in Limerick, progress in developing a pilot Dual Diagnosis service in Cork Prison, publication of the Mental Health Bill and the launch of the Mental Health Engagement Framework 2024 – 2028.

The High-Level Taskforce (HLTF) was established in 2021 to meet the government’s commitment to ensure the critical mental health needs of people in prison are met, addiction treatments are provided and appropriate primary care supports are available on release, in order to ensure improved outcomes for the individuals concerned and for society as a whole. The final report of the HLTF, published in September 2022, contained 61 recommendations reflecting the work of three subgroups.

Key items addressed in the Second Annual Progress Report over the period September 2023 to September 2024 include:

• roll out of Mental Health First Aid training to An Garda Síochána members nationally. 2024 saw 2,098 personnel within An Garda Síochána trained in Mental Health First Aid. The aim of this training is to improve the understanding of mental health, to reduce the stigma surrounding mental health, and to help participants to recognise when someone may be in difficulty or in crisis with their mental health
• launch of the Community Access Support Team (CAST) pilot project in Limerick was confirmed for October 2024 with implementation of CAST to commence in early 2025. The establishment of the new Health Service Executive (HSE) Crisis Resolution Team in Limerick in 2024 was central to progressing the new CAST pilot. The pilot project is a partnership between An Garda Síochána and HSE Mental Health Services. The pilot will endeavour to establish an appropriate co-response approach to calls relating to mental health and situational trauma. This approach moves towards the shared goal of providing a compassionate and effective response to people in distress and will enhance diversionary practices for relevant individuals
• a Crisis Resolution Team (CRT) was developed in Limerick in 2024 under the National Clinical Programme for CRTs in Ireland. A CRT is a community-based multidisciplinary team that provides rapid assessment and intensive support to individuals who are in a mental health crisis. The team’s model of care includes a community café that could become a key contact point when working with people in crisis. A city centre location in Limerick for the location of the café and a partner agency was agreed in 2024. Integration with this team will be central to the CAST pilot. CRTs, and the allied CAST model of care, also aims to decrease pressure on acute hospitals, reduce morbidity and mortality, and contribute to the de-stigmatisation of mental health difficulties
• the Irish Prison Service have consulted with HSE Dual Diagnosis Leads in relation to piloting a Dual Diagnosis service in Cork Prison. The service would provide for two referral pathways including mental health and social inclusion. A Model of Care for Dual Diagnosis has been developed as per recommendation 57 of Sharing the Vision
• the Probation Service Mental Health Action Plan 2024 – 2026 was finalised in 2024 and it takes into account recommendations of the High Level Taskforce, Sharing the Vision, Connecting for Life, and the Probation Service research ‘Moving Forward Together: Mental Health Among Persons Supervised by the Probation Service’ (2021)
• the Mental Health Bill was published on 31 July 2024 and the Bill passed Second Stage on 19 September 2024. The Bill represents the largest overhaul of mental health legislation since the introduction of the Mental Health Act 2001, making our legislation more person-centred and in closer alignment to Ireland’s international human rights obligations, such as under the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) and aligning with the Assisted Decision Making Capacity Acts 2015 and 2022
• the HLTF recommendation on tiered access to mental health care aligns with national mental health policy recommendations, which are being progressed as part of the dedicated Justice Workstream of Sharing the Vision. The Justice Workstream have met to progress a detailed delivery plan to ensure every person with mental health difficulties coming into contact with the forensics system has access to comprehensive stepped (or tiered) mental health support that is recovery-oriented and based on integrated co-produced recovery care plans supported by advocacy services as required. This model of care is being developed as a matter of priority
• Night-Time Confinement of patients in identified wards ceased in 2024 in line with Mental Health Commission registration conditions of the new Central Mental Hospital (Approved Centre) at Portrane
• the Central Mental Hospital (CMH) opened a second ward for women to meet evolving needs to provide a stratified pathway for women admitted to the CMH. Admissions of patients from the prison service continues to be a priority to ensure the length of time for prisoners on the waiting list for admissions to the CMH is as short as possible
• planning took place in 2024 to progress the phased opening of the National Forensic Mental Health Service in order to deliver increased capacity and to progress towards a full opening of the 130 beds in the CMH

The Final Report of the High Level Taskforce to consider the mental health and addiction challenges of those who come into contact with the Criminal Justice sector was published in September 2022. The Final Report reflects the work of the three subgroups of the Taskforce.

Subgroup 1: Diversion. Chaired by a member of An Garda Síochána. This subgroup looked at the very first contacts and seeking to divert individuals from progressing into the criminal justice system whereby An Garda Síochána implement a diversion policy for use in suitable cases when members come in contact with adults with mental illness who may have committed a minor offence.

Subgroup 2: Prison Service / Central Mental Hospital Capacity. Chaired by an Irish Prison Service Director. This subgroup examined the existing and future needs of individuals within the criminal justice system. The objective of Subgroup 2’s work was to ensure that there is adequate provision of services to meet the mental health and dual diagnosis needs of those in prisons. The recommendations from this subgroup focus on how improvements can be made to the existing care arrangements.

Subgroup 3: Community issues and through-care from custody. Chaired by the Director of the Probation Service. The focus of Subgroup 3’s work was an examination of service provision in the community and the related processes involved in a prisoner’s throughcare from custody to community. Subgroup 3’s objective is to ensure that there are sufficient safeguards in place and adequate provision of services to prevent individuals from relapsing into damaging behaviours undermining the rehabilitative efforts made by the individual and the State.