In 2006, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) was adopted, promoting autonomy, choice, independence, equality and participation. The CRPD includes provision for those with intellectual disability (ID). This is typically diagnosed if individuals have an IQ below 70; an impaired ability to effectively interact with society on all levels and care for themselves; and have had developmental difficulties prior to the age of 18.
Yet a recent report in the Journal of Intellectual Disability Research stated: "Ireland became the final EU member state to ratify the CRPD in March 2018. . . [but] opted out of the Optional Protocol which allows people or groups who believe their rights have been violated under the Convention to take a case to the UN, a move strongly criticised by disability advocacy groups".
This move is unhelpful, given an ID prevalence in Ireland of 6.13 per 1,000 members of the public. But what about ID in Ireland's prisons? This was addressed by a team led by Dr Gautam Gulati, adjunct clinical senior lecturer at the University of Limerick. Their report, "Intellectual disability in Irish prisoners: systematic review of prevalence", was recently published in the International Journal of Prisoner Health.
It uncovered scant information on ID in Irish prisons: “We found no single published study evaluating a nationwide cross-sectional survey of prevalence. . . ” The only nationwide survey was commissioned by the Irish government in 1999. Its assessment of 264 prisoners across 14 Irish prisons found that 28 per cent had an IQ below 70, suggesting “a significant degree of intellectual disability/mental handicap”. For comparison, a review of 10 surveys from four countries showed that typically 0.5-1.5 per cent of prisoners had ID.
Report co-author Prof Colum Dunne is director of research at the University of Limerick's graduate entry medical school. He told The Irish Times: "This study is the latest outcome from a programme of work in Limerick that investigated homelessness, mental health and intellectual difficulties in Irish prisons. In this case, our research not only confirmed that levels of ID may be higher among the Irish prison population than was thought previously, but also found that information regarding Irish prisoners compared with international counterparts is quite dated."
Gulati explained that the vulnerability of people with IDs in Ireland’s prisons is a major concern, noting an increased risk of sexual and violent victimisation: “Vulnerability may be magnified when there are co-morbidities such as autism spectrum disorder, which can lead to challenges arising from social naivety, sensory difficulties and ‘meltdowns’ being perceived as challenging behaviour. Placement on vulnerable prisoner wings,” he added, “may mitigate such risks, but exposes those placed in such settings to limited social contact, a restricted prison regime and potential stigmatisation.”
This report exposes shortcomings in the treatment of prisoners with ID, treatment which they are entitled to: “There is growing international recognition,” Gulati explained, “of the need for specialist care provision for those in prison which should be equivalent to that in the community. The principle of non-discrimination is enshrined in the CRPD.”
”A lack of standardised care for those with ID,” observes Gulati, “was highlighted in the UK by the prison inspectorate who found ‘extremely poor systems for identifying prisoners with learning disabilities’ and as a result, prisoners with IDs risk having a more difficult time in prison than those who don’t”.
What can be done?
Arguably, says Gulati, the answer lies in prevention, meaning an effective diversion before imprisonment. From an Irish perspective he highlights the interim report of the interdepartmental group to examine issues relating to people with mental illness who encounter the criminal justice system in Ireland, and also A Vision for Change, published by the department of health and children in 2006: "These raise the importance of inter-agency working and potential diversion of those with mental illness and/or ID at the point of arrest and/or custody. However, diversion services at the arrest and police custody stage of the criminal justice pathway are yet to be developed."
The researchers suggest that a potential starting point for effective screening for ID in prisons could be literacy-based, citing Irish studies uncovering poor literacy rates in the prison population. One study, for example, found that 12 per cent of a cross-sectional sample of female Irish prisoners attended special school or remedial classes in mainstream school; another found that amongst male sentenced Irish prisoners, 47 out of 436 (10.8 per cent) reported having no literacy skills, and 82 out of 438 (18.7 per cent) reported having attended a special school or had remedial classes at a mainstream school.”
“It seems prudent,” Dunne comments, “to get a more accurate view of the situation, relevant to current prison populations who themselves reflect changes in the mental health and wellbeing of Ireland generally. Our research is intended to be relevant to the real world, to develop solutions to real problems. The obvious next step is to take our findings and develop something new, something to help both the prisoners affected and the staff in prisons who are caring for them. We’ve done that. We’ve developed a new pathway for care in the prisons, based on dialogue with other clinical experts. That pathway is relevant to Irish and international prison services, and it’s available to the relevant government departments.”
One might reasonably expect “the relevant government departments” to take note and act accordingly. It is one of the hallmarks of a civilised society to ensure, as the CRPD stipulates, that the rights of those with ID – including prisoners – aren’t ignored but respected.
