Prisons must not be a substitute for psychiatric care

Sir, – Recent RTÉ Investigates programmes have highlighted the growing number of people with severe mental illness in Irish prisons, many detained after minor incidents linked to acute psychiatric conditions. While multidisciplinary teams provide care, the prison system lacks capacity for those needing inpatient treatment. Delays in transferring prisoners under the Criminal Law (Insanity) Act 2006 are now routine, largely due to insufficient psychiatric beds.

Most admissions involve remand prisoners with minor offences, many cycling through courts while acutely unwell and homeless. Ireland’s per-capita psychiatric bed provision is among the lowest in western Europe. Despite record increases in mental health funding – rising by over 50 per cent since 2020 to almost €1.6 billion in 2026 – mental health still accounts for only about 6 per cent of the overall health budget, well below the European average of between 10 and 13 per cent. The proportion has even declined slightly since the pandemic, despite unprecedented demand and repeated commitments under Sláintecare to reach 10 per cent of the healthcare budget.

The current approach is failing some of our most vulnerable citizens. As Sláintecare promises “one universal health service for all, providing the right care, in the right place, at the right time”, we invite policymakers to prioritise the expansion of community and forensic psychiatric beds, strengthen diversion schemes, reform transfer legislation, invest in community mental health services, and implement robust data monitoring. Prisons must not substitute for psychiatric care. If Sláintecare is to fulfil its vision, it must extend to those most at risk – because a society is judged by how it treats its most vulnerable. – Yours, etc,

Prof CONOR O’NEILL