The role of prison staff in addressing mental ill-health and promoting mental well-being Urgent responses There are some situations related to mental ill-health that require urgent responses from prison staff, including if prisoners pose a threat to themselves or others or to the safety and security of the facility. Identify warning signs Staff should be equipped to recognise the signs of serious mental health conditions in individuals that require immediate attention. These could include: • Suicide and self-harm attempts • Active suicide preparation • Confused thinking and speech • Experiencing extreme ups and downs • Sudden mood/behaviour changes • Erratic behaviour Prison staff can play a vital role in the prevention of mental ill-health and can improve prisoner well-being as part of their regular work. The way staff treat and interact with prisoners can prevent, cause or exacerbate mental ill-health. Whilst staff cannot control the numbers of people entering prison with mental health conditions, they can tackle many of the factors that exacerbate such conditions and which contribute to mental ill-health, without the need for additional resources. What can staff do? If staff suspect that a prisoner has a serious mental health condition that requires urgent attention, they should immediately: • Inform the prison healthcare staff and their managers and communicate necessary information to other relevant staff members. Prison staff should not be expected to diagnose specific conditions or to perform the functions of mental health professionals, but their timely and appropriate responses are crucial. Early detection and intervention by staff can prevent minor issues from developing into more serious conditions and may help prevent suicide and self-harm. • Take urgent protective action if there is danger to the relevant individual or others. • Speak in an open and sympathetic manner with the relevant individual to try to understand their situation. Prison staff must: • Not use restraints, unless it is strictly necessary to prevent prisoners from injuring themselves or others or from damaging property. (Mandela Rule 47) ‘[M]uch can be done, even in countries with the most limited resources, to make substantial and long-lasting improvements to the treatment and care of those people in prisons with mental disorders.’16 • Not use force, except in self-defence or in cases of attempted escape or physical resistance to an order, and any such force must be based on law or regulations. (Mandela Rule 82) • Not place the prisoner in solitary confinement as it is likely to exacerbate the prisoner’s condition. (Mandela Rules 43–46) 16 17