6. Will the First Minister make a statement on NHS support for mental health services in the criminal justice system? OAQ52678

We do recognise that offenders have a higher prevalence of mental health issues than the general population, and we do work with a range of partners, including Her Majesty's Prison and Probation Service and police forces in Wales, to provide mental health support for people in the criminal justice system.

Thank you for that answer, First Minister. During my recent work with health services in Merthyr Tydfil and Rhymney, I was very struck by the high incidences of mental health problems amongst people in parts of our criminal justice system, and I took particular interest in the amount of police time being taken up by the duty of care that they hold towards such vulnerable people. I know we have some incredible initiatives, actually, to help address this, like the clinical adviser project in the Gwent force police area, a model that is soon to be rolled out in the south Wales force area. But what further action can Welsh Government take to ensure places of sanctuary are provided for people with mental health issues that, in turn, can help to free up police resources for front-line policing? 

Of course, policing is a non-devolved service; mental health provision is devolved. It's right to say in 2017 police powers were extended in order to assist people with mental health issues, and there is a great deal of collaborative working with the commissioners, with the police forces and also with the mental health crisis care concordat assurance group, and the regional mental health and criminal justice groups. We have made £7 million available annually since 2015-16 to improve provision for people who present in crisis. There is an advice centre that offers confidential support 24 hours a day as well.

In terms of new actions, we have prioritised access to crisis and out-of-hours care in the mental health transformation and innovation fund, and we've received proposals that include around £1 million to support a range of interventions, extending crisis care, liaison services and street triage. So, we will continue to work with the partners that we have in this field in order to make sure that people are steered away from the criminal justice system and towards a service that is more appropriate to them. It's something that I saw in the early 1990s, where people ended up in prison because quite often they had been long term in psychiatric hospitals, they left, they didn't get the support that they needed, they ended up in the criminal justice system, and that's a situation that clearly we want to avoid in the future.

First Minister, in England, offenders with mental health problems are being referred to health services as part of community sentences, in an effort to steer them away from jails. Under a pilot scheme in five areas, psychologists and a panel comprising justice and health officials have been providing information to judges or magistrates to determine whether offenders should be required to receive treatment. A recent Ministry of Justice study found that when offenders were given a mental health treatment requirement as part of their sentence, they were significantly less likely to reoffend. Will the First Minister undertake to hold discussions with the Ministry of Justice about introducing a similar scheme in Wales, please?  

That's not a particularly new scheme. Schemes of that sort have been around for many, many years in terms of looking to deal with people for whom prison is not the appropriate response when they find themselves in the criminal justice system. Now, I don't know who funds those schemes, whether they are funded by the Ministry of Justice—and justice, of course, is not as yet devolved. But, clearly, we will always look at pilots elsewhere. As I say, it's not clear what these pilots are designed to do at the moment, nor is it clear who is funding them, but if there was funding available from the MOJ, well, of course, it's something that we'd like to look at.

Clearly, there's a link between drug abuse and mental health problems, and, from research I've looked at today, it would cost about £500 million to deal with drug-related crime for the individuals involved here in the UK. Now, there are many arrest referral schemes, but the take-up for them is quite low. They do things like methadone maintenance programmes to reduce both illegal heroin and related crime; they have medically supervised detoxification and counselling services, as has been mentioned previously. Now, I know we don't have power over the criminal justice system here in Wales, although on these benches we would like to see that come here, so what are you doing in relation to trying to target resources at those who are dependent on drugs in our society?

I went out with police in Port Talbot only a few weeks ago, and most of the people that we went out to assess or to look at were on drugs, were on heroin. This is something that is around us every day. How are you getting to grips with these particular schemes and working with the UK Government to ensure that they're working here in Wales?

Well, tackling drug misuse is a complex issue. We've always seen it in terms of health rather than in terms of it being a crime. The suppliers and the dealers are criminals; the users are victims and they are people who need help through the health system rather than through the criminal justice system. We have, of course, the substance misuse strategy and the plans that are associated with that, and that guides what we are doing in terms of reducing the harm associated with substance misuse. In terms of misuse in prisons, well, the services are delivered in line with clinical guidance and with prison health teams.

We also have a programme called take home Naloxone that is provided to prisoners at the point of release within prisons across Wales. That's helped to target drug-related deaths in the community. Naloxone, of course, is a drug that reverses the effects of a heroin overdose or, indeed, morphine drugs and that family—overdoses of those drugs—and brings people back very quickly, in seconds, from a situation where perhaps they're in difficulty with breathing, particularly, and in danger of dying. So, being able to provide the immediate support for people to avoid dying of a drug overdose is the first step. Secondly, of course, the substance misuse strategy looks at moving people on, long term, away from the drugs that have captured their lives for many years.