60% of security measures applied due to mental disorder exemption are carried out within prison

60% of sentences linked to crimes associated with mental disorder are served in prison psychiatric hospitals. Mental health professionals and experts consider that the current system offers insufficient tools to guarantee the recovery and reintegration into the community of those affected. This is one of the main conclusions of the 1st Conference on Mental Health in the Penitentiary, which took place today at the Sant Joan de Déu Health Park, under the title Building bridges towards comprehensive care. Experts warn that the stigma and difficulty in transferring people with serious mental disorders to community resources hinder their recovery and reintegration and, therefore, call for specialized units outside the prison environment.

In Catalonia, 40% of the 8,000 inmates required specialized care in mental health and addictions during 2024. The conference highlighted that, despite having a pioneering model, the Catalan prison and healthcare system still presents serious difficulties in externalizing people with serious mental disorders who have committed crimes in contexts of psychological alteration, without understanding the consequences of their behavior. This situation perpetuates a model that prioritizes safety over care, and becomes one of the challenges main work of the health policies, the penal model and human rights.

Aitor Eneko Olivé, head of management of Prison Mental Health Nursing at the SJD Health Park, believes that “people with mental disorders must receive specialized care and, when the risk decreases, continue treatment in community resources. But the reality is that 60% of security measures are met in prison psychiatric hospitals, which contradicts the principles of recovery, deinstitutionalization and dignity of care.”

One of the main obstacles to the reintegration of people who have committed a crime due to a mental disorder is the judicial requirement of zero risk when authorizing transfer to community resources. But this is, at this point, a condition that professionals consider clinically unfeasible. Although they can prove a very low and controlled risk, professionals consider that this assessment is usually insufficient. In fact, as a result of this, people with mental disorders remain in prison environments that distance them from the most appropriate resources for their recovery, despite being stabilized and prepared to begin a reintegration process.

Stigma, an added condemnation

People with mental disorders in prison suffer a double violation: for the disorder and for the deprivation of liberty. “When a person with a mental disorder commits a crime, they stop being seen as a person who needs care and treatment, and start being perceived as a threat,” explains Olivé. The testimony of Ismael Molina, who has been through the Penitentiary Psychiatric Hospitalization Unit (UHPP), has given voice to this reality. “When the health department considers that you have recovered, you can still be admitted for another three years due to the legal department. And when you come out, the social stigma is very strong. "They are more afraid of me because of my mental disorder than because of the crime I committed," he says.

Molina's passage through the UHPP of the Sant Joan de Déu Health Park has meant progress in breaking institutional protocols that were more aligned with serving the sentence than with recovery. Molina struggled to access a computer or enroll in university, among other things. For him, it is very important to plan life before leaving and, above all, to have family support and professional guidance in the mental health unit. Today, with a normalized life and a qualified profession, Molina participates in research on stigma and whenever asked, shares his experience, just as he did at the UHPP, acting as a patient expert to help new inmates adapt to the unit. “It's what I would have liked to find when I arrived,” he concludes.

A commitment to dignity and community

For decades, the Sant Joan de Déu Health Park has been committed to a model focused on the person and recovery in contact with the community. Professionals demand that this issue be a priority on the political and social agenda. "We are facing an emergency that deserves visibility and action," say the professionals who are in daily contact with people in mental health care units in prisons.

Along these lines, the SJD Health Park defends the creation of specialized services in the civil field. where existing strategies and techniques are implemented to ensure recovery projects by assessing the risk without it blocking, out of fear, treatments and community reintegration, with appropriate containment measures and focused on breaking the cycle of exclusion. Countries such as France or the United Kingdom have already implemented intermediate high-security community units that combine specialization with stigma-free reintegration.

With two psychiatric hospital units in Brians 1 and 2, and outpatient care programs, the Sant Joan de Déu Health Park is one of the main references in prison mental health in Catalonia. 250 professionals work there with the aim of ensuring that people who have committed crimes due to a mental disorder have access to treatment free of stigma and with the same possibilities of reintegration as those who undergo treatment in the community.