When Prison Is Used for Psychosis, the System Is Not Working

“Public safety and mental health care are not competing priorities. National policy recognises that timely, specialist mental health intervention is essential in crisis situations. When that care is unavailable and prison is used instead, outcomes worsen for individuals and risks increase for everyone. This is not a failure of intent, but a failure of implementation that must be addressed.”

Nicola Byrne, Shine CEO

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Recent reporting by RTÉ has highlighted cases where people experiencing acute psychosis have been detained in prison because appropriate mental health care was not available.

Psychosis is a serious mental illness that can involve hallucinations, delusional beliefs, severe thought disturbance and intense distress. It is widely recognised as a situation that requires timely specialist assessment and support. Prison is not designed to provide that care.

When someone is held in a prison setting solely because there is nowhere else for them to go, this reflects a failure of mental health service capacity and coordination. Even where such cases may be relatively small in number, the practice itself signals a system operating without adequate safeguards for people in acute crisis. This is not primarily a matter of criminal justice, nor is it the result of individual negligence or poor decision-making on the ground.

In practice, Gardaí, emergency services and prison staff are often responding to crisis situations with limited options. When acute psychiatric beds are unavailable, crisis teams are overstretched, and out-of-hours pathways are unclear or inconsistent, the justice system becomes an unintended holding space. This is an indicator of systemic strain, not suitability.

At Shine, we work closely with people who have experienced psychosis and with their families. Many describe periods of acute illness marked by fear, confusion and loss of insight, followed by long delays in accessing appropriate care. Some have spoken about being moved through emergency settings without clear clinical follow-up, or encountering the justice system at a point when their illness was most severe. These experiences are not shared to assign blame, but to underline a consistent pattern: when timely mental health intervention is absent, the consequences can be profound and long-lasting.

There is also a clinical reality that must be acknowledged. Detention in non-therapeutic environments during acute psychosis is associated with poorer outcomes. Restrictive settings can increase distress, complicate engagement with treatment, and delay recovery. Appropriate mental health intervention is not in opposition to public safety; it is one of its essential foundations.

The need for effective, health-led responses to mental health crisis is not contested policy ground. National mental health policy has repeatedly emphasised the importance of timely access to acute care, alternatives to hospital admission where appropriate, and strong continuity between inpatient and community services. Commitments to early intervention, crisis resolution, and recovery-oriented care are well established within Ireland’s strategic framework.

However, the continued reliance on prison as a place of containment for people experiencing psychosis indicates a persistent gap between policy intent and lived reality. Where crisis pathways are incomplete or inconsistently available, responsibility shifts by default to systems never designed to provide care.

Importantly, alternatives are well established. Effective responses to acute psychosis involve rapid access to specialist assessment, appropriate inpatient treatment when required, and structured follow-up in the community to reduce the risk of relapse or repeat crisis. Where these elements are properly resourced and coordinated, reliance on the criminal justice system diminishes.

People experiencing psychosis need the right supports in the right place and at the right time. Their care should be led by health and social care services, guided by clinical need, and delivered in environments that support treatment and recovery, in line with stated national commitments to dignity, rights and person-centred care.

If there is a lesson to be taken from recent reporting, it is that emergency mental health care must be treated as core public infrastructure. When it is not, other systems are left to absorb the impact, often with damaging consequences for individuals, families, and communities.

Ensuring that no one in acute mental health crisis is detained in prison due to lack of appropriate care is not an aspirational goal. It is a basic standard of a functioning health system.

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If you are affected by psychosis, or supporting someone who is, Shine is here to help.

Phone: 01 860 1610

Mobile: 086 040 7701

Email: support@shine.ie

Website: https://www.shine.ie

‍If you are in immediate distress, concerned about safety or need urgent help for a mental health issue:

Call 112 or 999 if emergency action is required (you or someone you know is about to harm themselves or someone else)

or

Call The Samaritans on Freephone 116 123  for 24-hour confidential, non-judgemental support, or email jo@smaritans.ie

or

Text About It. This is a free, 24/7 service. Free-text HELLO to 50808 for an anonymous chat with a trained volunteer, any time.