Mental health services at Europe’s largest women's prison in ‘worst state for 15 years’

The head of mental health services at Europe’s largest women’s prison has told its watchdog that care there is “the worst he has seen for 15 years”.

HMP Bronzefield’s annual independent monitoring board report found an increase in the number of women sent to the prison in southern England under the Mental Health Act is putting “considerable stress” on its services.

The chair of the board said it was “deeply concerned” the prison was being used as “a place of last resort for acutely mentally unwell women”. Women – and men – can be sent to prison in the UK as a ‘place of safety’ under the Mental Health Act or under the Bail Act for their own protection, including those who would not have otherwise been remanded in prison.

A shortage of available beds in secure psychiatric hospitals and “in-fighting” among NHS trusts over funding means there are “significant delays” in transferring women from Bronzefield to a hospital, the watchdog found. 

Between 2023-24, 19 women were detained at Bronzefield under the Mental Health Act, compared with nine in 2022-23. Although the prison has an 18-bed inpatient facility, assessment and care for patients under the Act cannot legally be provided in prisons. 

Sonya Ruparel, CEO of Women in Prison, said: “The use of prison as a so-called place of safety for very unwell women is unsafe and totally inappropriate. Prison should never be a replacement for medical, psychological, or psychiatric care.”

The Bronzefield monitoring board report noted instances of self-harm “remained high” – an average of 208 a month – with a large proportion attributed to those requiring admission to a secure hospital.

In February Charlie Taylor, chief inspector of prisons, released a report expressing similar concerns across the prison estate over “desperately unwell” men and women who “have no place in prison” waiting for transfer to secure hospitals.

“This is a scandalous way to treat some of society’s most vulnerable people,” Taylor said.

The prison inspectorate also criticised successive governments for repeatedly unfulfilled assurances that there were sufficient secure beds available and that hospital transfers would be expedited.

Tortoise understands NHS England is working towards integrating health services at Bronzefield, alongside commissioning additional capacity and services.

A spokesperson for the prison said: “We fully acknowledge the challenges highlighted by the IMB due to the increase in mentally unwell women remanded into the prison.

“However, we are continuing to work very closely with our commissioned healthcare provider to support ongoing improvements and to keep prisoners in our care safe.”

In June 2022, the Conservative government proposed removing prison as a place of safety and ending remand solely for mental health reasons in its Mental Health Bill, but the measure wasn’t included in the King’s Speech in 2023.

Last week, the House of Lords heard a second reading of the Mental Health Bill 2025 introduced by the Labour peer Baroness Merron. If it becomes law, it would also reform the Mental Health Act to remove prisons as a place of safety and end remand for a person’s own protection.

The Prison Reform Trust has warned enacting reforms will require investment in infrastructure and the workforce to deliver “accessible community health-based provision” and the hospital beds needed.

A Ministry of Justice spokesperson said: “The Mental Health Bill introduced to Parliament last month will rightly end the use of prison cells for people facing acute crisis as a so-called ‘place of safety’ and ensure they get the urgent specialist help they need instead.”