Response to interpellation 2024/25:593 on imprisonment for persons with serious mental diagnoses
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
The debate concerns prison sentences and care for persons with serious mental diagnoses. M argues that persons with mental disorders should receive forensic psychiatric care instead of prison, unless they have recovered 1. M emphasizes that the correctional services train staff in mental health and that the government is preparing proposals from the Safety Board to improve recidivism prevention care 1 2. S requests a timetable for these proposals and wants to improve the statistics on mental health within the correctional services 3 4. S wants to cooperate to ensure that the sick receive the right care in order to reduce the risk of them becoming more dangerous upon release 5. M intends to address all proposals during the mandate period 6.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Justitieministern Gunnar Strömmer (M)
Mr. Speaker! Heléne Björklund has asked me if I intend to take any measures in light of the fact that persons with documented serious mental illness are sentenced to prison instead of receiving care and proper treatment. Heléne Björklund has also asked if I have a current picture of how many persons with diagnosed serious mental illness are currently in prison, and if I can, in that case, account for the result.
The starting point in today's system is that persons who have committed crimes under the influence of a serious mental disorder shall be sentenced to a different penalty than imprisonment, for example, forensic psychiatric care. It is only in very special cases that imprisonment may be chosen as the penalty. This can, for example, be the case if the crime was committed under the influence of a temporary psychosis but the perpetrator has recovered by the time of the trial and no longer suffers from a serious mental disorder.
An important purpose of the regulation is that forensic psychiatric care should only be used as a penalty when the perpetrator truly has a need for care. There is currently no work being done to change the legislation on these points.
Among Kriminalvården's clients, both physical and mental ill-health are commonly encountered. Addressing clients with mental ill-health is therefore included in several of Kriminalvården's trainings. Kriminalvården's clients have the same right to good care according to the health and medical care legislation as other citizens. Due to medical confidentiality, it is, however, not possible to obtain a complete picture of how many inmates in Swedish institutions currently suffer from a mental illness.
In the autumn of 2024, the government received the so-called Safety Commission's final report (Paths to a Safer Society, SOU 2024:54). This commission notes that several of the Prison and Probation Service's clients are not reached by the right interventions, particularly regarding healthcare that prevents recidivism. Therefore, the commission also submitted a long series of assessments and proposals.
One of the proposals aims for healthcare that is effective from a recidivism prevention perspective to be provided by the Prison and Probation Service to a greater extent than today. We are currently preparing these important proposals in the Government Offices.
Heléne Björklund (S)
Mr. Speaker! Thank you, Minister of Justice, for the answer!
I am completely convinced that the Minister for Justice and I share the same ambition that Sweden should become safer and a better country for all of us to live in. My question in this case naturally concerns, to some extent, the care of those who may not receive the correct care and treatment within the correctional services and of their relatives. It also concerns the fear that people who are within the correctional services and are very ill may be both sicker and more dangerous when they have served their sentence and come out – and thus do not contribute to making our society safer. That is the background to my question. The Minister answers that the government does not intend to do anything right now but that the Safety Board's report is being prepared.
The Security Preparedness Board proposes in its report that the correctional services should be able to provide recidivism-preventing health and medical care. It also states, just as the Minister pointed out, that there are several cases where clients in our prisons do not receive the care they are entitled to and which they might need for the sake of society.
It also proposes increased use of contract care. What I understand, after conversations with, for example, forensic psychiatry, is that it is perhaps not always the clients in prisons who make the most noise who are the sickest. Very few referrals are sent from the criminal justice system to forensic psychiatry, where one perhaps has the right competence to provide care and, with the right treatment, ensure that no recidivism occurs.
My question to the Minister of Justice is partly whether there is any timetable for when the government will process the Security Preparedness Board's report, and partly whether there are any concrete initiatives already now to get better control over this – even if they may not involve changed legislation.
Justitieministern Gunnar Strömmer (M)
Mr. Speaker! We are, of course, in complete agreement on the importance of using time in prison in the right way. This applies regardless of whether one suffers from physical or mental illnesses, physical or mental ill-health, or if one, for that matter, is healthy. Time in prison should be used in such a way that one has good conditions to come out on the other side in better condition and with good – better – conditions to take up an honest livelihood once one has served their sentence.
Naturally, the challenges are greater when it concerns persons who, for various reasons, are not doing well or who are even ill. As I said initially, it is also important to emphasize that the correctional services carry out a very extensive work when it comes to treating both physical ailments and diseases and mental ill-health and mental illness. The Safety Commission also correctly points out that it is a reality that there are both development needs and development opportunities. I mentioned some of the things – and Heléne Björklund mentioned a few more – that are taken up in the Safety Commission's report, which, moreover, all parties in the Riksdag stood behind.
In that report, everything from the work on preventing recidivism to various interventions regarding specifically mental health was addressed. It is a well-known issue that there are also, in correctional care, just as in the surrounding society, many with mental illness who are not diagnosed and receive the correct treatment. Contract care was also mentioned here, and that is also something that Trygghetsberedningen points out. I am fundamentally very positive towards all the parts that are highlighted there.
Regarding the schedule, I usually say that it is better to shoot the bear first and sell the skin later, so I will come back when we are truly finished with the work. My ambition, however, is that all the points raised by the Safety Preparation Board shall be handled in an appropriate manner during the mandate period.
Are we or the Prison and Probation Service doing anything else to develop the work in the meantime? Yes, that is the case. The Prison and Probation Service has also had a government mandate to strengthen and develop the competence among the agency's staff regarding mental health and mental illness, suicidality and other matters through knowledge-enhancing interventions.
The Prison and Probation Service submitted the final report for that assignment earlier this year, and the report states that the authority has carried out major training initiatives among staff who work closely with the inmates. The evaluation that has been conducted also shows that the staff have gained in-depth knowledge about mental illness and that, through these initiatives, the staff have been able to adapt their treatment and approach towards clients who have different types of mental illness.
So, there is a constant development work in the correctional services in this area. But that being said, there are more things that can be done from a political standpoint, and I think the best basis we currently have at our disposal is the Trygghetsberedningen's proposal. I intend to return to how we approach each and every one of those proposals further ahead.
Heléne Björklund (S)
Mr. Speaker! Thank you, Minister of Justice Strömmer! It sounds very good that we share the commitment for a safer and better Sweden. This perhaps also applies to the concern that those who are ill should receive the right care, regardless of whether they are inside or outside the walls, and that one should receive the right care in the right place.
Now the Minister for Justice says that it is not possible to get a consolidated picture of how many in our prisons are possibly severely mentally ill because it is restricted by medical confidentiality. I feel that it is difficult to know what to do if one does not know how many it concerns. We cannot formulate solutions for a group that we cannot count and therefore cannot follow up or understand.
Therefore, a follow-up question arises: Does the government intend to do anything nationally to improve the statistics on mental health within the correctional services? I am not sufficiently informed – I understand that – but it feels like it could be done in a fairly simple way without breaking medical confidentiality.
It also feels like a very pressing issue, and thus perhaps one – consciously or unconsciously – raises the question of more referrals from the correctional services to, for example, forensic psychiatry if this becomes clearer. The Government may have an ambition regarding that. It is also well known that we need more places in the correctional services and that forensic psychiatry has extended a hand and said: Here we have both competence and space.
The concrete question is therefore whether the government can imagine making any national collection or taking any initiative to improve the statistics on mental ill-health within the criminal justice system.
Justitieministern Gunnar Strömmer (M)
Mr. Speaker! As I said, and as Heléne Björklund is also touching upon, it is of course a limitation here that healthcare confidentiality means that it is not possible to get a complete picture at the exact individual level or of how many inmates in the institutions suffer from mental illness here and now. It is also of course a rather fluid matter depending on how long sentences the inmates have received; there is still a quite large turnover of clients in the institutions.
We can once again look at the Safety Preparation. The proposals submitted there are nevertheless submitted in the light of a fairly solid problem inventory. There is a relatively good picture that all the questions that Heléne Björklund raises are justified and have an anchoring in real problems in the criminal justice system. I also think that the problem description that exists in the report goes very far in drawing some systematic conclusions about what is required to further develop the operations in this area.
As we have touched upon, there is a need to develop the recidivism prevention work in the correctional system generally, but not least in relation to persons who suffer from mental ill-health or mental illnesses. One needs to work with mental ill-health generally. The Safety Board points out, as stated, that group of persons, which is judged to be quite large, who suffer from mental ill-health but have not been diagnosed correctly and therefore cannot receive the correct treatment.
There are, therefore, problems that must be solved. As said, it is also about the interaction with municipalities regarding contract care. There are a number of different things we can do already on the basis of the knowledge of the problem we have today.
When it comes to forensic psychiatry, there is naturally a very close and good cooperation with the prison and probation service, and if it is the case that forensic psychiatry considers itself able to contribute further, I naturally assume that the prison and probation service welcomes those efforts. I think it is good that we discuss the issues, and I feel secure in the fact that there is already an offensive development work within the prison and probation service in these matters.
I am also convinced that we, from the political side, with a number of changes, not least based on the proposals submitted by the Safety Preparedness Board, can create even better conditions to meet those who have these needs.
Heléne Björklund (S)
Mr. Speaker! Thank you to the Minister for Justice!
In conclusion, I note that the Minister for Justice has a good grasp of the proposals that the Safety Board has submitted in its report. Still, I hear a vague attitude regarding when they might possibly be submitted as proposals from the government. I think that is a pity, and I want to urge the Minister to address the issue immediately.
I also want to extend a hand from us Social Democrats. We are happy to participate and cooperate on these proposals. We have processed many other proposals quickly in the Riksdag, for valid reasons, and this is another such issue. We are therefore here when the government and the Minister for Justice want to discuss more proposals – even from the Safety Preparation Board.
The question is, as said, urgent. People who have committed very dangerous acts but who are also very ill must receive care, not only for their own sake and for the sake of their relatives but also for the sake of society. There is a risk that they will be released after many years of imprisonment and be both sicker and more dangerous, and that is not our ambition.
Justitieministern Gunnar Strömmer (M)
Mr. Speaker! Thank you to Heléne Björklund for the opportunity to discuss these important issues today!
I perceive that we are in agreement on most things; possibly there is one point where I still have a slightly differing opinion, and that is that I would be vague regarding the timeline. I am happy to repeat that my intention is that we shall treat all proposals that Trygghetsberedningen has submitted during the mandate period, which in other words will be at some point between today and the late summer next year.
Since it was a parliamentarily composed committee, it is also my intention to return to all parties in the Riksdag with our assessment of how we best proceed with the content of the committee. I cannot say if it happens during this summer or after the summer, but for me, the next step is to return to all parties and report how we see we best take care of this material. And I can at least say this: We are at the end of April, and within the course of half a year, we will have the conversations, between the parties, on how these issues are best to be handled moving forward, as well as our assessment of that.
Thank you very much for the discussion today, Heléne Björklund!
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.