Australia’s biggest prison is so “grossly understaffed” in mental health services that people with acute needs should not be held there, the NSW prison inspector has found.
The UK-based private company Serco has operated Clarence Correctional Centre in New South Wales since it opened in 2020. The prison can hold up to 1,700 people, making it the largest prison in the country.
The Inspector of Custodial Services NSW conducted its first inspection of the prison in late 2024 and released a report on its findings this week.
The Inspector found severe understaffing at the centre, particularly with healthcare staff, which it said is creating “huge risks”.
Clarence prison is “simply unable to deliver appropriate care to patients with acute mental health needs, to keep pace with demand for drug and alcohol services, and to identify and manage people at risk of self-harm and suicide”, the Inspector found.
People experiencing psychosis were waiting three days to see a mental health worker in the prison at the time of the inspections, and someone who was acutely psychotic was waiting more than 50 days to be admitted to hospital.
The mental health team at the prison was “grossly understaffed”, the Inspector said, with 1.6 full-time equivalent mental health nurses and just one full-time mental health nurse to provide care for nearly 1,300 people.
“This is a dangerously low staffing level,” the Inspector’s report said. “At least five mental health nurses are needed to meet the mental health needs of the contemporary population.”
There are now three mental health registered nurses and one mental health nurse working full-time at the prison.
The mental health team were “overwhelmed” and the understaffing meant there were “serious deficiencies” in what could be achieved at the time of inspection, the Inspector found.
The under-resourcing was so serious that the Inspector’s consultant forensic psychiatrist became “gravely concerned by the level of unmanaged risk”.
The Inspector recommended that no person with acute mental health should be taken to the Clarence prison.
Despite the huge demand for these services in prisons, a requirement for secondary mental health care is not included in the NSW government’s contract with Serco, the report said.
A spokesperson for Clarence prison said the organisation was now “carefully considering” the recommendations in the report, with “some actions already underway”.
A spokesperson for Corrective Services NSW said that the report was “welcomed” and that Serco would be reviewing the recommendations and responding “in due course”.
Understaffing was common across health services at the prison, the Inspector found, including with alcohol and drug services, and there was no Aboriginal health worker on staff, despite First Nations people being disproportionately represented in the prison.
Serco has been able to introduce some “innovative custodial tools and practices” at Clarence, but this has been hampered by the continual understaffing, the report said.
Ultimately, in assessing the range of issues at Clarence prison and its future ability to operate effectively, the Inspector concluded that it is essential for the prison to address and overcome:
"numerous key challenges including poor performance in key contractual obligations, chronic staff shortages, lack of stability in leadership positions, and under-resourcing in custodial, health and other non-custodial workforces."
