Learning lessons from the past: What the Government can do right now to do to radically reduce the prison population

 

David Scott, The Open University

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The prison system is now widely considered to be in crisis, with the most recent damning revelations coming from a BBC documentary about Sodexo run jail HMP Northumberland

Source: Chroniclelive.co.uk

 

Prison does not work. Prisons are antiquated institutions that are particularly ill-suited to dealing with people with complex social needs or in response to people who have perpetrated acts of violence.  More than half of adult prisoners are reconvicted within one year of release; there were record numbers of self-inflicted deaths in 2016; and there have been a spate of highly visible prison disturbances across the country in recent months.

 

These and other intractable problems – such drug taking, mental ill-health, demoralised staff, violence, fear, insecurity and difficulties in maintaining order / control – were all exposed in the BBC Panorama programme on HMP Northumberland earlier this week.

 

Reducing prison populations in the past

The Average Daily Prison population in England and Wales stands today at 85,000 people and this is more than double what it was in December 1992.  The current prison population is also an incredible eight times higher than that of the late 1930s.  In 1908 more than 200,000 people were sent to prison that year, largely for very short sentences.  The Average Daily Population was 22,029 that year.  Yet, by 1918 the Average Daily Population had more than halved to 9,196.

 

By the late 1930s the Average Daily Population had stabilised at around 11,000, significantly with less than 40,000 people sentenced to prison each year.  The Average Daily Population was to fall below 10,000 again shortly after the start of World War Two.

 

The prison population in England and Wales was dramatically cut through diversion schemes; genuine alternatives in place of prison sentences; the abolishment of imprisonment for debt; and by allowing time for fines to be paid by offenders.

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Lady Constance Lytton, a suffraggette, prisoner and sister in law of Liberal prime-minster

Source: npg.org.uk

 

The main reason the prison population collapsed, however, was because there was a political commitment to do so.  There was recognition among politicians that prisons were brutal institutions that did not work.  In the late nineteenth and early twentieth century a number of wealthy and influential people experienced imprisonment – suffragettes, prisoners of war, conscientious objectors to World War One, political prisoners and those imprisoned for their (homo)sexuality.

 

Rich and influential former prisoners, like the suffragette Lady Constance Lytton, who was sister in law to a former Liberal prime-minster, talked openly and wrote about the pain and unnecessary suffering generated by prisons.  As such a bad conscience about using prisons was created among the political elite.  Despite many changes in prison policy over the last 100 years, prisons remain in many ways the same today.

 

The current government agenda

The Conservative government will shortly release its new Prisons and Courts Bill.  It is set on the path of building five new ‘super-sized’ prisons and increasing capacity of the prison estate by 10,000 places over the coming years.

 

Yet, the historical and contemporary evidence overwhelmingly shows we cannot build our way out of the humanitarian disaster unfolding in our prisons on a daily basis.  What is required are policies, like those of 100 years ago, that can immediately reduce the prison population.

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HMP Berwyn under construction in 2016

Source: Wrexhamprison.com

 

Alternative policy proposals

The policy suggestions are simple but not easy.  A starting point would be to halt plans to build the five new mega-prisons.  There should be an immediate prison building moratorium.  A clear and unequivocal message should also be sent to the judiciary that in cases of relatively harmless offences or where the person who has broken the law has considerable vulnerabilities, that a prison sentences should, if at all possible, be avoided.

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The call for penal reductionism is sometimes referred to as “playing the get out of jail free card”

Source: pinterest.com

 

The age of criminal responsibility should be raised as soon as possible to 16 years and diversion schemes introduced which keep young people out of the criminal process.  Petty but persistent property offenders should be dealt with in their own community through schemes that help build a collective sense of safety and redress for the harm done, as well as fostering notions of respect and responsibility for all.

 

The vast majority of women prisoners have been sentenced for petty and non-violent offences and could be released through probation, home monitoring or amnesties.  Sentencers could also pilot the introduction of prison waiting lists for women offenders.

 

Residential therapeutic communities have been shown to work in addressing problematic behaviours and drug usage and could be expanded to help deal with the estimated 45,000 ‘problematic drug users’ in prison.  There should also be further priority given to diverting people with mental health problems from the criminal process.

 

Politicians and members of the public need to once again recognise that prisons are places of intense pain, harm and suffering.  Rather than defending the size of current prison populations, our high ranking politicians and members of the judiciary should profoundly regret the existence of the prison at all.

 

Public education, informed rational debates and deep-seated reflections on exactly what the prison is and what it does to people, are urgently required.  Perhaps then, calls for a radical reduction in prison population will be warmly welcomed.

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Anaesthetising the Pain: Prison chaos and the enormous demand for drugs

David Scott, The Open University

 

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Source: @prison.uk

 

The revelations from Panorama (BBC, 8.30pm 13th February, 2017) on HMP Northumberland have put the problems of drug taking in prisons firmly into the spotlight. The terrible harms psychoactive drugs create for both prisoners and prison officers are laid bare: secretly recorded footage shows prisoners overdosing on drugs, a prisoner threatening an officer with a weapon and a prison officer collapsing after inhaling fumes from the psychoactive drug ‘Spice’.

 

Seen through the eyes of an undercover BBC journalist who joined the Prison Service as prison officer, the chaos and harms of the privately run Sodexo jail are revealed for all to see.  Concerns around levels of safety for both prisoners and staff and the ease at which psychoactive drugs are getting into prisons (such as by prison visits, ‘drones’ and prison officer smuggling) are raised by the BBC journalist – who illustrates part of the problem himself by being able to smuggle a camera into HMP Northumberland to record conversations and events.

 

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It is little surprise that the media coverage following the Panorama programme has focused on the availability of drugs in prison and the apparent inability of prison officers to control their supply and use by prisoners (and indeed their control over the prison population more broadly).  Yet the debate should not be restricted to talk of staffing, security and prisoner violence alone.  It is important that we focus on the demand for drugs in prison and the need to increase safety by reducing the harm of drug taking for all who live or work in prisons.  .

 

Drug taking in prison should be situated within two of the most painful harms of imprisonment: the conscious experience of time and the loss of personal autonomy. It is well documented that prison life is both highly regulated yet filled with emptiness. Drugs distort time and prisons are all about the wasting and loss of time.  Many prisoners attempt to suspend time and find ways to manage life on the edge of this meaningless and dehumanising penal abyss.

 

Drugs, especially cannabis, can be a means of controlling unstructured time by inducing sleep, thus making time consciousness much less evident.  Psychoactive drugs, like Spice (a synthetic version of cannabis), alter perceptions, moods and can eve induce unconsciousness.  Though the psychoactive drug Spice presents serious damage to health and impacts negatively upon behaviour this should be weighed against the way in which it eases the pains of confinement for the prisoner.

 

Taking drugs in prison can provide sanctuary and be a means of self-medication and self-help. Drugs can help mask the harsh realities of penal regimes and ease the consequences of being exposed to low levels of mental and physical stimulation. They provide a ready-made anaesthetic and prisoners often take drugs to alleviate physical or emotional pain. Drugs can become ‘chemical comforts’ to deal with loneliness, trauma, isolation or alienation rather than for hedonism. Imprisonment is highly stressful and taking drugs may become a crucial coping mechanism to get through hard times and the mundane daily monotony of prison life.

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Source: hamptonroads.com

 

Drug taking should be considered as a direct consequence of the processes of penal confinement itself and as an important survival strategy for many prisoners.  The problem of drug taking in prison is not new but something that has been present in the reformed prisons since the 1800s, albeit at that time the concern was around alcohol and tobacco and their relationship to prisoner violence.

 

Focusing only on supply and lapses in security, misses the crucial point that prisons generate on a daily basis enormous demand for drug taking.  We need to take the harms of psychoactive drugs seriously, as evidenced in the Panorama programme, but also acknowledge that a harm reduction approach is the most sensible strategy for moving forward.  In so doing we should acknowledge that the only effective way to increase safety and reduce drug taking by prisoners is by radically reducing the size of the prison population itself.

 

A slightly longer version of this article was published as “Why there is such an enormous demand for drugs in UK prisons” in The Conversation on the 14th February 2017.

Prison is not a safe place for people with mental health problems

Deborah H. Drake and David Scott, The Open University

 

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Prison as a warehouse for mental health problems – Source: Pinterest.com

 

In extreme circumstances or environments, psychological wellbeing can be precarious and effectively ‘under siege’ even for those with robust internal coping strategies.  Prisons are such environments.  They are places that can induce extreme stress and distress.  For those living in the extreme environment of the prison, the line between mental well-being and diagnosable or enduring mental illness can be blurred.  There are three distinct, yet overlapping, populations to consider when taking account of mental health within prisons:

  • Those who are committed to prison with a pre-existing (either diagnosed or not) mental health condition. Prisons are places that tend to confine a disproportionate number of people with mental health problems.  Mental health problems, for this population, are imported into prison with them.
  • Those who are committed to prison without a diagnosed pre-existing mental health problem but have a latent mental illness that can be triggered in the stressful or traumatic environment of the prison.
  • Those who are committed to prison without a pre-existing mental health problem and no history of mental health problems, but during the course of a prison sentence develop mental ill-health or experience extreme deterioration of psychological well-being.

 

The prison environment

Prisons are designed as ‘anti-social’ places.  They de-stimulate, create barriers to positive human interaction and deliberately promote conditions that exacerbate feelings of alienation, anxiety and despair.  This is part of their stated purpose as places of punishment.  Although the research literature on the enduring social and psychological impact of imprisonment is complex and, in some ways, inconclusive, it is well understood that the prolonged passivity and antisocial nature of prison life leads to individual and social isolation and, as a result, the prison place can present a serious danger to the mental health of those confined and those who work within its walls. Prison officer stress is a relatively well-researched problem in multiple jurisdictions and attests to the inherent damage of the prison environment.

Numerous aspects of the daily prison regime are harmful: separation from social life and from family and loved ones; over-crowding; loss of autonomy; frustrations in dealing with the minutiae of everyday life; limited mental or physical stimulation; negative relationships rooted in fear, anxiety and mistrust; physical, emotional, sexual or financial exploitation; inadequate ventilation, nutrition and care and a general culture of stigmatisation and distrust.  Sitting alongside these harms are the ever-present structured pains of confinement that characterise the loss of one’s liberty and, for many, the uncertainty of what they will face upon release.

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The suffering and isolation of prison – Source: ferloo.com

 

Greater vigilance is needed amongst psychological and penal experts to avoid over-applying ideas about enduring psychological difficulties located within individuals when those individuals are living in the extreme environment of the prison.  Prisoners can be individually “pathologised” and, as a result, there is a masking of deeply entrenched iatrogenic harms and institutionally-structured violence that characterises the daily workings of the prison. We must remain observant of the way in which the label of ‘mental ill-health’ can be deployed as a means to classify, manage and disempower people within the existing perimeters of legal and medical authorities rather than reflecting the interests or needs of the individual labelled as such. In recent decades there has been an increasing readiness to recognise ‘pathological’ traits in prisoners who may formerly have been regarded as ‘normal’.

At the same time mental health may significantly deteriorate or only start to manifest itself as a problem once a person is committed to prison. Mental health problems and confinement may, in this sense, go hand in hand.  Prisoners in prison health care centres sometimes spend only 3.5 hours a day unlocked rather than the recommended 12 hours a day.  Prisoners have also raised concerns that not all staff understand their problems and that they do not have much time with highly trained medical staff.  Prisoners with mild symptoms are often dumped together with much more problematic cases.  The result of this practice is that many prisoners with complex needs are left with too little or no support. Evidence from a range of studies which have consulted prisoners with mental health problems have found that what prisoners need are ‘someone to talk to’; therapy and advice about medication; ‘something meaningful to do’; support from staff, family and other prisoners; help when facing a ‘crisis’ and support with future planning.  Such needs, however, are rarely met inside prisons.

 

The inappropriateness of prison for people with mental health difficulties

When understood in social and historical context it is apparent that the presence of large numbers of people with mental health problems in prisons is not an aberration but an enduring and essential part of the confinement project. Their constant presence in prison indicates that imprisonment has had a clear historical mission: to identify, classify, contain or transform ‘unproductive’, ‘distasteful’ and ‘unwanted’ elements of society.

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The “General Penitentiary”, Millbank, London (Opened 1816) – Source: blackcablondon.net

 

Prison management requires a relatively docile population if it is to discipline the able-bodied and the presence of ‘the mad’ disrupt this. The problem of mental health in prisons has never just been a result of ‘importing people’ with mental health difficulties. From the introduction of the ‘reform prisons’ in the early 1800s there is accumulating evidence of the detrimental impact on prisoner health. For example, at the special unit on mental health at HMP Birmingham from 1919 to the 1930s Dr Hamblin Smith came to the conclusion that prisons could not be an effective means of delivering psychological treatments because the punitive ethos and the deliberate structural pains of confinement were anti-therapeutic.

 

On numerous occasions since the nineteenth century prison authorities have claimed that not only are mental health problems largely imported but that the prison place could be a major opportunity to address them. The modern prison is often discussed as a “health promoting environment” where prisoners can expect to receive a similar level of care (in terms of health treatment, for example) as those in the community.  In practice, however, this is rarely the case.  Moreover, given the extreme environment of prisons the level of care within them would need to be significantly greater than that available on the outside merely to ameliorate the negative effects of the environment alone.  When we then consider those who enter prisons with serious mental health difficulties, some of whom may, arguably, require the very highest levels of care available, we see that prisons are profoundly inappropriate for responding to and treating those with extreme mental health needs.

 

Mental health services in prison face enormous obstacles

Mental health difficulties are undesirable, disabling and potentially frightening for all involved. When such difficulties present in a prison, the staff and other prisoners often feel ill-equipped to respond appropriately.  Prisons are sometimes utilised by well-meaning judges as ‘places of safety’ for people with mental health difficulties.  Prison staff on the landings (e.g. officers) and healthcare professionals alike are unable to manage these sorts of difficulties.  Moreover, psychologists in prisons are – in the vast majority of cases – not focused on the mental health and well-being of prisoners.

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Source: National Health Service

 

At the same time, tangled up in the complexity of the prison environment and the baggage of chronic cynicism and risk aversion are those who have serious mental health difficulties – either that they came in with or difficulties triggered by the environment.  One of the key aims of the influential 2001 policy document Changing the Outlook was to introduce Mental Health In-Reach Teams [MHRIT] into prisons. Alongside an exceptionally high average caseload for MHRIT practitioners, MHRIT’s are also shackled by prison security, the inherent harms of prison life and the contradictory ideologies of punishment and care. With an emphasis on security and highly restrictive daily routines it is very difficult for MHIRTs to meet the needs of prisoners. MHIRTs were initially established to serve people with severe mental illness [SMIs] but many teams cannot focus exclusively on those with these difficulties because they are swamped by other cases. As a result of these difficulties and the range of other complexities associated with the prisons environment, outlined above, there is a huge amount of unmet mental health need in prisons that is unlikely to be addressed through a simple reform initiative or some other ‘programme of change’.

 

Learning lessons for the future

The lesson we need to learn is that prisons are places which systematically undermine well-being and health – for all who enter them (both prisoners and staff) – and for people with pre-existing mental health difficulties the prison is an especially unsafe environment to send them to.   When we consider mental health in prison in historical context we find that penal confinement has consistently been used as means of housing ‘unwanted’ people who have been failed by wider social policies.  People with mental health problems have been ever-present in prisons, as indeed have large numbers of deaths.  If we are to change this in the future there is only one policy option that can do this – a radical reduction in the prison population coupled with improved welfare provision for people in the community and public education campaigns which can promote a more caring and supportive approach to people suffering from mental health problems.  Tinkering with penal policies has been tried for decades if not centuries.  It is time for a bolder, evidence based approach to mental health problems in prison that acknowledges the true nature of both mental health and the demands and harms of the prison place.

We need greater commitment to listening to the wrongdoer and the democratic participation of all parties in a given conflict when deciding the best means of redress. There must be acknowledgement that psycho-medical labels and treatments can lead to an increase in harm and that people with mental health problems require detailed information about treatment options and help in developing skills, rather than being simply stigmatised as needing some ill-defined ‘treatment’. This requires consultative interventions rooted in respect, support, patience. On the ground there needs to be active engagement with service users; the development of services people actually want to use; recognition of legal rights; and real support for finding financial security, housing, jobs, and other initiatives aimed at ending social exclusion.

There are crises in mental health despite the fact that many people with such problems cope most of the time. If we are to take the mental health problems of lawbreakers seriously we need to deploy social policies that emphasise social justice and human rights. In essence we argue that state confinement is a major obstacle to the well being of those confined and largely exacerbates or even triggers mental health problems. Ultimately what is needed are creative solutions that look beyond the prison.