I spent a couple of hours this week in the House of Lords, courtesy of Lord Bradley, discussing Tamara Pattison’s research project carried out under the umbrella of the Griffins Society on why prisons should not be seen as ‘a place of safety’ for women with complex mental health needs. Tamara, a governor at HMP Low Newton, has a powerful but depressing message: everyone who works in prison is convinced that mentally ill people should not be detained in prison, and they can come up with endless depressing ‘stories’ (too often ending with suicide and self-harm). But why does nothing change? Indeed, why does the situation continue to deteriorate?
Tamara’s first solution is better advocacy for mentally ill offenders. Far too often mentally ill suspects in police stations do not ask for legal advice. And they find themselves swiftly remanded in custody. It is a slow road out, as they queue for a hospital bed. Then there’s the need for better screening, better training: we have heard it all before and Tamara is to be congratulated on keeping these vital issues on the agenda.
Why does the ‘system’ let people down so badly? It is difficult to answer that question. Partly it is the ‘silo’ mentality, everyone working away in their own little part of the system. Magistrates, who make bail decisions, need to understand why prisons are not the best place for the mentally ill: understanding can be helped by better guidance, but nothing beats spending time talking to people in prison. Listening to Tamara, and to the Prisons and Probation Ombudsman (PPO) is certainly enriching. Should magistrates be encouraged to join Independent Monitoring Boards, to see for themselves the consequences of their decisions?
More than one voice in the House of Lords discussion suggested that the current fixation with ‘contracts’ consolidates the status quo, and stifles innovation. There are some very good things going on diverting women from police stations, but the news from Women’s Centres was less encouraging, as some are losing out in the contractual world of ‘Transforming Rehabilitation’. Good learning and continuity of provision are both lost as contracts change hands.There’s even a fragmented approach to commissioning in health care. How difficult it is to provide a good service for prisoners. It would certainly be easier if we could halve the prison population and provide better mental health care in the community.
I was reminded of my blog of 17 April 2015 ‘You can’t learn to swim without water’, where I proposed that every prisoner at the very start of his or her sentence should have a ‘ champion’, a key worker… who “would have the lead as the offender’s advocate, arguing loudly for measures and interventions which support rather than impede desistance. Pushing the prisoner’s case for reintegration, for progress through the system, at every corner”. We have a long way to go before we reach that point. What sort of tools and incentives can be offered to prison staff to help them achieve what they so clearly want to achieve – moving those with severe mental health needs out of the prison environment?