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How Can Prisons In Crisis Help People In Crisis?

29/06/2017 12:49 BST | Updated 29/06/2017 12:49 BST
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The National Audit Office's excoriating report on mental health in prisons, published today, paints an alarming picture of what going to prison means for someone with mental health problems. It rightly points out that admirable intentions are not being delivered on the ground. As good auditors do, it bemoans the lack of reliable statistics and measures of success. It tells us that we simply can't know whether the money we spend trying to care for people in the chaos of our current prison system is delivering "value", but unsurprisingly concludes that the policy ambitions can't be delivered as things stand.

But ultimately, it is an audit of prisons doing the job they're currently asked to do in the context of the capital and human resources currently available. What does that look like on the ground?

Imagine you are the duty governor in a busy local prison. It is eight in the evening and you've already been at work for 12 hours. You hope you might be out by 10 if all goes well. You are chatting to the officers in reception about when the last van from court will arrive and how many "new numbers" will be on it.

The van eventually arrives, having completed a tour of other prisons dropping off other prisoners. You were the most accommodating of all the duty governors at prisons on the round - that's why you're the last to receive and why some of your reception officers are less than impressed.

It's bad news - there are several prisoners on the van who really are new to the prison, not even known to the staff who tend to recognise the frequent flyers. And so the lengthy process starts. Prisoners returning from court who were with you this morning get processed first and returned, if they're lucky, to the cell they left behind earlier in the day. The new numbers come last. The first task is to find out if they speak English and if they have any idea where they are or why they're where they are. Have they been sentenced, and do they know what the sentence means?

And then, by way of welcome, they will be subjected to a "full search". There's a good chance that they may be carrying drugs, so this is going to be thorough and, however sympathetically conducted, pretty demeaning. A microwaved meal and cup of tea in a holding room with the other people off the van follows. Then it's on to a succession of interviews conducted by checklist. In between, men in distinctive T shirts offer practical advice about what to expect - it turns out they are serving prisoners and they seem to be giving the most helpful and realistic advice.

As duty governor, you now have some judgements to make. Is the person in front of you a risk to themselves? There's a brief form from court, and the police have said there's a history of self harm. But that could mean anything from a serious suicide attempt to long past teenage cry for help. Are they vulnerable to others? The very worst that could happen is unthinkable - this assessment was introduced because a prisoner was killed by a cellmate. But bullying and extortion could start on the first night and quickly develop into something dangerous. Or are they actually a risk to others? If they know the system a bit, they might well go out of their way to persuade you that they are - it's the quickest route to a single cell.

What you know is that when they leave reception, the prisoner will be going to a unit that is overcrowded. All day staff will have been negotiating prisoners out of it to make space for the evening. But the space could be a single, or a bunk in a double. You hope the staff on duty know a bit about who's on there and have some jailcraft to sense when a combination is not going to work.

Meanwhile, in the heathcare unit, a prisoner has nearly killed themselves. They need to be watched continuously overnight. So you have to take a member of staff away from an ordinary wing to do that job overnight. But they leave behind a single colleague to monitor 180 prisoners, several of whom have been identified as at risk of suicide, and who must be checked hourly, with entries made in a log to testify that they were alive. You close your mind to how a member of staff actually does that - wake someone every hour, or trust your eyes that you saw movement in the gloom of the cell, peering past the structure of the bunk and the pile of blankets.

Prisons will always have to care for people who are suffering from a range of mental health conditions. Imprisonment will always do damage, and will always make recovery from mental illness harder. But why should we expect prisons to have to rise to that challenge for people who will spend only a few days or weeks inside, and in institutions that have space for only a fraction of the human beings they are asked to hold?

This is the challenge for the new justice secretary. He must lead a step change that sees punishment in the community as the default option for all the but the most serious offending. If he has the courage to grip demand, he can start to build a prison system with a fair chance of caring properly for the people who really need to be within it. If not, he is condemning many more duty governors to sleepless nights worrying if the judgements they were forced to make will keep everyone alive until morning.