Mental Health Behind Bars: Prisons in Crisis

There are currently 86,000 people in prisons in the UK, and around 61,000 are currently suffering from two or more mental health disorders. This is hardly surprising, when we consider the conditions that prisoners operate under. Some convicted prisoners are allowed just two hour-long visits every four weeks, while almost half of those released from prison in 2008 were still claiming unemployment benefits two years later, having been unable to find employment. The overwhelming message coming from this is that the negative effects stemming from a stay in prison do not end upon release, and thus it is often difficult for prisoners to develop the positivity which is needed to foster good mental health and wellbeing.

One of the major issues that comes from poor mental health amongst prisoners is repeat re-offending. With an awareness of the uphill struggle facing them post-release, a huge number of prisoners turn to re-offence, mainly because life in prison appears more appealing than the options they have outside.

In an interview in June 2014, James, a prisoner in HMP Barlinnie, North-East Glasgow, said: “In the last three months, out of the 20 prisoners I’ve seen leave, I’d say, maybe 17 have come back, and for the exact same thing they first came in on. Why? Because they had nothing out there.”

Poor mental health in prisons is not something that doctors and politicians have only just become aware of, but it is only in the last 20 years that real development in the recognition and treatment of mental health disorders has taken place.

Over 200 years ago in 1784, John Howard, often regarded as Britain’s first prison reformer, wrote about prison mental health and its poor treatment in his text The State of the Prisons in England and Wales: with preliminary observations, and an account of some foreign prisons. Writing about prisons in England, Howard notes, “many of the bridewells are crowded and offensive, because the rooms which were designed for prisoners are occupied by lunatics…no care is taken of them, although it is probable that by medicines, and proper regimen, some of them might be restored to their senses, and usefulness in life”.

Despite this assessment, and its suggestions, it was not for another 215 years, in 1998, that the first full survey of mental health in prisons provided a statistical, objective insight into exactly how bad mental wellbeing was amongst the prison population. Until the following year, in 1999, doctors working in prisons only had to have general qualifications, as ‘registered medical practitioners’, rather than specific expertise and specialist training in their fields. This meant that those working in prisons often did not have enough expertise to care for prisoner with mental health disorders, and thus, a lot of treatment came in the form of medication, rather than therapy.

Although medication for treating mental health has some benefits, the shortcomings of it being used independent of other methods can be found in the story of John McCue, whose mother Isabel would later go on to found Scottish mental health charity, Theatre Nemo, in 2000.

John McCue suffered a number of mental health problems in the 1990s which were not effectively treated despite visits to hospitals and GPs. Due to a lack of medical attention in the early stages, his problems with mental health reached the point where, because of his paranoia, he punched a man putting his child into a car because he thought that the child was being abducted. John was sentenced to six months in Barlinnie, despite his history of mental health problems, and according to Isabel, was offered no treatment, except medication, with one doctor even rushing through an appointment because they had “ill people to see”. The story unfortunately has a tragic ending, as on 12 May 2000, John walked into a park in Eastern Glasgow, and committed suicide.

Since this traumatic experience, treatment of mental health issues, particularly in Scottish Prisons, has experienced a great deal of progress. Organisations like Theatre Nemo and the Scottish Association for Mental Health have created a number of channels for Scottish prisoners to learn skills, have a creative outlet, and build confidence, to hopefully raise their well-being and employment prospects, and thus curb re-offending.

Theatre Nemo works in a number of Scottish Prisons including Barlinnie and Edinburgh, completing art projects with prisoners in the fields of music, visual art, drama, animation, and video-editing to help stimulate prisoners’ natural creativity, and raise self-esteem. The charity gives those involved the chance to learn skills, such as camera work, directing, and the chance to perform to a public audience.

The response from prisoners to such schemes has been overwhelmingly positive. After performing in one of Theatre Nemo’s drama projects, Steve, another prisoner in Barlinnie said: “I’ve been in every prison in Scotland, and I’ve never seen anything like Theatre Nemo. See, when I get back up to my cell, I feel brilliant. I’ve never spoke up for myself, I’ve never stood up for myself, but that [the performance he had completed] is the biggest mountain in my life and I’ve just gone past that.”

Another participant in one of Theatre Nemo’s film projects focused on the skills he had learnt, saying: “It’s interesting to be on the other side of the camera. When I was at home watching TV, I didn’t think about angles and different shots.”

Theatre Nemo is not alone in providing such opportunities for Scottish prisoners. Events like the Scottish Mental Health Arts and Film Festival have given those in prisons the opportunity to express their reactions to struggles with mental health, and challenge common perceptions of such issues. The festival is now in its eighth year, and runs each October.

Ultimately, the overall trend appears to be that treatment of mental health in prisons is improving, but a vast majority of the work completed which is not medication-focused is being done by independent charities, such as Theatre Nemo and the Scottish Association for Mental Health, rather than governmental organisations. It is possible that if organisations like the National Health Service were to fund or undertake the work that charities were currently completing, then treatment of mental health in prisons could become more widespread and accessible to everyone. For now, although there has been much progress, this is not the case.

Most of the names in this article have been changed.

 Photo: Chris Upson

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