Article by: Sophie Walker, crime and prison law barrister at One Pump Court

My work in the criminal justice system stretches from cradle to grave: I work with pregnant women and new mothers facing custodial sentences, young defendants in youth offender institutions and older prisoners who have spent decades inside. I also represent bereaved families at inquests whose loved ones have died in prison or while on probation, as a result of mental health issues. If there is one thing that unites these people, it is that they entered the criminal justice system in poor mental health, and left it worse.  

I was recently instructed in an inquest on behalf of a family whose loved one died on the day of his release. A report from his treating psychiatrist in prison outlined his reasons for prescribing him a strong anti-psychotic drug during his prison sentence. They explained that it is common for prisoners to start experiencing psychosis despite not having any underlying mental health disorders like schizophrenia. In other words, the experience of incarceration can seriously impact a prisoner’s mental health. 

The prison community is a vulnerable one. As reported by the Prison Reform Trust, 26% of women and 16% of men had received treatment for a mental health problem the year before they entered custody. While only 4% of general public have symptoms indicative of psychosis, 25% of women and 15% of men in prison do. Further, you are 8.6 times more likely to commit suicide in prison than on the outside. 

While it is no surprise that prisoners face difficulties in accessing mental health support while in prison, what is even more concerning is that 40% of prison officers, who are at the coalface of the prison mental health crisis lack the training they need to know how to help a prisoner for support.  

An initiative developed in collaboration with NHS England and the Probation Service called the Offender Personality Disorder pathway is helping to train officers on how to manage prisoners who can pose a high risk of harm to themselves and to others, so progress is being made.   

Given that around two-thirds of prisoners meet the criteria for at least one type of personality disorder, the pathway develops treatment services for prisoners in prisons and support as they transition into the community. Such initiatives are desperately needed if we are to go from warehousing prisoners, to rehabilitating them, but a woeful lack of funding means that sending staff on training courses like this isn’t always possible.