Imprisoning mentally ill women - a cruel and inhumane punishment

Chief inspector finds mental healthcare lacking in prison for women

Announced inspection of HMP Bronzefield, June 2005

Commenting today on the HMCIP report on Bronzefield prison, Juliet Lyon, director of the Prison Reform Trust, stated:

‘This report makes it clear that locking up mentally ill women will make them worse not better. It’s time that government listened to its chief inspector of prisons, and its independent monitors appointed by the Home Secretary, and took immediate action to divert women who are mentally ill out of the courts and into the healthcare they so badly need.

The chief inspector found high numbers of women with serious mental health problems confined in a prison which is ill-equipped to respond to this level of need. The chief inspector voiced her concern about “the paucity of primary mental healthcare for the majority of women, and the length of time taken to transfer acutely mentally ill women to appropriate NHS facilities.” For example, at the time of the inspection, seven of the 17 inpatients being held in the healthcare centre were waiting for a psychiatric assessment, necessary to transfer them to the specialist mental healthcare they required.

The chief inspector’s assessment is echoed by a timely annual report from the prison’s Independent Monitoring Board (IMB). While the IMB praises the ‘consistent, kind, and decent approach’ of healthcare staff to the prisoners held there, it concludes that even the community mental health team in the prison is ill-equipped to respond to this level of need. As the IMB records:

The board have grave concerns about prisoners held with severe mental health problems. The board feels that these prisoners should have been diverted to secure hospitals rather than being sentenced to a local prison, which does not have the expertise to deal with their complex problems.

The IMB was sufficiently alarmed by the number of severely mentally ill women in Bronzefield prison to direct a question to the minister:

What is the government’s plan to divert convicted and remand prisoners with serious mental health problems from prisons where staff do not have specific training in their management or treatment; or to fund and staff prisons appropriately?

This and other inspectorate reports can be found at the HMCIP website

Notes:

Women in prison suffer from numerous mental health problems. Two-thirds of women show symptoms of at least one neurotic disorder such as depression, anxiety and phobias. More than half are suffering from a personality disorder. Among the general population less than a fifth of women suffer from these disorders. Half of the women in prison are on prescribed medication such as anti-depressants or anti-psychotic medicine and there is evidence that the use of medication increases whilst in custody.

1. Of all the women who are sent to prison, thirty-seven per cent say they have attempted suicide at some time in their life.

2. The number and rate of self-harm incidents is much higher amongst women than men. In 2003, 30 per cent of women were reported to have harmed themselves compared with six per cent of men. On average each woman who injured herself did so five times compared to twice for men. While women make up just six per cent of the prison population they accounted for nearly half (46 per cent) of all reported self-harm incidents.

3. In 2005, the Prison Service women’s team reported that of every 1000 women now in prison, 587 injure themselves repeatedly. A survey carried out in 2001 found that nearly two-thirds of women in prison have a drug problem.

4. An early study concluded that around 40 per cent could be diagnosed as harmful or dependent users of drugs.

5. One in four women in prison has spent time in local authority care as a child. Nearly 40 per cent of women in prison left school before the age of 16 years, almost one in ten were aged 13 or younger.

6. Over half the women in prison say they have suffered domestic violence and one in three has experienced sexual abuse.

7. 1 Singleton et al (1998) Psychiatric Morbidity among Prisoners in England and Wales, London: Office for National Statistics.
2 Ibid
3 Prison Service (June 2004) Safer Custody News, London: Prison Service.
4 Borrill, J et al (2001) Differential substance misuse treatment needs of women, ethnic minorities and young offenders in prison: prevalence of substance misuse and
treatment needs. Home Office online report 33/03.
5 Singleton et al (1998) Psychiatric Morbidity among Prisoners in England and Wales, London: Office for National Statistics.
6 Social Exclusion Unit (2002) Reducing re-offending by ex-prisoners, London: Social Exclusion Unit.