Stephen Daisley

Progressives are right about our rotten prisons

Prison reform means action, not just words

Progressives are right about our rotten prisons
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When we talk about ‘under-served communities’, we typically think in terms of an absent or neglectful state. Yet one of the most under-served groups of all is one for whom the state is never absent: prisoners. Justice secretary Dominic Raab is in the headlines after he sent prison and probation staff a style guide instructing them to avoid ‘woke’ terminology such as ‘service-user’ and ‘room’ and stick to ‘inmate’ and ‘cell’. On the face of it, Raab’s orders are another salvo in the culture wars and a bit of positioning by an ambitious deputy prime minister, but the Lord Chancellor might be onto something, if perhaps inadvertently.

Progressives love linguistic activism but changing terminology doesn’t always change outcomes. The situation in Scotland’s prisons is instructive. Scotland is steadily, if unevenly, becoming the most progressive part of the UK when it comes to criminal justice. As I’ve written about previously on Coffee House, there is an ongoing revolution in criminal justice policy under the SNP, with the Scottish government advocating an ‘effective, modern person-centred’ justice system in which ‘people should only be held in custody where they present a risk of serious harm’. To some, this might sound like wishy-washy, soft-on-crime liberalism. In fact, it’s gradual but encouraging, smart-on-crime liberalism, and what’s more, it works.

Yet, for all its progressive buzzwords and some substantively enlightened policy, Scotland’s penal system is still getting a lot of things wrong. One of them is mental health. A new report from the Mental Welfare Commission for Scotland underscores just how serious the problem is. Based on a series of visits to all 15 Scottish prisons, and building on similar research conducted a decade ago, Mental Health Support in Scotland’s Prisons 2021 documents severe and widespread need, inadequate and under-resourced services, and acute concern among prison staff.

Three-quarters of prisoners interviewed had a history of mental ill-health; six in ten were undergoing treatment before entering the criminal justice system. Three-quarters also reported an addiction to alcohol or drugs. Almost eight in ten prison officers expressed concerns about mental health services within their institution and nearly nine in ten wanted more training in dealing with prisoners’ mental health.

Julie Paterson, chief executive of the Mental Welfare Commission, says that ‘little has changed’ since the 2011 report, and that mental health provision in prisons is ‘inconsistent and lacks cohesion’. ‘Seriously and acutely mentally ill’ prisoners are ‘still not being transferred to hospital care without delay’. Paterson concludes that, despite ‘pockets of good practice and a committed workforce’, ‘the overall experience of mental health service provision in prisons continues to be in need of significant improvement’. The Commission’s new report finds prisoners and staff ‘under-served and under-resourced’ and determines that the ‘key messages’ of the 2011 report ‘have not been realised’ and that ‘anticipated improvements of health care responsibilities being transferred to NHS Scotland have not materialised’.

Instead, the Commission observed ‘inconsistency and reliance on small numbers of specialist staff’, ‘no overarching strategic approach’ to treating prisoners’ mental health needs, and the absence of ‘any correlation between resources, size of the prison and the specific needs of the particular prison’s population’. Covid-19 is a running theme in the report, with the pandemic said to have ‘exposed the fragility of the mental health resources’. (Last year I wrote about prisoners’ greater vulnerability to coronavirus.) The Commission further notes ‘significant concerns that no consideration has been given to proactive post-pandemic planning and additional resource to support both prisoners and staff’. There are also specific problems in relation to severely mentally-ill inmates, the use of segregation and a failure to engage with prisoners’ families.

The Commission has issued ten recommendations, covering collaborative workforce planning and training between the Scottish Prison Service and the NHS, improvements to mental health screening, and an audit of segregation policies. There are larger issues raised by the report, not least the failure to make meaningful improvements in the course of the past decade, the appropriateness of prison for mentally ill people and the scale of change needed across the carceral estate.

There are four points worth making. First, empty rhetoric is the marshalling of language to create an impression without making a change. Much was said in response to the Commission’s 2011 report but nowhere near enough was done, either through a lack of institutional or political will or because of a paucity of resources, or a combination of all these factors. Talking about a more progressive criminal justice system is no substitute for doing it.

Second, as the Commission states: ‘prison is not the place for seriously and acutely mentally ill prisoners.’ To the greatest extent possible, it should not be the place for mentally ill offenders in general. Even so, among the mentally ill inmates interviewed by the Commission, ‘some of their reported experience was akin to punishment for breaking rules e.g. being kept in a cell without right to open air or alternative setting, removal of privileges’. Society may have a legitimate interest in punishing offenders who happen to suffer from mental illness, but to treat them in a way that appears to punish them for that illness or which superadds to their suffering, even inadvertently, cannot be in the public interest and can have no penological justification. It is unnervingly proximate to torture.

As a matter of policy, offenders suffering mental ill-health should, where detention is required, be placed in secure therapeutic settings in which they may receive the same quality of healthcare as they would on the outside. Public policy and public attitudes are slow-moving, however, and this kind of change would have to be carried out gradually, beginning with the lowest-risk prisoners and working up to the hard cases. Until then, and acknowledging that prison may ultimately still be necessary for some of the hard cases, there should be significant improvements made to mental health provision; greater investment in recruiting clinical and support staff and in mental health training for prison officers; and a reduction in the use of segregation, with mandatory care plans and upgrades to facilities where segregation is necessary ‘to protect the health or welfare of the prisoner or any other prisoners’.

Finally, a prison system in which 76 per cent of inmates arrive with a background of mental ill-health is one being used as a dumping ground for wider societal problems. That is not to excuse criminal behaviour; it is simply to recognise a correlation between the prison population and mental health problems. Reducing one may require reducing the other. There are many proposed benefits to giving parity to mental and physical wellbeing in health policy and to them we might be able to add reduced offending and greater public safety.

The political circumstances in England are such that these kinds of reforms are non-starters but there is another opportunity for Scotland to lead the way, as it did with its Violence Reduction Unit and prisoner voting, and demonstrate that a truly progressive justice system is one that makes changes rather than just talking about it.

Written byStephen Daisley

Stephen Daisley is a Spectator regular and a columnist for the Scottish Daily Mail

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