The mental health crisis in women’s prisons
Experts slam the government’s £1.5m plan to create more jail places in England as prisoners’ self-harm rates soar
During her first 24 hours in HMP Styal in December 2020, Francesca Barker-Mills remembers looking for a way to kill herself.
“But I had no access to anything suitable,” she said. “My prison cell was in Covid isolation on the main wing. The wall next to my bed was speckled with blood.”
As her time in the Cheshire prison continued, she found that blood on walls wasn’t unusual. “Blood splatter was a common occurrence,” she said. “Self-inflicted or through violence among the women.”
Barker-Mills’ eight-month sentence stretched throughout the pandemic, and saw her held at both HMP Styal and HMP Askham in York. Lockdowns meant women were held in their cells for almost the entire day.
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“Hundreds of women were confined to their cells, segregated, alienated and isolated,” the 35-year-old told openDemocracy of her time at Styal. “All we were left with was time inside, with no mental health support. Staff shortages meant that even basic rights like fresh air were removed because no one could facilitate this.
“I spent my first two weeks in prison alone, with no pastoral support or engagement other than my door opening twice a day to slide a paper bag of food across the floor at a safe distance – like a colony of lepers.”
“Did I want to die?” she asked rhetorically. “Absolutely. It was desolate and without hope.”
‘Not safe spaces for women’
While the pandemic had a particularly detrimental effect on Barker-Mills’ detention, similar issues have recently been reported at other prisons.
Earlier this month, HMP Eastwood Park, a women’s prison in south Gloucestershire, was given the lowest grade for safety by the Inspectorate of Prisons. Some 83% of the women held at the prison at the time of inspection reported having mental health problems, while self-harm rates were 128% higher than at the last inspection in 2019.
The 70-page report raised particular issues with a dilapidated block that held women awaiting transfer to a secure mental health facility or who had been placed in segregation due to a breach, or suspected breach, of prison rules. One cell in the block had blood splattered on its walls and several had scratch marks – clear signs that women experienced distress and trauma while detained there.
Inspectors said inmates told them their poor mental health was the result of too much time locked in cells, a lack of purposeful activity, basic requests taking too long to resolve, insufficient support, and not enough contact with family and friends.
Other women who have been detained in English prisons told openDemocracy of witnessing high rates of both mental health issues and self-harm.
Adetola Adio Adeogun, who was held in London’s Holloway Prison for five months in 2015, described women smashing their heads against walls until blood flowed and cutting their skin open into crosses. The prison closed the following year after it was found to be “inadequate and unconducive to the rehabilitation of its residents”.
Women smashed up their rooms, barricaded themselves in their rooms, refused food, refused medication, screamed, banged. It was scary
Dainya Ebanks, who was held in a unit for under-21s in Holloway, remembers: “A lot of women I came across suffered from anxiety, depression and panic attacks. With a lock on your door, officers not attending to your needs, and refusing to allow you to see a nurse – that can bring people to act out.
“Women smashed up their rooms, barricaded themselves in their rooms, refused food, refused medication, screamed, banged. It was scary.”
Charities supporting women in the criminal justice system have pointed to similar problems for years.
“The rate of self-harm in women’s prisons is alarming and [it] keeps rising,” said Antonia Cross of Clinks, a charity that supports, promotes and represents the voluntary sector working with people in the criminal justice system.
Cross added: “We have continuous conversations about prisons being unsafe because many of the women in them have mental health needs that the experience of prison exacerbates. Prisons are not safe places for women.”
Recent inspections have also identified serious failings. Last year, 86 women were found to be being held in HMP/YOI Bronzefield in Surrey due to a lack of “appropriate mental health provision in the community”. Derbyshire’s Foston Hall, a prison and young offender institution for women, received the lowest possible score for safety in a 2021 inspection, with use of force having doubled since its last inspection in 2019. Self-harm had also surged and two women had died by suicide.
Unfit for purpose
Prisons aren’t suitable environments in which to hold the vast majority of women caught up in the criminal justice system, said Cross, citing the government’s own 2018 Female Offender Strategy.
This states: “Women in contact with the criminal justice system are amongst the most vulnerable in society. Many experience trauma, domestic abuse, mental health problems or have a history of alcohol and drug misuse.”
Former prisoner Adeogun met many women in prison who were unhelpfully locked up for minor offences. “There was one woman in there for stealing Vaseline,” she told openDemocracy. “You also had some people who were mentally ill who shouldn’t have been in prison – they should have been in hospital.”
Adeogun also noted the number of women in on drug charges – whom she felt weren’t receiving the rehabilitation support needed to avoid using again once released.
Cross believes one major problem is “a lack of experienced staff and gaps in regimes due to pre-Covid provision not being restored”.
She told openDemocracy this is leading to women being “locked up [during the day] for much longer than necessary”, which “impacts their access to education, work, healthcare and well-being and rehabilitation support”.
The Justice Select Committee is currently looking into the issue of staff shortages in prisons, trying to establish why high volumes of prison officers are leaving the prison service and the implications of staff turnover against the backdrop of existing pressures.
Barker-Mills said the staff at HMP Styal treated the women detainees with a “lack of empathy, decency and integrity”. She described “officers propositioning inmates [for sexual favours], using their power to manipulate vulnerable women to their own ends”.
“The attitudes, the rudeness, the abuse of position, of trust, of boundaries,” she remembered. “It is what haunts me most now.”
The treatment of mothers was particularly bad, said Barker-Mills, describing it as one of the “greatest indignities” she witnessed in prison. She recalled the case of a Romanian woman held in Styal who couldn’t speak English and still had bandages covering her C-section scars.
“She was in a dirty overcrowded house of 22 inmates, in a pandemic, locked in with no access to proper healthcare, nutrition and proper postpartum support,” Barker-Mills said. “She was beside herself trying to find out what was happening with her baby.
“She was due to be deported and no one was providing any insights into whether the baby would go with her or remain in the care of the state.”
In the end, the woman was deported. Barker-Mills is not sure what happened to her child.
Most women in prison have mental health issues and have experienced abuse, and are very often victims of crime themselves
Lucy Baldwin of Durham University, whose research focuses mostly on the impact of imprisonment on mothers and their children, says prisons are particularly bad places for mothers – with incarceration only adding to the issues that have led to their imprisonment.
“Decades of research have shown unequivocally that women are often criminalised because of trauma and poverty. Most women in prison have mental health issues and have experienced abuse, and are very often victims of crime themselves,” she said.
“It also causes great harm to her children,” Baldwin added. “From the day of her imprisonment, children are impacted and disadvantaged, making them, too, vulnerable to negative future events and outcomes.”
What women need
New legislation such as the Police, Crime, Courts and Sentencing Bill is likely to lead to longer sentences, raising the prison population and putting yet more stress on prisons. Women who haven’t been found guilty, or who are waiting for their cases to be heard in court, are already being remanded in custody longer.
It’s perhaps unsurprising, then, that the government plans to create 500 new prison places for women in England – at a cost of £150m.
This is despite the Female Offender Strategy’s stated aim that “custody should be a last resort” and an evidence-based consensus among experts in the criminal justice system that it is better to keep as many women as possible out of prison.
Antonia Cross from Clinks said she is “highly disappointed” by the plans, believing the money would be better spent on women’s community services provided by the voluntary sector.
She explained: “Government strategy should be refocused to divert women from the criminal justice system into trauma-informed, gender-responsive services in the community. The root causes of women’s offending should be tackled in the community, where women can retain employment, family relationships, housing and support systems.”
Barker-Mills agrees, telling openDemocracy that for most women, prison serves no purpose. “It strips women of dignity, identity and opportunity,” she said. “It rips [them] from homes, families, friends, jobs and support networks. It humiliates, alienates and stigmatises beyond recovery to the point of lifelong inequality and judgement.”
A spokesperson for the Prison Service said: “Custody is already a last resort for women and the number of women in prison has fallen by a quarter since 2010.
“But we know that the root causes of female offending are often poor mental health, addiction or abuse which is why we are investing millions into community services like women’s centres, drug rehabilitation and accommodation support so even fewer end up in prison.”
Jo Daniels, head of operations for health and justice at Greater Manchester Mental Health NHS Foundation Trust (GMMH), the mental health provider for HMP Styal, where Barker-Mills was held, said: “GMMH fully understands that being in prison can affect people’s mental health, and we are here to ensure that everyone receives the individualised care and treatment they need at this challenging time.
“We operate an open referral service so that anyone who is struggling can reach out for support or if anyone sees that someone needs help, they can refer them.
“We work closely as a team with those who self-harm to ensure that strategies are in place to keep them safe. Where service users require more intensive or specialist support, including transfer to mental health inpatient services, we expedite the referral process to get them the required treatment.”
If you or someone you know are feeling emotionally distressed, the following organisations offer advice and support.
Available for anyone struggling to cope. They provide a safe place to talk 24 hours a day.
Phone: 116 123. Website: Samaritans
A 24/7 text service, free on all major mobile networks, for anyone struggling to cope and in need of immediate help.
Text SHOUT to 85258. Website: Shout
Support, practical advice and information to young people considering suicide and can also offer help and advice if you’re concerned about someone you know.
Phone: 0800 068 41 41. Website: Papyrus
Support to people suffering distress or despair in Northern Ireland, regardless of age or district.
Phone: 0808 808 8000 (24 hours a day). Website: Lifeline
Community Advice & Listening Line
Emotional support and information on mental health and related matters to people in Wales.
Phone: 0800 132 737 (24/7) or text "help" to 81066. Website: Community Advice & Listening Line
Confidential phone and web based service for people in Scotland experiencing low mood, depression or anxiety.
Phone: 0800 83 85 87 (Mon-Thu 6pm-2am, weekends 24 hours). A BSL service is also available via the website: Breathing Space
Survivors of Bereavement by Suicide
Exists to meet the needs and break the isolation of those bereaved by the suicide of a close relative or friend.
Website: Survivors of Bereavement by Suicide
Confidential, anonymous, non-judgemental support services run by students for students.
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