How to Improve the Mental Health of the Prison Population
Answering questions submitted to me in my “Ask Me Anything” segments on my Instagram account.
I think it goes without saying that this is just my opinion. There may be others out there who also work in prisons who think things are OK as they are and that there should be no changes. There may also be those who do not work in prisons who think that things are OK as they are and that there should be no changes. It is also possible that there exists a Venn Diagram of a) people who think that prisons work well as they do, b) people who think there should be more prisons and c) people who think that those who commit crimes should receive harsher punishments, which is a perfect circle.
It might please you to know that I am not one of those people. As a psychologist interested in rehabilitation and wanting to give those who have offended an opportunity to live a different life, I have a slightly different view of things.
Unfortunately, I can’t narrow this down to just one thing. I think a few things would contribute to the welfare of those in our prisons here in the UK (and it is possible these things could apply to prisons worldwide, but who am I to say…)
The first thing is obviously more money. But I am not talking about money to fund more prisons and increase the prison capacity that we have. I remember reading a Guardian article in 2022, which stated the government at the time wanted to increase the prison capacity by 4,000 places and just thinking, “What a waste of money!”
Not all prisons are the same; some are looked after and run much better. However, on the whole, I think most people who work in prisons would agree that they could do more funding to update some of the older government-run prisons. Some of the privately run prisons are more newly built/furnished and are better resourced facilities-wise, while those run by the government are perhaps less so (I can’t say this exclusively as I have only ever worked in one prison, but I have heard views from other prison colleagues who have worked in multiple prisons about this). However, the quality of someone’s living environment will have some kind of impact on their mental wellbeing. So, instead of spending what I sure would be millions of pounds on creating more spaces for prisoners, it would make sense (to me) for the government to re-direct some of that money to improving the environments of the prisons that currently exist.
Tied to the first point is investing money in prison staff. I am listening to a great episode of “The Forensic Psychology Podcast” (which is timely considering this blog) in which Professor Jo Clarke, an expert in studying and promoting resiliency in prison staff, talks about how one of the most important things the prison service can do is to train staff to be resilient and to cope with some of the stresses and traumas that they experience while doing what is known as a critical occupation, which “refer[s] to professions in which workers perform critical duties to protect and serve the public; the nature of these jobs often exposes workers to events and conditions that critically impact their mental and physical well-being.” Being a prison officer is hard, and if prison staff are not looked after adequately and given opportunities for support while doing their job, this will lead to greater burnout and greater impact of stress (and to a more extreme degree, the development of PTSD), all of which, in turn, will have an impact on how they work with and care for prisoners.
The third thing would be for prisons to do more to address trauma symptomology and neurodiversity needs. In terms of trauma, a recent review indicated that 53% of women and 27% of men in prisons in the UK had disclosed childhood experiences of abuse (the number is likely to be higher, accounting for those who have not disclosed). Similarly, a 2021 review of the prevalence of neurodiversity difficulties in UK prisons estimated (estimated, by the way) that 20% of the prison population presented with Autistic Spectrum Condition (ASC) while 25% were thought to meet the criteria for Attention Deficit Hyperactivity Disorder (ADHD). This doesn’t account for those who will have experienced trauma and have neurodiversity needs. For most, prison is a pretty hard place to be: it can be scary and isolating and alien and hostile. Add to this experiences of trauma and difficulties related to neurodiversity; it can be all the harder to be in prison. Therefore, it would be supportive of all prisoner’s well-being and mental health if prisons became more trauma-informed.
A trauma-informed approach “is a harm reduction approach where we recognise the harms that can occur to people in the system, either because of past or present experiences, and work to reduce the likelihood that our current practice adds to that harm.” What that looks like would be specific to a particular prison, but it would largely still involve working towards several trauma-informed principles (i.e., safety, trustworthiness, choice, collaboration, empowerment, and cultural considerations). Part of making prisons more trauma-informed would likely also entail making them neuro-affirming. This would, by and large, involve recognising and respecting those with neurodiversity needs and understanding their experience; where possible, offering individualised support; reducing stigmatization; thinking about the best way to communicate with those with neurodiversity needs; and promoting autonomy.
There we go. In a nutshell, in order to improve the mental health of those within the prison population, I would advocate for more money to improve the environments, offer training and support to prison staff to increase their resiliency and reduce burnout and the impact of what they experience while doing the job, considering neurodiversity, and taking both a trauma-informed and neuro-affirming approach.
Let me know your thoughts and if there is anything you would add to or challenge about my views.
As always, thanks for being here.
All the best,
Nice-ish.