By Hardeep Matharu

Five years ago, at an exhibition marking 160 years of Wandsworth Prison, a volunteer who worked at the jail said something to me which shifted my perspective on those society incarcerates.

Both our gazes had found a black-and-white photograph, shot close-up, of a prisoner staring through bars, tears streaming down his face. It had been taken by another inmate as part of a photography project that was run inside the prison in the 1990s called ‘Inside Eye’.

Bryan Burgess, who helped inmates with drug and alcohol problems, started speaking to me about the hope he saw in the, albeit, slow march onward from the punishment of the Victorian days to a greater acceptance of prisoners as human beings today.

But, he said: “The prison system is old in its thinking. It locks prisoners away, hoping for the best, but offenders are sometimes leaving prison in a worse state than when they went in.

“We must take responsibility for our actions, but the period of time for which this occurs in prison should be used differently than it is.

“Seeing how long prisoners are locked in their cells for each day has shocked me.

“Leaving a man with his own head is a cruel punishment.”

It was that last line, in particular, that has stayed with me.

For it was then, that the lens through which I had looked at imprisonment changed.

Depriving people of their liberty was the punishment society handed to those judged to have violated its norms. But, the additional punishment of leaving a man locked up with his mind – the same stale bell jar of past trauma, failures and hopelessness which had got him there? That did seem futile.

And what sort of behaviours were resulting in people ending up there in the first place?

As reports of people with mental health issues dying or unable to find support in prison have continued to surface in recent weeks, Bryan’s words have come back to me.

Many prisoners are believed to have some kind of issue affecting their mental health – a spectrum encompassing many different conditions and behaviours. 

But can or will prison ever be the type of environment that can provide them with the help they need?

“Sorry doesn’t give me back my son so if they’re sorry prove they are sorry by making changes,” said the mother of Dean Saunders last week. She was speaking after she and her had husband met with Justice Secretary Liz Truss.

Dean electrocuted himself in HMP Chelmsford last January. The 25-year-old had never been in prison before, but ended up there after a psychotic episode in which he stabbed his father. He was placed in prison because a bed in a secure hospital ward was not available. 

Further details of Marcin Dlugolecki, 33, who hanged himself in HMP Nottingham in January while awaiting trial for arson, also emerged last week. His family said he had been deeply paranoid and believe he should have been placed in a mental health unit not prison.

Then, there was the inquest of 41-year-old Gareth Edwards. He was found hanging in his cell at HMP Bullingdon in December 2015 while serving a 12-month sentence for attempted burglary. His “troubled life” had been punctuated with alcoholism and depression, his family said. The coroner told the prison it had to do more to prevent future deaths in similar circumstances.

Stories like this have continued in a sad, steady stream over the last few years.

In 2016, 119 people in the UK’s prisons took their own lives – a 34% increase on the year before, according to the Ministry of Justice (MoJ). In 2011-12, the number was 57.

Self-injury has also risen with 36,440 incidents – a 26% increase on the previous year – recorded in the 12 months up to June 2016.

It’s no coincidence that these figures have grown in line with a slash in funding, staff cuts, overcrowding, increased ‘lockdown’ periods in cells, violence and a very troubling rise in psychoactive drugs such as Spice in jails since 2013.

The Government has pledged a turnaround, but repeatedly emphasises this will not happen quickly – a sort of mea culpa cloaked in a frankness that is no absolution of its responsibility for the current situation. 

It did, however, publish what it has called its “historic” Prisons and Courts Bill last week – which formally places a duty on prisons to ‘reform’ offenders.

The bill “sets out in law for the first time that a key purpose of prisons is to reform offenders, as well as punish them for the crimes they have committed”, a MoJ press release said.

No measures to support mental health needs were mentioned among the bill’s 166 pages.

But the press release stated: “More than 2,000 new senior positions are being created for our valued and experienced officers to be promoted into. These posts, which include specific mental health training, will have a salary of up to £30,000.”

The growing concern for how those with mental health issues are treated inside our prisons and why they are ending up there to begin with – coupled with this now ‘official’ emphasis on reform – demonstrate the very real tension at the heart of the philosophy underpinning the UK’s prisons system.

When the primary aim of prison is to punish and, secondarily to reform, what effect does that have on the outcomes that can be achieved in terms of offenders bettering their lives and crime being reduced to create a safer society?

Can a criminal justice system deliver social change?

Do penal policies and social policies have the same aims?

Is crime controlled through punishment, or, in some cases, exacerbated by it?

Are we sending offenders with mental health issues or people with mental health issues who offend to prison?

This new legal commitment to reform, along with initiatives such as the six ‘reform prisons’ that were launched last year, are steps in the right direction.

But they still don’t, in and of themselves, begin to grapple with some of the more fundamental questions about the tension created by an intention to reform people within a system primarily designed to punish. (Or where the funding required to implement ‘reform’ in any meaningful way will come from.)

Ms Truss, while acknowledging that more mental health specialists are required, is not challenging the premise that people with mental health issues are sent to prison.

Whether they should be or not and why is a discussion that should be had by society as a whole.

But, what must be appreciated is that there are consequences that stem from giving primacy to one value over another.

Currently, offenders with underlying mental health problems are neither being diverted out of the prison system nor being sent to jails that are comprehensive rehabilitation centres.

Why? Because the dominant principle that underlines the existence of the system is the one that sets the tone.

People with mental health problems are finding themselves in prison because other interventions are not seen as appropriate as the censure of the criminal justice response.

And our prisons are not comprehensive rehabilitation centres because they are based, first and foremost, on the principle of punishment and this frames the culture within which incarceration occurs.

‘Reform’ can be added to this – but it has to find for itself a place in a system that has been designed to achieve a different aim.

In a number of cases, punishment will have a place. It’s just that if this is the principle that dominates when deciding who is sent to prison and how time inside should be spent, this will affect the outcomes prisons achieve.

Jan Roelof van der Spoel, deputy governor of the Norgerhaven high-security prison in the Netherlands, spoke to the BBC last year for a report on the country’s prisoners shortage.

“In the Dutch service, we look at the individual,” he said.

“If somebody has a drug problem we treat their addiction, if they are aggressive we provide anger management, if they have got money problems we give them debt counselling. So, we try to remove whatever it was that caused the crime. The inmate himself must be willing to change but our method has been very effective.”

Prisoners do have to engage with their own rehabilitation and, it is true, many may not be this way inclined. But, for those who are and would readily benefit from help to tackle the underlying reasons for their offending, it makes sense for the system to be set up in a way that provides genuine opportunities for improvement. That places a real emphasis, beyond headlines, on rehabilitation.

Such a system would have ‘reform’ as the dominating principle, viewing all prisoners as individuals capable of change if they choose this, while recognising the deprivation of liberty that comes with being sent to prison as the ‘punishment’ required for criminal justice.

Back in the summer, Andrew Neilson, director of campaigns at the Howard League for Penal Reform, said at a prison reform event: “The public want people to be punished and reformed. Those are absolutely in conflict and no one’s talking about that.”

He’s right.

Over the last year, the Howard League, together with the Centre for Mental Health, has published a series of reports on prison suicide and mental health.

In them, it calls for change, “to recognise the influence of the prison environment on people’s vulnerability”, and raises questions as to whether prison is the right intervention.

In its ‘Perspectives from the Inside’ report, it said: “Prisoners described historic and current risks that were not being addressed. These include historic mental health problems, exposure to trauma and abuse, having lived in care, homelessness, drug use, receiving a sentence later in life, risk of depression and child custody concerns. Prison exacerbated these challenges because they were not appropriately addressed within the prison system.”

Earlier this year, Dr Mark Sanford-Wood, a GP in HMP Exeter, raised similar concerns in an interview with the GP website.

“We are seeing increasing numbers coming through reception direct from court where the crime they are accused of appears to be the result of mental illness, rather than anything else,” he said. “There does seem to be an increasing number of people who clinically, you would question whether they are in the right system.

“Inevitably, the prison system is going to be more challenged in providing them the care they need.”

Having read some of my previous writing on prisons, Isabel McCue MBE got in touch to share her insights on whether prison is the right place for people with mental health problems.

Isabel’s son John committed suicide in 2000, a short time after being released from prison where he had already attempted to take his own life. He had severe mental health problems and struggled to get the support he needed.

In John’s memory, Isabel founded Theatre Nemo, a Glasgow-based charity that works in prisons and mental health hospitals to bring creative therapy to prisoners and patients.

She clearly sees support for mental health – or the lack of – as a social justice issue, telling me: “There’s no such thing as equal opportunity at all, it’s just on paper.”

Although positive in her outlook, she is frustrated by how “people can come to be seen as the problem, rather than people with problems”.

“It’s a very historic thing that people want to punish people that have done wrong,” Isabel told me.

“Okay, but what you have to understand is how has this problem arisen? We really need to think about how we can help them. We can fix it, but the resources to fix it are given to doing tiny bits here and there and that’s not good enough. Tiny bits are not going to fix a big problem.”

Concerned that people such as ex-prisoners are not having their mental health needs consistently addressed, Isabel is now establishing a ‘creative holistic support centre’ in Glasgow, a one-stop shop bringing together different agencies under one roof, to help them.

After seeing his iconic photo displayed at the exhibition in 2012, I spoke to Kris Allan about how it had come about.

“That photo was the star of all the photos I took,” he told me.

“Certain prisoners were willing to be involved and be subjects for the photographs and this prisoner was one of them. We were talking about his past and what had happened to him in his life and tears started coming from his eyes. He was about to wipe them away, but I told him not to and took four frames with my camera.”

If we want to understand what is really going on, we have to make an effort to examine the lens through which we are looking or being made to look.

This is true of many areas of our lives if progress is to be made.

And, in the life of a society, no where does this ring true more than when it comes to understanding what’s happening inside our prisons and why.



  1. Spot on.

    It’s very difficult for the majority of people to see further than punishment when it comes to dealing with someone who has committed a crime; little realizing that this mindset will paradoxically only serve to INCREASE the likelihood of further crime being committed.

    And of course there is no way that the prison system that exists in this country is going to be able to deal with someone who has mental health issues, let alone HELP them!

    The Dutch approach sounds greatly more sophisticated.


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