Policy Workshop: The Prison and Mental Health. From Confinement to Diversion

Location: Warwick Business School, London Campus, Eastern Lecture Theatre, The Shard, London

Date: 12 February 2016

Conveners: Hilary Marland (University of Warwick) and Catherine Cox (University College Dublin)



Background Reading

Presentations from the Workshop


In 2015 26%­ of­ women ­and ­16% ­of ­men in English prisons ­claimed that ­they ­had­ received treatment for a mental health problem in the year prior to custody. According to the same study, 46%­ of female prisoners­ and 21% of male prisoners reported having ­attempted­ suicide at some point in their lives.

In 2012 half of the sample of children and young people who had died in custody had a history of self-harm and nearly half had a history of mental health problems.

Such statistics are not unique to England: Ireland, with a smaller, though expanding prison population, exhibits similar trends. In 2013 it was reported that 7.6% of remand prisoners in Ireland had psychotic illness – ten times the rate in the community – and 3.8% of remand prisoners were actively psychotic on committal.

The prison continues to act as a hospital for prisoners with complex psychiatric problems, as it has for well over 150 years. However, since 2006 when health services were separated from prison management in England and Wales and the 2009 Bradley Report there has been an increased diversion from prison, separating clinical judgement from criminal justice priorities.

The relationship between prisons and mental illness has preoccupied prison administrators, physicians and reformers from the establishment of the modern prison service in the nineteenth century to the current day. In the early 1840s, the medical officers and chaplain to Pentonville Prison reported instances of mental breakdown, delusions, hallucinations, panic, depression, anxiety and morbid feelings on an almost daily basis. In the late nineteenth and twentieth century prison doctors, observers and reform organisations and prisoners themselves continued to highlight the high rates of mental disorder in prison. In 1985 the Prison Medical Association informed the House of Commons Social Services Select Committee that England and Wales’s penal establishments were ‘in effect…. acute psychiatric assessment centres for all those whose behaviour has brought them into conflict with the law’.

Funded by a Wellcome Trust Senior Investigator Award, ‘Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000’, this workshop aims to explore the potential for historians, criminologists, NGOs, policy makers and prison service employees to share ideas, information, knowledge, experience and practice around the theme of mental health in the prison system. The Irish and English prison systems have followed different historical trajectories, but face similar challenges in terms of managing mental heath. Two sessions, focusing on 1) the prison and mental health and 2) juvenile mental health in prison, will seek to link the historical past with the present, to question whether a comparative approach is helpful in highlighting parallels and differences, and examine the ways in which historical research might inform, enhance and shape discussions on prison mental health today. We also ask how current debates and key issues regarding mental health in the prison system might prompt, shape and inform our historical inquiries and questions.

Image: MSS 16A/7/23/1, Howard League Papers. Photograph courtesy of Modern Record Centre, University of Warwick

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