In National Mental Health Awareness week, Independent Monitoring Boards again drew attention to the high level of mental health need and self-harm incidents in women’s prisons via a report published yesterday (16 May 2023). Independent Monitoring Boards (IMBs) monitor and report on the conditions and treatment of those detained in every prison in England and Wales. Boards in women’s prisons have repeatedly reported on high levels of mental health need and self-harm incidents. This briefing sets out Board findings from seven women’s prisons with the establishment reports published between April 2021 to March 2023.
Imprisoned for being ill
Boards have expressed repeated concern about the increasing number of women with severe mental health conditions who are being sent to prison solely on mental health grounds, either under the Bail Act for their ‘own protection’ or as a ‘place of safety’ under the Mental Health Act.
The Mental Health Bill currently before Parliament proposes to remove the courts’ power to use prison as a ‘place of safety’ and to prevent courts from remanding people to prison for their ‘own protection’ solely on mental health grounds. However, in practice, IMBs have found that the number of women with severe mental health needs detained or remanded under these provisions has increased in some prisons.
Between 1 August 2021 and 31 August 2022, the courts sent 75 women to Bronzefield on mental health grounds owing to the lack of mental health beds available in the community, an increase from 28 women between 1 August 2020 and 31 July 2021.
In September 2022, six women at Bronzefield were identified as having been sent to prison by the courts specifically on ‘own protection’ grounds. Six months later, only three of these women had been transferred to a mental health hospital.
Similarly, the Board at Styal found that, between the beginning of May and the end of July 2022, 13 women were sent to prison solely on mental health grounds. This included six women who were imprisoned because they had attempted suicide, and others who were at high risk of suicide or self-harm or had been diagnosed with a severe mental illness and needed medication. Some of these women required constant supervision due to the risk they posed to themselves. The Board was made aware of one woman who was sent to prison due to having no fixed abode and because there was no psychiatric intensive care bed available in the community.
Overall, Boards in the women’s estate have reported high levels of self-harm, which often reflected a relatively small number of women with complex mental health needs. These figures reflect the continuing rise in self-harm across women’s prisons which have featured all too regularly in recent Prison Safety bulletins.
Women with severe mental health needs
Some Boards reported that healthcare or specialist units were close to full or full. The high demand meant that other women with severe mental health needs could be held in segregation or on general prison wings alongside other prisoners.
For example, at Bronzefield, the 18-bed inpatient healthcare unit is almost constantly full, and the majority of women located there have mental health issues. The Board reported that, on some days, there were more than 20 self-harm incidents occurring on the unit. During a two-week period, two officers had to provide constant supervision for one woman who was frequently self-harming.
Likewise, the Board at Eastwood Park reported that a 10-cell unit that accommodates women with mental health issues was constantly full. At one point, three women on the unit at high risk to themselves from self-harm or suicidal intent were under individual constant supervision. A woman on the unit tried to ligature nine times.
- Women continue to be sent to prison for their ‘own protection’ or as a ‘place of safety’ due to their severe mental health needs, high risk of self-harm and suicide, previous suicide attempts and a lack of secure or community mental health beds.
- For women with severe mental health issues, prison is not an appropriate environment. Some women with mental health needs were being held in segregation or on general prison wings without adequate treatment and support.
- Inpatient and specialist units in women’s prisons, where they existed, were often full due to high levels of mental health need.
- Women requiring assessment and admission to secure mental health hospitals were not assessed or transferred promptly enough.
- Overall, the rate of self-harm across the women’s estate has continually increased. There are a small number of women with particularly complex needs who account for many of these incidents across the estate.
- Prison staff are required to care for and supervise women with high levels of need. This has exacerbated staffing shortages.
Thanks to Andy Aitchison for kind permission to use the images in this post. You can see Andy’s work here