In bad nick?

‘Graham Brief’ didn’t expect to end up in prison. What he saw during his two year sentence made him wonder if anyone cares about prisoner’s mental health

Words cannot describe how terrifying it is to have the drug squad kick your door in at six o’clock in the morning. At first you think, ‘Who are these people and why are they in my house?’ Then it dawns on you that you are in a lot of trouble and your fear of the unknown transforms to fear of ending in prison.

Most people finish university and either get a job or spend a year travelling. Unfortunately, I am not ‘most people’. What prevented me from doing either of these activities is a condition known as social anxiety disorder, characterised by extreme shyness and fear of socialising. I could have gone off travelling, but sitting muted in a corner in a far and distant land would have no doubt been a similar experience to sitting muted in a corner in England. As for getting a job – you can have all the qualifications in the world but if you clam up and feel as if you are physically unable to speak in interviews, the betting is that you are going to remain unemployed.

University had at least got me out of the house and forced me to talk to people. Now that my course was over, I stayed at home most days. The anxiety was so bad that I would rarely even come out of my room to speak to my housemates and only went downstairs to eat when I was sure the kitchen was empty.

One day I was sat in the pub avoiding eye contact and not contributing enough to the conversation, when somebody offered me an ecstasy pill. I had never taken drugs before but thought, ‘What have I got to lose?’ It was hardly going to make my life any worse than it already was.

Within the space of half an hour, I went from nervous and withdrawn to confident and talkative. It was the first time I had felt comfortable in my own skin for years. When in a state of anxiety, I can literally hardly talk. Any words that I do try to utter either come out stammered or are barely coherent. The ability to socialise was a godsend. I could finally express myself.

Over the next few months, I started using more and more ecstasy. Whenever I needed to interact with anyone, I would take it in its powdered form, which cost me £40 a gram. My Jobseekers Allowance was only £50 a week so I eventually ended up selling some of what I bought on to my friends in order to fund my habit. When I was high, I still felt slightly on edge, but my anxiety was at a manageable level. I honestly thought that E was the best thing that had ever happened to me. That is, until the day of my arrest.

‘Who are you calling mental?’

After being taken down to the station, I was told that an undercover officer had infiltrated my group of friends and bought some drugs off me, which meant that the police had me bang to rights.

Going to jail is frightening for all first time offenders but even more so for somebody who can hardly say a word and has the social skills of a rock. In the run up to my sentencing date, I felt as if my heart was going to beat out of my chest. The judge gave me two years.

Shortly after entering the prison system and being taken to reception, I was approached by a member of staff and asked if I suffered from any mental illnesses. A particularly scary-looking armed robber at the table next to me was asked the same question and immediately started yelling, ‘Who are you calling f**king mental?’ This didn’t make it easy for me to pour my heart out about my life of loneliness and isolation.

‘It sounds like you’ve had a rough time,’ the staff member told me after I had finished stammering my way through my story. ‘We’re going to place you on a course called “safer custody”. It’s for prisoners who we think are vulnerable and pose a risk of suicide or self-harm.’

My name was put down for the programme and I was taken to the wing and locked up with a huge, aggressive-looking gang member. My custody would have felt a lot safer if I didn’t have to share a room with somebody who talked about violence 24/7 from the minute he got up to the minute he went to sleep. He was serving a life sentence for fatally shooting somebody so his words were not bravado either. He was quite possibly one of the scariest people I have ever met to date – and I had the pleasure of having him as my room mate.

Token gesture?

After a sleepless first night inside, I was woken up by the sound of the heavy metal door opening with a bang and a guard calling me out for safer custody. I was then taken to a room where an assortment of prisoners were sat around a table drinking tea. I soon learnt that most of the people on the course were not particularly vulnerable. They had simply managed to blag their way onto the programme because they got money added to their prison account for attending.

The course consisted of sitting and chatting for ten minutes, then using some gym equipment whilst a guard took the Mickey out of how unfit we all were. It seemed very pointless but got me out of my cell for an hour, so I wasn’t complaining. The problem was that it was hit or miss whether or not the guards would unlock my door and take me to the safer custody room each morning. I only actually got to attend around one in three sessions. It was obvious that nobody cared about the mental state of the inmates in the jail. ‘Safer custody’ was a token gesture aimed at giving the impression that the authorities were attempting to make things easier for at-risk prisoners. In reality, they might as well not have bothered.

The jail was full of mentally ill inmates who could have benefited from some real help. Literally every second person had scars from self-harm. Some inmates didn’t seem to know where they were or what was going on. But medical staff were reluctant to diagnose them as being ill, as the doctors appeared to have an ingrained belief that most prisoners who claimed to be unwell were faking it. One prisoner claimed to be a secret government scientist and spent the whole time telling people that he had been locked up because he knew too much. The fact that somebody like him was forced to share a wing with murderers, muggers and armed robbers was shocking. He was in for breach of an ASBO.

I put in for counselling sessions almost as soon as I entered the prison but didn’t see a counsellor until at least six months through my sentence. The counsellor’s advice was, ‘whenever you feel nervous, just say bollocks to it’. He seemed to think this was a piece of particularly insightful wisdom. It was definitely not the standard of care that I would have got outside.

I only saw the mental health worker twice. I enquired several times about when my next appointment was but nobody seemed to know. Fortunately the other inmates were sympathetic to my plight and did their best to comfort me whenever it was clear that I was in the grip of anxiety. They gave me a lot more support than the authorities did. Had I been a weaker willed person, this might have steered me further towards a life of crime.

On the outside

The weeks flew by and before I knew it, I walked out through the gates clutching my transparent HMP bag, wondering what my life would be like now that I was free. The probation service had promised me that I would get help for my anxiety. Could it be that I was finally going to rid myself of my demons and be able to move on with my life? Well, not exactly.

Despite having to attend weekly probation sessions and repeatedly asking about the treatment that I had been told I would receive, I was still never referred to the local mental health service. It made me wonder how many other people with psychological illnesses had slipped through the net. Many of the offenders that I had met in jail appeared to have committed their crimes due to underlying mental issues. It begs the question, how much would it reduce the rate of recidivism if prisoners received the help they need?

I eventually plucked up the courage to book myself onto a cognitive behavioural therapy (CBT) course, which improved my methods of coping with my condition. Although I still suffer from social anxiety, I now feel that I am better equipped to deal with the symptoms.

I would advise those who have ended up in jail due to mental illness not to be too harsh on themselves and to remember that we are all human and all make mistakes.

Rather than relying upon the probation services to help you to find treatment, use your sentence as a wake up call to seek out help yourself. Take small steps to heal and rehabilitate yourself and one day you will eventually reach your goal. Prison is not the end of the world and nor is mental illness.

According to a recent briefing on mental health and the criminal justice system by the Centre for Mental Health, up to 90% of prisoners may have a diagnosable mental health condition. 10% suffer from psychosis, 61% have a personality disorder, over a third show notable anxiety and/or depression, and between 30-45% have some type of alcohol or drug dependency. In 2011, 58 suicides and 26,983 instances were recorded inside prisons, and although women only make up 5% of the prison population, they account for nearly half of all recorded self-harm.

Prison health care was transferred to the NHS in 2006, but mental health service provision inside prisons is spotty at best. Specialist ‘inreach’ teams were set up to engage with people with severe and enduring mental health difficulties, but they have received no common implementation guidance. Service provision on release is rarely ensured, with little support on issues like housing and employment; there are also reports that community mental health teams are reluctant to accept responsibility for released prisoners. Men released from prison are 8 times as likely to commit suicide as the general population, for women, this figure rises to 36 times.

This article appears in the Spring 2012 issue of One in Four

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