Written evidence from Imago Dei Prison Ministry

Imago Dei Prison Ministry (ID) is a non-statutory, charitable organisation based within the Chaplaincy Departments in HMP Downview, HMP Send and HMP East Sutton Park. These are all women’s prison holding women aged 18 upwards, except for HMP Send who only have women aged 21 and over. ID are not paid by the establishments we work in, instead we opt to run on grant funding and individual donors as this is more sustainable and reliable than the short-term contracts on offer through prisons. ID comprises of three main projects, ID Prison Ministry, ID Essence (18-25’s) and ID Grace House, all of which work to address issues around reoffending, issues of the women's life and responsibilities such as parenting, money and emotional management and providing resettlement support to reduce recidivism. Across the different components of ID we have supported over 700 women in prison and 20 women in the community after prison.

I am the Project Manager of ID Essence – ID’s young adults project - and am submitting this evidence on behalf of Imago Dei Prison Ministry as a whole charity. I co-founded ID Essence (fka Kahaila-Reflex) in 2012 in HMP Holloway before its closure and have been managing the project and delivering its activities in both prison and the community since then. Prior to this I had gained 2 years prison experience volunteering in HMP Frankland and HMP Low Newton and completed a Masters in Criminology and Criminal Justice at Kings College London.

The evidence we are submitting focusses on questions 8-10 in the Women in Custody section as this is our area of work and expertise.

Summary of Evidence

In question 8 we identify what we believe are key areas of risk for self-harm in prison: bullying/relationships going wrong; relationship with staff; uncertainty in the run up to release; unresolved trauma; bereavements and anniversaries; dealing with the pain of separation from children. We consider what is already being done to address the high levels of self-harm in the female estate and then go on to make 4 recommendations for what more could be done: 1. Introducing specialist mental health workers for young adults in prison 2. Expanding and prioritising mental health provision for women of all ages in prison 3. Improving housing options for women leaving prison 4. Establishing consistent and innovative behaviour management processes in the female prison estate.

In Question 9 we identify areas were there is still work to be done to ensure the female estate is a trauma informed environment. We consider certain security practices that can be re-traumatising, such as control and restraint and cell searches, as well as the role that race and racism play in the prison estate and the need to pursue anti-racism in every aspect of prison life alongside increasing staff diversity to ensure that custody is trauma-informed for all women there. Finally, we consider the need for greater recognition of and provision for those women in prison who are neurodiverse.

In Question 10 we highlight the significant barriers to resettlement we have seen women face after prison of: lack of housing and support; difficulties gaining employment; access to education; and access to mental health services after release from prison. We make recommendations of providing more government incentives for employers and education providers to take on women with criminal records, investing in more supportive housing options for women leaving prison and introducing specialist mental health services for women after prison.

 

8. What factors contribute to the high levels of self-harm in the female estate?

Part of our role within the Chaplaincy Departments we are based with, is supporting women on Assessment, Care in Custody and Teamwork (ACCT) documents pastorally i.e. those who have been identified as being at immediate risk of self-harm or suicide. This aspect of our role means we are well aware of the high rates of self-harm in the prison estate. The Director of ID visits approximately 12 women on ACCT documents per week and also attends ACCT reviews. In 2018, our ID Essence team were working with a young woman in HMP Downview who tragically took her own life, so this is an area of the prison estate we have a considerable amount of experience in and are painfully aware of the dangers it entails.

Through our work, ID have found that there are several factors that seem to contribute to a woman self-harming or attempting suicide in custody. In addition to the high levels of mental health needs of a high proportion of women in prison, the key factors that we have identified as having an impact on a woman’s risk of self-harming are:

1.      Bullying/relationships with one another going wrong. The prison environment is intense. In women’s prisons relational situations can escalate very quickly for various reasons that can leave people feeling trapped, unsafe and hopeless, increasing their risk of self harm or attempted suicide. Examples of situations that can cause this are; rumours circulating about what a person’s crime is (especially for sex offences); rumours that a person has ‘snitched’ (given information to staff about other people); falling out with someone else in the prison and lots of other people getting involved and taking sides; someone getting into drugs debt.

 

2.      Relationship with staff. Particularly when women have interactions with staff that leave them with feelings of anger, frustration and powerlessness. These emotions seem to occur when someone feels they have been unheard, misunderstood, belittled or disrespected by staff, particularly when there is something they feel they need e.g. to move to another landing or to get a job within the prison. This is particularly the case with women who are regularly on ACCT documents and who also have quite challenging behaviour to manage more generally. For these women, we have seen that inconsistency in the way their behaviour is managed leaves them more vulnerable to self-harming. For example, one woman we support whose behaviour the prison finds particularly difficult to manage has taken 3 or 4 overdoses in the last year, which seem to have been triggered by a combination of frustration with the prison regime and how she is being managed by staff on top of deep trauma she experienced just before coming to prison that she is struggling to process (See below)

 

3.      Uncertainty in the run up to release – especially surrounding housing. The national housing crisis is felt very acutely by women leaving prison, who often won’t know where they will be housed until the week of their release and sometimes not until the day they are released, when they have to present themselves as homeless to their local council. Having spent time in prison no longer helps you gain priority for being housed by councils and so it is increasingly hard to obtain housing for women after prison. This uncertainty is hugely stressful for those approaching their release and not knowing if they will have anywhere to live. For women leaving prison who are not allowed to go straight home due to their risk, rather, needing to go to ‘Approved Premises’ hostels (AP’s), there are currently only 3 AP’s for women in London and the South East; one in Bedford, one in Reading and one recently opened in Battersea. This lack of choice of location of AP’s is another source of stress for women approaching release and can make them reluctant to go there, as not many women have family members, support networks or local links to the locations of the current AP’s. These uncertainties and lack of options can leave women vulnerable to increased risk of self-harm or suicide in the run up to their release. It is this need that inspired ID to set up ID Grace House.

 

4.      Unresolved trauma. Nearly every woman we have supported in prison has experienced significant trauma in her life, which will have had an impact on their mental health in some way. There can be a lot of stigma/reluctance to talk about mental health struggles, especially amongst the young women we support through ID Essence. This means young women in particular can sometimes miss out on Mental Health Support available to them, increasing their risk of self-harm. Mental Health Teams in prison don’t currently have specialist 18-25/young adults workers, which means that young women can struggle to access or engage well with some aspects of Mental Health Support available in prison. Because of this, a key part of our support through our ID Essence team is to act as a gateway between young women and the mental health team to help increase their willingness to engage with their interventions. For example, one of our team was supporting a young lady recently who had a lot of unresolved trauma linked to sexual assault and bereavement and so was often on an ACCT document. She felt comfortable to speak with Essence worker first about her past experiences of trauma and then gave her consent for her Essence Worker to refer her to the mental health team to do some work around trauma therapy. The referral was successful and the young lady engaged with the therapy, she tried to stop it a couple of times, but spoke it through with her Essence worker first who was able to encourage her to stick at it, which she did. Once she completed the therapeutic intervention she didn’t self harm again in prison. However, if ID Essence had not been there she would have been unlikely to have seen the work through or to even make the initial disclosure about her trauma that was the root cause of her self-harming.

 

5.      A bereavement, or anniversary of a bereavement or their offence especially for those who are in for serious offences such as murder, manslaughter or harming their child. We have worked with at least three women who have made serious suicide attempts more than once during their sentence because they felt overwhelmed by feelings of guilt for their crime and feel unable to forgive themselves. ID Prison Ministry’s ‘Understanding Forgiveness’ course and engagement with a faith tradition through chaplaincy are helpful for women struggling in this way, as it can help them to make peace with themself and come to be able to accept what has happened and begin to see a way forward.

 

6.      The pain of not being with their children, limited contact with their children, dealing with Social Services and those caring for their children whilst they are absent, as well as coping with children being adopted whilst they are in custody.

What is being done?

There has recently been a review of the ACCT process in prison for those who are risk of suicide and self-harm. It is too early days to tell if this will make a difference. In the prisons we work in, self-harm rates have gone down during Covid lockdown due to there being more restricted interactions with people from different landings, we have heard that some prisons locally may try to maintain some of these restrictions, which could improve things for some women, but may have a detrimental impact on others.

As part of the ACCT process, it is good now that restrictions are gradually lifting, that staff can now be more pro-active in getting women currently on ACCTs out of their cells, back into work or education and positive purposeful activity, to engage them and help them find purpose and meaning.

The new Offender Manager in Custody (OMiC), key worker scheme should help too. This scheme means each woman has a dedicated officer who acts as their key worker and meets with them weekly. This should help women to feel less powerless and frustrated at the prison as they will have a designated member of staff who they can speak to directly about what their problem is and who can help them feel more supported and in control of their own situation.

Charities such as ours also play a key part in reducing levels of self-harm and suicide in prisons. The pastoral support that our teams in the prisons provide helps reduce the risk of self-harm and suicide as we provide a safe and objective space for women to speak about what they are struggling with to someone who is from an external agency, so separate from ‘the establishment.We have found this makes a big difference. The women will often say to us that they see us somewhere ‘in-between staff and friend’ and support sessions will regularly end with women saying things like “I feel so much better now I’ve got that off my chest.” Feeling listened to without judgement has a vital impact when someone feels on the edge of hopelessness.

The ‘Listeners Scheme’ through the Samaritans is also very helpful for similar reasons, particularly as they have such high levels of confidentiality which the information someone shares with them.

Chaplaincy teams are also part of the solution as they are actively involved in supporting those at risk of self-harm or suicide. It is part of their statutory duties that they regularly visit every person in the prison on an ACCT document providing a friendly and listening ear and spiritual support for those of who want it.

What more could be done?

We would recommend:

  1. Introducing specialist mental health workers for young adults in prison, who can help to meet the specific needs of young adults and make mental health support more accessible. We have found that interventions that are relational, long-term, flexible and they trust to have high levels of confidentiality are particularly effective for young women in prison. Having specialist mental health workers that can build positive relationships with young women in prison and provide these kinds of interventions for them could make a significant difference for that population within the female estate.

 

  1. Expanding and prioritising mental health provision for women of all ages in prison, providing greater access to counsellors (with the aim that there are no longer long waiting lists for this provision) and longer-term therapy/counselling options so they have time to build up trust and get to the underlying issues of why women are self-harming.

 

  1. Improving housing options for women leaving prison and finding a way that women’s housing can be secured further in advance to their release. Offering more ongoing support with reintegration after release too so women know they will not be alone outside if other issues come up which they are unprepared for.

 

  1. Consistent, established and innovative behaviour management processes in the female prison estate, that are relational and trauma informed. This would make a significant difference for young women in particular and those women whose risk of self-harm and attempting suicide is linked with challenging behaviour and how it is managed by the prison. 

9. Does the custodial estate offer a trauma-informed environment for females? (a trauma informed environment, being that which is about putting experience, behaviours and needs first, and creating a safer, healing environment that aims to reduce and prevent trauma and retraumatising an individual)

 Could more be done? If so, what?

We have been pleased to see that over the last few years there has been a significant training drive for staff around how to operate in a ‘trauma informed’ way within women’s prisons. Our teams have been able to engage on this training and we have found it to be of a good quality. We get the sense that the need to be trauma-informed is taken seriously by leaders in the Female Estate and there is a new emphasis on ‘Rehabilitative Culture’, which should help prisons work towards a more trauma-informed environment.

However, in the day to day running of a prison it can seem that having a prison as a trauma-informed environment can feel like an unrealistic and there are certain practices regarding security in prisons that young women we have supported through ID Essence have told us they have found re-traumatising. The use of restraint on them and unexpected cell searches (especially those by external search teams) that happen early in the morning and without warning are two such practices. For example, two young women I have supported both said that when they are restrained it reminds them of past experiences they have had of abuse and assault. Particularly when they are restrained by male staff. Another two women I supported spoke about how an unexpected cell search they went through first thing in the morning made them feel vulnerable, as they were not allowed to get dressed properly before staff entered their room (as it would give them time to hide any contraband they had in their room) and one of them, who suffered from anxiety, said that her anxiety got worse for the time period following the cell search because of the shock of it and a fear that it might happen again. Prisons could be more trauma-informed if practices such as these were considered specifically, and methods explored for how to minimise harm when carrying them out (if they genuinely can’t be avoided) as much as possible for the women involved.

The potential for trauma because of restraint and fear of this experience seemed to be exacerbated for women from minoritized ethnicities following the murder of George Floyd in 2020, as this left them feeling concerned that the same could happen to them. One woman I was speaking to near that time said, “It’s scary because you realise that could happen to me.” One of David Lammy MP’s recommendations from The Lammy Review involved ensuring that there is racial diversity in Use of Force Committees that review whether C&R’s have been carried out ethically and necessarily, ‘with consequences for officers misusing force on more than one occasion.’[1] If this has not yet been implemented, it should be seen as high priority.

Increasing diversity in the workforce in the female estate, particularly amongst the Senior Management Teams and being more intentional in creating an anti-racist prison environment at every staffing level is an area that is vital to ensuring a trauma-informed environment for all women in prison. HMP Holloway had a diverse workforce (except in senior management – that was still an issue there too) and in the 3 and a half years we were based there I did not have any women speak to me about experiencing racism. Whereas since Holloway has closed, it is something that comes up frequently, meaning prison can be a retraumatising environment for women from minoritized ethnicities as they continue to come up against racial trauma. Some examples of experiences women have spoken to us about are; friendship groups of women from minoritized ethnicities feeling they are labelled as a ‘gang’ whereas their white counterparts are seen as a friendship group; women from minoritized ethnicities being restrained quicker than a white woman may be; there being less hair and beauty products available through the prison’s ‘canteen’ catalogues for women from minoritized ethnicities than there are for women who are white; staff having conversations with the women in response to the Black Lives Matter protests last year where they voice scepticism that racism still exists in the UK or having a general attitude that complaints of racism are just playing the ‘race card,’ rather than being taken seriously. We have found that women do not feel they can formally complain about these experiences because they don’t want to be seen as ‘causing trouble’ and also because they don’t feel their complaint will make a difference. There is a lot of work still to be done in this area.

Another area of where more could be done is regarding provision for people with specified learning differences such as autism, ADHD, oppositional defiance disorder or anything else that can impact a person’s behaviour and relationship to rules and authority. We are aware there is only limited provision for and training around neurodiversity in the prison population and how to work with women with specified learning differences. The impact of a person having a learning difference such as autism or ADHD is significant in how they will experience the prison environment, so it could be an improvement if staff can become better equipped to know how to work well with neurodiverse people and if the prison regime could become flexible enough to accommodate their specific needs where possible.  So far, we have worked with 3 young women who have been assessed as having autism during their prison sentence. This indicates that there is a high chance that there are more women in custody with undiagnosed specified learning differences, especially when you take into account the fact that nationally autism is underdiagnosed amongst women and girls.[2] Perhaps carrying out more routine assessments, or training staff on how to identify and signpost women who may have undiagnosed learning differences so that they can access the specialised support they need, could also improve the outcomes for this group of women within the female estate and make prison a more trauma-informed environment for them.

10. What support is available to ensure that women are successfully resettled into the community upon release and reduce reoffending?

 Are there any barriers to effective resettlement, and reduced reoffending?

Women’s experiences leaving prison and why more resettlement focus is important

We have found across all our projects that there is a significant gap in provision in resettlement support and there are many barriers to effective resettlement and reduced offending after prison. Having come from an environment where there is a constant staff presence, to one where there is a significant shortage of staff or support, after prison women can be left feeling isolated and overwhelmed in uncertain situations (see the barriers below). This can leave a person without any sense of hope that they can obtain stability or purpose in their life moving forward and makes it harder to stay away from crime. This is why ID Essence introduced the resettlement aspect of their work in 2016, providing long-term support for women after there release from prison. It is also why ID have made the decision to open ID Grace House, which will be accommodation with life skills training and support specifically for women leaving prison.

What barriers stop effective resettlement

Figures from prisons show that there are over 300 women leaving prison homeless on the day of their release in the South East alone.  These figures do not include those who may be sofa surfing, staying with someone for favours or going back to a place where they will suffer abuse.  They ostensibly have an address when they leave, even if it Is not safe. If women are living on the streets or without safe housing, they will often reoffend so that they can go back to prison where they can be safe.  Women that we meet who are back inside will also tell us that the one thing that tripped them up, leading to being recalled, is lack of support. They say that even if they do get a hostel place, the accommodation is often rife with drugs and alcohol and there is not the support they need to resettle well.  Women leaving prison are not statutorily given a designated support worker beyond their probation officer. Probation services have been very stretched for several years now and so this means that women have varying experiences regarding how involved their probation officer is in helping to them to resettle effectively.

As well as a lack of suitable housing to resettle women, we see that employers and education providers regularly use criminal records to unfairly and unjustly bar women from finding meaningful activity after prison. Although it does seem that there are an increasing number of employers who are committed to employing people after prison, more needs to be done. Women who have been to prison need fulfilling employment opportunities with prospects to build a career or get paid well, otherwise the profits of crime are much harder to resist – particularly for those who have engaged in drug dealing previously, as this is a very profitable crime.

The same goes for education providers, such as colleges and universities, who we have found to have criminal justice policies that put unnecessary barriers for people with criminal records. For example, one young woman who had served time for drug dealing as a teenager was denied a place to study photography at an Art’s College because their accrediting University’s criminal records policy held the same exclusions for those who had been convicted of drug dealing as those who had been convicted of sexual offences and violent crimes. Although it did not exclude her permanently from being able to apply, it put a significant delay on when she would be able to apply, by which point it may have been too late. (Although in this case, thankfully it wasn’t).

Access to mental health services also seems more difficult in the community than it is in prison. Mental health services in the community are so stretched now that women leaving prison with mental health issues seem to be amongst the many people who are falling through the gaps. Nearly all the women we have supported in the community have spoken to their GP about their mental health struggles, but from there none of them have managed to go on to access mental health support or services beyond their GP. This is an area that can provide a barrier to resettlement as a woman’s mental health can impact their ability to successfully resettle back into the community after prison.

What can be done

More incentives should be given from the government to education providers and employers to take on people with criminal records because this is currently a significant barrier for women leaving prison, almost regardless of what their index offence is.

More initiatives such as ID Grace House, set up in a range of locations, to provide safe housing and assistance to help gain work, training around budgeting and the necessary emotional support and guidance too. 

More mental health services available for women leaving prison. Consider establishing specialist mental health initiatives primarily for women leaving prison that are easy for women to access and that work in a way that is accessible for this demographic and the life situation they are in e.g. being flexible and persistent in their pursuit to get women engaged in the provision available.


[1]https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/643001/lammy-review-final-report.pdf The Lammy Review: Final Report pp. 7-9

[2] https://www.autism.org.uk/advice-and-guidance/what-is-autism/autistic-women-and-girls accessed 04/06/21