Urgent review of COVID restrictions in prisons needed to tackle growing mental health crisis

Almost a year on from the first lockdown restrictions imposed across the country, the inevitable impact on mental health is beginning to reveal itself in national statistics, and the results are alarming. The number of people seeking help from mental health helplines has dramatically increased, and the number of prescriptions for anti-depressants has reached an all-time high.

These statistics are disturbing and rightly deserve the level of concern and attention they receive. Yet one group who have received less attention are those who have been subject to the most severe lockdown restrictions: those detained in our prison system - a system which, prior to the start of the pandemic, was already being heavily criticised for failing to do enough to tackle a potential mental health crisis amongst prisoners.

When the pandemic started, there were inevitable concerns about how to adequately protect the physical safety of prisoners (which we wrote about here). Infectious diseases are much more likely to run rampant in prisons; prisoners are more likely to suffer from serious underlying health conditions than those in the general population and risks of infection are exacerbated by overcrowding and poor living conditions.

In response to those concerns, the initial lockdown restrictions imposed in our prison system were severe. The majority of prisoners were locked in often cramped, poorly ventilated cells for 23.5 hours, seven days a week, in living conditions akin to solitary confinement. The short time spent out of their cells was primarily used to shower and undertake some brief exercise. For most prisoners, access to key rehabilitative and sentence-planning services was significantly limited, with education and work opportunities also largely suspended.

Whilst severe, at the start of the pandemic, many considered that prioritising the physical safety of prisoners was paramount and that these initial lockdown restrictions were necessary in doing that. Indeed, a recent HMIP report on the impact of the pandemic in prisons found that some prisoners believed that the prison service’s initial strategy was necessary in keeping them safe from infection.

However, these restrictions were only considered to be temporary. The hope was that the severity of these restrictions would keep the infection rates low and buy time for the prison service to formulate and implement a more proportionate, long-term strategy; one which properly balanced the risks posed by infection rates against the other risks posed to prisoners, including to their mental health.

Yet one year on, whilst the severity of lockdown restrictions has peaked and troughed in the community in line with the changing infection rates, the restrictions in prisons have remained constant and unrelenting. There has been little in the way of the easing of restrictions or prioritising of freedoms like that in the community, which to so many have served as an essential release valve to the burdens and anxieties of lockdown.

At the same time, the prison service appears to have been been slow or ineffective in driving down infection rates by other means.

According to the HMIP report, it was only October 2020, seven months after lockdown restrictions were imposed, when prisoners were finally issued with two washable face coverings.

The HMIP report found repeated reports of prisoners not having ready access to hand sanitiser, and of staff ignoring social distancing rules and failing to wear the required PPE.

What is more, the government’s latest figures reveal that, even with the ongoing and extreme restrictions, the infection rates amongst prisoners are considerable and on the rise: one in eight prisoners have tested positive for COVID in the past year, compared to just one in 20 people in the community, and there has been a 70 per cent increase in positive cases since December 2020 alone.

Accordingly, as time has passed and the severity of restrictions has continued, many have started to question the fairness and effectiveness of the ongoing lockdown regime. Indeed, the HMIP report found that some prisoners believed the maintenance of these restrictions to be increasingly punitive in nature. Women prisoners in particular raised concerns that the extended periods of time locked in their cells was becoming the “normal, even preferable practice” to staff who “found the restricted daily routines easier to deliver”.

In addition, the impact of the ongoing severity of the lockdown restrictions on prisoners’ mental health has been considerable.

The HMIP’s interviews with prisoners revealed many are resorting to “unhealthy coping strategies like drugs and self-harm to manage the prolonged periods locked in their cells”, with reports of heightened anxiety due to feeling they have little control over the environment and the measures they could take to protect their safety.

Of particular concern is the female estate, where, according to the government’s latest figures, incidents of self-harm amongst women prisoners have reached another record high. Between June and September 2020 alone, there was a 24 per cent increase in incidents of self-harm compared to the previous quarter.

The need for a change in the prison service’s current strategy and the easing of the ongoing severity of the lockdown restrictions imposed in our prison system seems clear and obvious.

Yet opportunities to reduce the risks posed to prisoners have been repeatedly passed up. Calls for the large-scale, early release of low-risk or vulnerable prisoners have resulted in only a handful of releases and have continued to focus on risks to physical rather than mental health. In fact, somewhat counter-intuitively, the Ministry of Justice has recently announced plans to expand the female prison estate by 500 spaces, as part of their “commitment to reduce the number of women in custody and improve conditions”.

Our prison system is an incubator for mental health issues and the impact of the ongoing severity of the lockdown restrictions is exacerbating this problem.

As the roadmap out of lockdown for the general population is announced, it is imperative the prison service re-evaluates its current strategy for the sake of the mental wellbeing of those in its care.

Crucially, the regime must adapt so that the activities and services so fundamental to prisoners’ wellbeing and development can still be delivered in a COVID-secure environment.

When deciding what restrictions should be eased and freedoms should be prioritised, the wellbeing of some of our country’s most vulnerable individuals needs to be properly accounted for.