Mental Health in Prisons: The Insider Perspective
Written by Elise Blakemore, Research Assistant Psychologist, PROSPECT project
I recently had the pleasure of meeting with the Listeners and Safer Custody Reps in prison to discuss their perspective on mental health in prisons and how their role fits into this.
What is the role of the Listeners and Safer Custody Reps?
Trained by the Samaritans scheme, the Listeners are current prisoners who provide support to fellow prisoners who are experiencing difficulties with their mental health and well-being. The Safer Custody Reps are also current prisoners who work alongside the prison’s Safer Custody team and help those prisoners who are receiving care under the Assessment, Care in Custody and Teamwork system.
‘Our role is to support people under stress, listen to them and support them with any problems.’
‘Be present, don’t always offer advice … just listen.’
They are encouraged to ‘be pro-active and reach out to people.’
‘We can spot behavioural differences why may not always be apparent or made aware to staff.’
Despite being an incredibly useful and necessary resource, the implementation of this type of support, like many other sources of help in this environment, is met with some challenges. The role is ‘staff dependent’ and ‘regimes within the prison can interfere with the work.’ Not only can this leave those in need in the dark, it can also take a toll on those providing the support. ‘It can feel frustrating and like you’re letting them down.’
What are the Listeners’ and Safer Custody Reps’ views of mental health in prisons?
Like in the community, attitudes towards mental health, a providing a therapeutic space for those in needs, widely vary across the prison. This, coupled with long waiting times and the operational barriers to providing timely support, can sometimes mean that many go without the care and attention they feel is needed.
‘There is little support.’
‘On paper there is support but in reality, not enough is there.’
The Listeners and Safer Custody Reps told me they feel that the long-lasting impact of COVID-19 has created a harsh reality for those in prison. It was highlighted that despite many parts of prison life returning to normal, mental heath support still seems to be stuck in the restrictions of the pandemic.
‘There has been a deterioration in the support, pre-COVID our role was easier.’
Both in the community and in prisons there is still a stigma around mental health and people’s ability to ask for help can be overshadowed by this stigma. At a first glance, some fellow prisoners can often associate the Listeners and Safer Custody reps as akin to prison staff, which may lead some prisoners to feel reluctant to open up. This can create an additional barrier making it harder for the Listeners and Safer Custody reps to get through to people. However, the Listeners and Safer Custody reps feel that over time this is changing. People are becoming more open to talking about their struggles and feel more supported in asking for help.
‘The stigma can be reduced once people see us for who we are.’
Creating a culture that provides a safe and confidential space to open up and talk can be challenging in this environment, but it is helped by those who share the same experiences. Trained staff often face the perception that they don’t understand what someone on the inside is going through. The lived experience of the Listeners and Safer Custody reps can help to bridge this gap.
‘We are living in the same situation, we can be more relatable than professional staff sometimes.’
‘We see things happening day-to-day, we have hands on experience.’
What needs to happen going forward?
‘Prisons needs a new outlook on mental health, staff themselves sometimes feel like they can’t help.’
The Listeners and Safer Custody reps told me about the apparent gap between the help needed by prisoners experiencing difficulties and the help that is able to be provided to them. There seems to be a number of reasons for this. Too often mental health problems may be seen as ‘bad behaviour, and is not dealt with in the appropriate way.’ In prison settings, plans are often put in place, but numerous barriers prohibit successful implementation. Scientific research is moving towards more support from patient-public involvement groups to gain insight and perspective from those with lived experience. Prison research will benefit from this too.
The work that the Listeners and Safer Custody Reps do is crucial to the well-being of prisoners and provides tremendous support to both prisoners, and staff, who can often struggle to meet the needs of everyone who is asking for help. I thoroughly enjoyed hearing from the Listeners and Safer Custody Reps and learning from their own experience of providing support in prisons.
About Elise Blakemore:
Elise is a full time Research Assistant working for Greater Manchester Mental Health NHS Foundation Trust at the Suicide Risk and Safety Research Unit on the PROSPECT project. She has previously worked as an Assistant Clinical Research Practitioner within GMMH and as a Research Assistant on a Nuffield Foundation funded trial and a mental health support worker. Elise attended the University of Leeds for her undergraduate and postgraduate degrees and assisted on a systematic review that is published in Autism journal. So far Elise’s work on PROSPECT has involved setting up in the prisons and completing initial assessments with participants.