Women offenders: after the Corston Report - United Kingdom ...

Women offenders: after the Corston Report 67The ethos of regimes173. It is very clear from the evidence we received that a key issue that the review of thewomen’s estate must resolve is the treatment of women with mental health problems, andthe way in which prison responds appropriately to the complex needs of women who haveoffended. 360 The Howard League suggested that such problems may be inappropriatelytreated in prison: “The distress manifested by imprisoned girls and women with mentalhealth needs is often treated as a discipline issue by prison staff. This leads to an increase inself-harming and suicidal behaviour. Prison staff are not appropriately trained or qualifiedto deal with this behaviour and it can be damaging for everyone involved.” 361 Two of thewomen we spoke to had received poor mental health treatment whilst in prison, andexplained that there was a tendency to medicalise mental health problems rather thanaddress them; similarly another had received support to come off drugs but not to tacklethe underlying reasons for that drug use. 362 They also identified good practice, for example,a pilot alcohol support project at HMP Bronzefield but we were told that this was notcommonplace experience:“There are AA meetings, which are held on a weekly basis in the prison, which theprison accommodates. There are very supportive prison staff and a lot of care fromnormal officers, even if there was no psychiatric treatment available. I was treated asa high risk, so I was monitored very closely and supervised throughout movementsin the prison. The everyday officers and the alcohol treatment people did theirabsolute utmost to give as much pastoral care as they could.” 363174. Similar sentiments were echoed by practitioners in the field who called for morepsychotherapeutics intervention which can deal with emotional distress. 364 TheHuntercombe Group, which provides independent specialist mental health care, believedthat effective services must be “trauma informed” i.e. they must take account of women’shistories, which may be traumatic, avoid triggering further traumatic reactions, andsupport the development of coping capacity to facilitate control, responsibility, decisionmaking and judgment; prison environments are not conducive to this, for example,because the culture of control is itself counter-therapeutic. 365 This was raised with us by Dr.Robinson from HMP Styal who believed that such therapy was invaluable, but noted thatwhere it was provided in prisons this was often hindered by short sentence lengths, andmovement between prisons. At the time of our visit HMP Styal was undergoing somechanges to health provision, which he hoped would facilitate greater access to talkingtherapies. More generally, we heard that, unlike in women’s centres which seek toempower women to take control of their lives, the ethos of prison regimes often removesresponsibility to such an extent that in Juliet Lyon’s view “[w]omen in prison are360 See for example Ev w4, Ev 103, Ev w12361 Ev 114362 Qq 55–56363 Q 54364 Ev w49, Ev w77365 Ev w77. INQUEST also called for hospital based psychiatric care, see Ev w124. See also Ev w12