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Coping in the chaos: Pentonville’s neurodiverse unit is changing prison life

A radical and caring prison experiment has changed both prisoners and wardens. Nick Jones visited London's oldest prison.

Nick is the senior editor of Seen & Unseen.

An arched gateway to a prison sits behind a low raised wall. No windows are visible
First opened in 1842, Pentonville Prison serves a large part of central and east London.
Ben Sutherland via Wikimedia Commons

A London prison has seen a reduction in violence among prisoners and improved staff morale thanks to a new neurodiverse unit.  Pentonville prison’s new unit identifies and treats prisoners with autism, brain-injury, learning difficulties and even dementia. 

Jo Davies, Pentonville’s managing chaplain, helped set up the programme after conducting many regular prisoner reviews with colleagues. She noted that there was an apparent higher incidence of autism among prisoners than the general population. 

Prison is a challenging environment for those with autism. Routines are imposed, vulnerabilities are exploited by others. Frustrations can boil over into violent and self-destructive behaviours. Non-verbal behaviour also makes each interaction with other prisoners and staff a potential flashpoint leading to protesting behaviours or withdrawal.  All against a backdrop of a harsh white noise. Metal doors slam, Conversations and challenges are shouted, all constantly echo through the four open floors of each wing of the prison.  

Other neurodiverse conditions are present in prisons. An ageing prison population even has prisoners suffering from early onset dementia. Some forget the circumstances of their imprisonment.  

Teaming up with prison officers and support staff like psychologists, doctors and teachers, chaplain Davies notes that “now staff make it their business to work out how to work with these prisoners”. The unit has capacity for 45 prisoners in single cells. They share a common area for eating and other activities. Staff spend 10 weeks assessing the prisoners who can then benefit from up to 12 weeks of additional support. 

Ruth Hipwell, who leads the new unit, says: “it’s good to have a place in prison for those people who can’t cope.” Support ranges from little things like teaching a prisoner how to make a cup of tea or providing earplugs to reduce noise, to helping prisoners make better plans for coping and learning – both in prison and outside. 

On the wall of the unit is a timetable of events, illustrated by pictograms. Sessions include how to handle familiar tasks in the unfamiliar environment of prison: how to buy things or use the telephone, getting clean clothes and even how to handle being unwell.  Other sessions include accessing learning and getting a job.  

Robbie*, a prisoner in the unit says:

“It relaxes you. It’s wicked. The difference is the support.” 

The unit started work in October 2022 and the difference it made was spotted fast. It transformed staff, recalls Hipwell. “They have found their purpose. We have a level of multi-agency integration others can’t match.” 

Ian Blakeman, Pentonville prison’s governor, identifies additional benefits. “It frees up staff time and staff export skills to other parts of the prison.” These positive effects also help him keep good staff. A major challenge in London’s competitive labour market.  Other programmes reinforce this change in culture across the prison range from addiction treatment to rebuilding family relationships affected by gang affiliations.  

Pentonville now has the lowest self-harm rates in the country and is the least violent prison of its type in the UK. 

With prisons a low political priority, it’s even more remarkable to learn that Pentonville’s neurodiverse unit required no additional budget. Its win-win results are a flicker of hope in a bleak landscape. Times columnist Matthew Parris recently wrote: 

“Every generation looks back and spots an outrage. Today, when we think of slavery, child labour and lunatic asylums, we wonder how our ancestors could have been so cruel. What will horrify our own successors is our disgraceful prison system.” 

In response to Parris’s column, Jonathan Aitken, a former prisoner and now a chaplain at Pentonville who works with the neurodiverse unit, wrote to the Times.   

“The real disgrace lies not inside our prisons but in the failure of both public and private rehabilitation efforts to help prisoners into jobs, housing and law-abiding lives after their release. The good work done by prison officers, managers and governors is underreported… We are on a roll of improvements… But such advances are like clapping with one hand if they are not met by comparable efforts to rebuild the lives of prisoners after they walk out of the gate. Correcting the failures in this area should be a high priority for our politicians and for our society.” 

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Mental Health
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4 min read

Rachel Reeves’ tears: public life still mocks those who show anything but the positive

‘Mental health awareness’ is failing, our words are not matched by our actions

Rachael is an author and theology of mental health specialist. 

 

 

A woman sits and holds back a tear.
Rachel Reeves on the front bench.
Parliament TV.

It’s a bad day at work. Everyone is on high alert, and tempers are frayed. You have your own reasons for being extra ‘on edge’, but now isn’t the time to get into it because it’s the big weekly meeting and everyone is going to be there - worse still, the cameras are going to be there. Despite this, you take a deep breath and take your seat (which, although an honour, is regrettably in the front row).  

But as the fractious meeting begins, you feel the ache of impending tears at the back of your throat, and to your horror, your eyes fill. You do your best to wick them away, but you know they’ve been spotted when someone opposite announces how miserable you look. 

Many of us will have been in a similar, if probably less public, situation at some point in our careers when the emotions we stuff down in the name of professionalism spill out - but I doubt any of us will have done so in the House of Commons with cameras trained on every movement and a less than friendly crowd opposite.  

There have been countless articles already speculating about the reason for the tears of the Chancellor, Rachel Reeves, during Prime Minister’s Questions - but most seem devoid of sympathy or empathy, concerned only with the political implications, but not the person at the centre of this story.  

Our reaction to Rachel’s tears is an echo of the sentiment behind the Welfare Reform Bill, which seems to say that need is unacceptable and we should all be able to don that famously British ‘stiff upper lip’ and just get on with life.  

Regardless of what you think of the Welfare Reform Bill, the way it has been briefed and communicated has raised anxiety and fear amongst the disabled community (me included).  

The main message has been that too many people are receiving Personal Independence Payments (PIP) for mental illnesses such as anxiety and depression, with even the former Prime Minister Tony Blair telling people to ‘stop diagnosing themselves’ to combat out rising welfare bill - despite the fact that accessing PIP requires rigorous assessments and support from medical professionals. (It also has a 0.01% fraud rate and was designed to compensate people for the extra cost of being disabled which is estimated to be up to £1000 a month.) 

This tableau is emblematic of how ‘mental health awareness’ is failing in this country; our words are not matched by our actions. 

We know, 27 years after the first ‘Mental Health Awareness Week’, that mental health is important, that emotions are natural and valid - and yet we mock any leader who shows anything but positive emotions.  

We know that people suffer, are disabled by and killed by mental illnesses, and yet we seek to strip support from those who need it most, claiming that they are diagnosing themselves. 

We need a different approach, both to how we handle emotions in public life and the way we talk about those who need extra support due to their mental illnesses.  

Emotions aren’t bad - they help us connect, keep us away from danger and allow our bodies to release unbearable tension, as in the case of crying, whereby tears of pain are intricately designed to help us cope. The tears we shed when faced with chopping a pile of onions are chemically different to those that fall when we are grieving, angry or in pain. Tears of pain should inspire us to reach out to the one in pain with compassion not contempt.  

The way Jesus led 2,000 years ago shows us another way, both of leading and emoting.  

Jesus consistently welcomed those most in need; from healing the woman who had bled for twelve years, considered unclean and rejected by her community, to healing a paralysed man lowered through his roof by friends.  

And yet his ministry was not just one characterised by miracles and might, but demonstrated humility and humanity as he wept over the death of his friend Lazarus and allowed himself to be stripped of all strength as he hung on a cross made for criminals.  

The night before he died, he gathered his friends and through tears and blood-soaked sweat submitted to the Father in the most painful way, and I, like many others, draw comfort and strength from Jesus’ willingness to cry.  

As preacher Charles Haddon Spurgeon said, "A Jesus who never wept could never wipe away my tears."  

So perhaps rather than mock Rachel’s tears, they should cause us to rethink how we approach need and recognise none of us are immune.  

Perhaps, we may even join with Paul’s words in his letter to the Corinthians: “For when I am weak, then I am strong.” 

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