Article
Change
Freedom
Mental Health
3 min read

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 Jones

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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Article
Care
Change
Mental Health
4 min read

Social prescribing for whole person care

Responding to an anxiety epidemic, there’s a growth in social prescribing with a spiritual wellbeing element. Esther Platt explores how it's working out locally.

Esther Platt

Esther works as a Senior Consultant for the Good Faith Partnership. She sits in the secretariat for the ChurchWorks Commission.

Two people sit at a table with their hands resting on top of it. One speaks to the other
Photo by Christina @ wocintechchat.com on Unsplash

Since 2001, Mental Health Awareness Week has been marked once a year in May. This year, the theme was anxiety - an increasingly relevant topic in a country that has endured three years of world-changing crises and the soaring cost of living. Research from the Mental Health Foundation has found that 1 in 10 UK adults feel hopeless about financial circumstances and more than one-third feel anxious. 

For centuries, it has been recognised that spiritual well-being is closely tied to mental well-being. By spiritual wellbeing, I don’t mean organised religion. I mean our sense of relationship to a higher-power or reality beyond our own, and our sense of purpose and meaning in life, as Craig Ellison outlines it as in his paper Spiritual Well-Being: Conceptualization and Measurement. 

In Man’s Search for Meaning holocaust survivor Victor Frankl compellingly makes the case that in a world of suffering, our survival depends on our sense of purpose, meaning and hope. Frankl coined the term ‘the self-transcendence of human existence’ by which he explained that human beings look for meaning beyond themselves, either in a cause, a person to love, or a higher power.

With an increased understanding of the holistic nature of wellbeing, and the value of spirituality, a new way of looking at health is emerging. 

While modern psychologists are still building a clinical-grade evidence base on the value of spirituality, there is clear agreement that spiritual wellbeing is crucial for a good quality of life, especially for those who are facing adverse life events, as you can read on the US National Library of Medicine web site. Traditionally, health provision in the UK has focused exclusively on the physical, and more recently the mental. However, with an increased understanding of the holistic nature of wellbeing, and the value of spirituality, a new way of looking at health is emerging.  

Social prescribing is one way in which this is being done, and across the country. 

In social prescribing, local agencies such as charities, social care and health services refer people to a social prescribing link worker. Social prescribing link workers give people time, focusing on ‘what matters to me?’ to coproduce a simple personalised care and support plan. This involves ‘prescribing’ individuals to local community groups such as walking clubs, art classes, gardening groups and many other activities. 

Churches are playing a crucial role making social prescribing happen. St Mary’s Church in Andover, offer a wellbeing course to members of the community who have been directed to them through the local GP surgery.  

Members of Revival Fires Church in Dudley have been trained to offer Listening and Guidance support to those who are referred by a GP.  

Beyond social prescribing, St John’s Hoxton in London offer the Sanctuary Mental Health course to their community which gives people an opportunity to share their experiences and find solidarity in their struggles.  

Church provides a space where the breadth of our wellbeing, our desire for purpose, community and hope can be supported in a way that the NHS does not have capacity or experience to deliver. As the Archbishop of Canterbury, Justin Welby, writes  

"The issue of mental health is one that requires a holistic approach on an individual basis, incorporating as appropriate psychiatric, medical and religious support’.  

Olivia Amartey, Executive Director for Elim, an international movement of Pentecostal churches adds,  

‘I am convinced that there is no other organisation on earth that cares for the whole person, as well as the church. Its engagement with the statutory authorities, focussed on individuals’ well-being, provides an invaluable opportunity for a synchronised partnership to the benefit of all our communities.’ 

Jesus told his followers, ‘I have come so that you can have life and have it to the full’. This is the hope that animates churches. Christians find meaning and purpose in the hope of life, peace and justice that Jesus gives. Church can be a space where the complexity of hurt and suffering is acknowledged, and where we can find solidarity and support in the presence of those who can help us find purpose and meaning.  

At ChurchWorks, a commission of leaders from the 15 biggest church denominations in the UK, we are excited by the prospect of more churches providing this space. On 18th May we held ChurchWorks for Wellbeing, in which we gathered over 300 church leaders to explore how the church can bring hope to our communities in this time. We shared stories of small and simple conversations, where offering a listening service, an art class or a food pantry enabled churches to give people in their community space to be, to grieve, to process and to grow. From the conference, it is our hope that we will see hundreds more churches start to engage in social prescribing and welcome their communities to access holistic wellbeing support.  

At a time when anxiety is rife, and it is so easy to feel despair and hopelessness, the church offers a vital resource to us: a place where our spiritual wellbeing can be nurtured, where we can find purpose, where we can find community, where we can find hope. 

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