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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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Freedom
Trust
9 min read

Reviving post-liberal society

There’s a crisis of trust, anxiety, and relationship in post-liberal society. Graham Tomlin looks into what might revive it.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A loose rabble of a protest in the street is siluhetted against light and a shower of rain
A protest in Santiago, Chile.
Ignacio Amenábar on Unsplash.

Much has been made in recent times of the alleged demise of liberalism. From the heady heights of 1989, when Francis Fukuyama’s famous essay announced ‘The End of History’ and it seemed that liberal democracy was the only game in town, things don’t look so auspicious now. Back then, it seemed that of the three great twentieth-century political creeds, fascism had met its ugly end in the Second World War, communism had crumbled in the ruins of the Berlin Wall in 1989, and so western, free market, secular liberalism was the last one standing, the only realistic political and philosophical option for the future of the world.

Then a whole series of events challenged that narrative. The attack on the twin towers in 2001 announced that religion was not a spent force in the modern world but a powerful motivator outside the western European and American bubble, for better or worse. Throughout the twentieth century, Christianity had been quietly growing in Africa from just 9% of the continent’s population in 1900 to 48% a century later, and it continues to grow. The remarkable rise of Chinese Christianity after the devastation of the Cultural Revolution, the resurgence of Islam worldwide and the prediction that in coming decades, atheists, agnostics and others who do not affiliate with any religion will make up a declining share of the world’s total population, made the prediction of a secular future suddenly seem foolish. The financial crash of 2008 put paid to the hope of gradual economic growth in the trusted hands of the market, and then the rise of Trump, Bolsonaro, Erdogan and, of course, the political and social earthquake of Brexit placed a huge question mark over the assumption of a globalised, liberal order gradually taking over the world.

In the wake of these events, a growing number of voices started to call attention to the travails of liberalism. Patrick Deneen’s 2018 book Why Liberalism Failed argued that liberalism had failed to achieve its lofty goals:

“A political philosophy that was launched to foster greater equality, defend a pluralist tapestry of different cultures and beliefs, protect human dignity and, of course, expand human liberty, in practice generates titanic inequality, enforces uniformity and homogeneity, fosters material and spiritual degradation, and undermines freedom.”

The crisis in liberalism is a theme that runs through the worried pages of many political broadsheets or cultural commentaries. Is liberalism dying, or is just going through a period of sickness before recovering in new forms? Most people think it’s not on its last legs yet, and yet the crisis in liberalism have led us into a number of crises in modern life, many of which can be traced to the flaws which lie alongside the strengths of the liberal project.

A crisis in trust

First, we have a crisis of Trust. Liberalism presented itself as a rejection of the tyrannical and stifling control of social, religious and political convention. The controlling eye of Church, school, family and government was seen as oppressive, contravening the rights of the individual. Throwing off the yoke of such supposed authorities was essential to living an authentic life. John Stuart Mill, one of the great pioneers of liberalism, wrote of the ‘despotism of custom’. And while Mill’s rejection of starched Victorian conformity may be understandable, the result of the revolt he helped to unleash was to undermine trust in authority and government.

A society full of mutual suspicion cannot function well, and is not good for us.

Examples abound. A recent one was Baroness Casey’s recent report on the Metropolitan Police, that accused it of being institutionally racist, misogynistic and homophobic. Before that, the abuse of expenses trashed the reputation of MPs; the financial crash taught us bankers couldn’t be trusted; and the phone-tapping scandal bersmirched the reputation of journalists. In addition, a number of studies suggest that the length of tenure of CEO’s has decreased in recent years as they struggle to maintain legitimacy, while here in the UK, we have gone through Prime Ministers as quickly as football managers. The Church is no different – the many stories of child abuse, the betrayal of vulnerable adults, the prejudice against minorities have all eroded levels of trust in the clergy.  Whether you look at business leaders, bishops, local politicians, estate agents – levels of trust in sectors of our society that are crucial for the good functioning of social life are at a very low ebb.

It's hard to tell whether the crisis stems from our increasing scepticism that truth-claims are only ever power-plays, or because the rise of movements like #MeToo or Black Lives Matter have led to our leaders being held to a higher sense of accountability. Have standards in public life diminished? Have our leaders become less trustworthy? Are our institutions more systemically corrupted? Or is it that we now expect far more of our public figures than we used to and therefore constantly find them wanting? Whatever the answer, the overall result is catastrophic. Trust is essential for the good functioning of any human community. A society full of mutual suspicion cannot function well, and is not good for us. As Graham Greene once put it:

“it is impossible to go through life without trust; that is to be imprisoned in the worst cell of all: oneself.”

Liberalism's tendency to challenge past authorities may been justified. Taken to the extreme it has been, however, has bred a society in which it’s hard to put your faith in anyone.

A crisis of anxiety

As well as a crisis of trust, we have a crisis of anxiety. Economic liberalism valorized free markets, liberating individuals to benefit from the mutual exchange of goods and releasing human enterprise from the shackles of convention and control. Deregulation would liberate the human spirit of adventure to develop a future shaped by progress. Rather than accepting to live within the limits and rhythms of the natural world and the givenness of a broader cosmic order, the liberal instinct was to declare the freedom of the individual to self-create, to forge individual identities in the search for autonomy and self-realisation.

Yet today, Generation Z perceive climate change as the number one threat to their future. Climate Change Anxiety is an increasingly recognised syndrome, leading people to forego – out of despair - bringing children into such a damaging world, and fuelling high levels of mental health problems especially amongst young people. Add in a global pandemic, spread rapidly around the world by our fondness for limitless travel, that saw levels of anxiety rocket. We now have war within the borders of Europe, for the first time since 1945, with the added prospect of China being drawn into the war on the side of Russia. And as a result of this, and never quite learning the lessons of the 2008 financial crash, we have a cost of living crisis more severe than has been known for decades. The progress of the sophisticated algorithmic technology of social media fuel increases levels of anxiety and mental health problems for those addicted to clickbait or the desire for likes, and talk of an epidemic of mental health problems doesn’t seem an exaggeration.

A crisis of relationship

Third, we have a crisis of relationship. At liberalism’s core is the idea of the freedom of the individual from societal expectations and strictures. Michael Freeden, Professor of Political Theory of Nottingham University, summarised the heart of liberalism as “a rallying cry for individuals desiring space to be free from unjustifiable limitations." Theorists such as Ronald Dworkin argued that the individual is best placed to choose their own vision of the good (and therefore the state must remain neutral on such notion), leaving the playing field open to myriad definitions of what people ought to aspire to – almost as many as there are people.

If that is our central moral ideal – that the individual should be free from obligation or restriction from everyone else, should we be surprised that we end up more distant from each other?

The liberal ideal of individual freedom – that each person should be free of interference from their neighbour in their choice of the good life as long as they don’t harm others – is superficially attractive. Attractive, that is, until we realise that it gives us no good reason to care for one another, and in fact encourages us to think of our neighbours as potential infringements on our freedom to do as we choose. The result has been a slow erosion of the social bonds that tie us to each other. If that is our central moral ideal – that the individual should be free from obligation or restriction from everyone else, should we be surprised that we end up more distant from each other? Should we be surprised that we treat each other as enemies on social media? Or that we refuse to have contact with those of another political tribe? Or that we abandon those older ties, those social institutions that bound us to each other - family, parish, church, local voluntary societies?

Now, a crisis of trust, anxiety and relationships is, in fact, a crisis of Faith, Hope and Love.

This trio has a long history in Christian life and thinking ever since St Paul coined it in a letter to the fledgling church in Corinth in the first century, in words that echo in many a wedding service today: “Now these three remain: faith, hope and love. But the greatest of these is love.”

Christianity focusses attention on these three ‘theological virtues’ as they are known, and the Church, with all its flaws and failures, has continued to be a school in which they can be learnt, though a number of distinct practices.

Trust is built when people keep their promises.

First, faith. The creeds begin with the simple word ‘Credo’ – I believe. It’s the first thing you do as a Christian, to put your trust in something - or better, someone - who you cannot see, cannot prove, and yet you are invited to do exactly that – take the risk of faith. Trust is built when people keep their promises. The God that the writers of the Bible speak of describe him with exactly that idea: that he is faithful to his promises, like a marriage partner who does not give up on the other, no matter how wayward they might be. Being a Christian starts to teach you to trust God, in a way than might even lead to learning to trust people again. That doesn’t mean accepting deeply flawed and abusive institutions, but it does mean giving people the benefit of the doubt - the assumption of trust rather than mistrust – that tends to bring the best out of most people.

If our hope is in our political leaders to deliver radical solutions to combat mental wellbeing, it’s unsurprising Generation Z despairs.

Second hope. In politics false dawns are as predictable as taxes. If our hope is in our political leaders to deliver radical solutions to combat mental wellbeing, it’s unsurprising Generation Z despairs. Christian hope on the other hand, rests not on any human promise or expertise, not (thank God) on the superior qualities of bishops or popes, but on something entirely outside human capacity – the story of the Resurrection of Jesus, the conviction of a divine break-in to the order of the universe that has always had the capacity to bring a sense of hope in the darkest moments of an individual’s or a community’s life.

When I look into the eyes of my neighbour I see not a potential threat to my personal autonomy, but a person of infinite value.

Last, love. At the heart of the Christian faith is the conviction that each person (whatever his or her qualities, background or even character) is infinitely valuable because loved by the God who made them. The outworking of this idea in history is to make love, not suspicion or even tolerance the ideal bedrock of social life. This is the tie that binds. When I look into the eyes of my enemy I see my brother. When I look into the eyes of my neighbour I see not a potential threat to my personal autonomy, but a person of infinite value, whom I am bound to love as God does, however annoying, contrary or wrong their personality or political opinions.

These three qualities – faith, hope and love, are like muscles. The more you exercise them, the more they grow stronger. A life, or a society that chooses to root itself in Christian faith tends to grow in its capacity for faith, hope and love.