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.”

Article

Care

Culture

Mental Health

12 May 2025

3 min read

Separating mind and body still stigmatises mental health

Our minds and bodies are meant to be inseparable.

Rachael Newham

Rachael is an author and theology of mental health specialist.

Two bird sit on wires facing in opposite directions.

Eduardo Soares on Unsplash.

I recently had a somewhat surreal experience whilst trying to get two consultants to agree to some treatment I needed to have.

One was a cardiologist, the other a psychiatrist - both consultants, working in the same geographical area - and I found, to my surprise, that there was no recourse for my physical health records to be viewed by the psychiatrist and vice versa.

And as I went through the process of trying to mediate between these two professionals, it made me reflect that whilst in theory there is agreement that our minds and our bodies are one and that they cannot be treated wholly separately, the reality is something rather different.

Mental and physical health problems are, in fact, treated as entirely separate entities, with different trusts and funding models in place to deliver care and treatment for mental illness and physical illness.

Now, there is probably a bureaucratic reason for this, but I believe it uncovers a perhaps unconscious belief that our minds and bodies are distant relatives at best, and not only that, but our mental health is still the poorer relation - best ignored unless it’s particularly bothersome.

I think this separation sits at the heart of the stigma that mental health problems still face - a stigma that persists even in the mental health system. It has ancient roots. Go back to ancient Greece and its philosophers. They held to a doctrine where the body and soul were completely separate - our bodies are simply houses for our souls. In a way, the stigma that exists about mental health is the inverse of this- that our minds are less important than our physical bodies and that caring for mental health always comes second to caring for physical health.

Yet, also in those ancient times, the Bible's treatment of humanity shows that we are creations of mind, body, and soul—all equal, beloved, and cared for by God. In Mark’s gospel, we read that the command to love God and one another is multi-faceted: “Love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength.’ The second is this: ‘Love your neighbour as yourself.’ There is no commandment greater than these.” To love one another, then, means we need to care for one another’s mental health as well as physical health and strength, as we love with our minds and bodies.

In truth, we cannot care well for ourselves or one another without considering both our mental and physical health. To ignore the mental strain of physical illnesses like cancer, and ignore the physical pains that mental illnesses cause, such as their effects on digestion and blood pressure, is to ignore significant parts of people's suffering.

In the Old Testament of the Bible there is the story of Elijah, one of the great prophets who flees from a murderous ruler and, whilst spiritually and physically exhausted, begs God for death. “I have had enough, LORD,” he said. “Take my life; I am no better than my ancestors.”

These are words of desperation that echo those who struggle with their mental health, and God’s reply to Elijah’s pain is to meet him with an encounter with an angel who urges him to sleep and eat, comforting him with the words “the journey is too much for you”. There is no reprimand for Elijah’s suffering, simply comfort for a tortured mind and provision for an exhausted body.

The answer, then, is to treat ourselves and others as the embodied creations we are, with mind and body inseparable and interconnected in ways that even science cannot quite explain or articulate.

The answer is to trust in the embodied hope of Christ, who chose to save us through not only his bodily crucifixion and resurrection, but through experiencing the breadth and depth of human emotions so that we may never again feel alone in them.

Both our bodies and our minds matter to God, and we need to see that reflected in society, where we care not just for single ailments, but the whole person. We need not just an awareness of our minds, but an understanding of what it means to be mentally healthy, as well as a recognition of the horrors of mental illness. Only then, I believe, can we see a society which cares and serves those most in need not simply as isolated symptoms, but as valuable creations.