The Guardian is presently doing a series of stories on prisons

Sick, suicidal - and locked up in jail


A shocking new report claims that too many of the 4,300 women in Britain's prisons are vulnerable and a danger to themselves - and already this year two have taken their own lives

Jamie Doward, home affairs editor
Sunday March 4, 2007
The Observer

Susan's mother saw bodies in the walls of her house and blood pouring from the ceiling. She attacked her husband with an axe. One day she painted the outside of her house pink, including the lawn.

Even before she had hit puberty, Susan was encouraged by her mother, who was prone to hallucinations, to drink alcohol. For Susan it was a way of coping with her mother's violence and her manic mood swings. Soon Susan was taking amphetamines. When she was 13, Susan's mother took her out of school. Social workers noted Susan had become a 'virtual prisoner' in her own home.

By the time she was 17 Susan was a real prisoner, serving a sentence for assault. Uncared for, confused and emotionally unstable, she and an acquaintance had kidnapped a girl, tied her up and cut off her hair. Prison was not a place for a vulnerable teenager and the self-harm got worse, with Susan regularly covered in blood after slashing her wrists. She is now in a secure psychiatric unit.

Susan's story is typical of many of the 4,300 women currently in the UK's prisons. Now a government-commissioned review, to be published in the next few days, will warn there are too many Susans in prison, too many vulnerable women prone to suicide and self-harm.

Baroness Jean Corston's review was triggered by the deaths of six female inmates at Styal jail in Cheshire over a 12-month period, starting in August 2002. The deaths came after a highly critical report by the Chief Inspector of Prisons that recommended sweeping changes at the prison, few of which were acted upon.

Experts who have worked on the review, including Juliet Lyon, director of the Prison Reform Trust, believe Corston will not pull her punches, given the information with which she has been presented.

Corston's message is expected to be stark: the prison system is not suited to caring for vulnerable women. Instead Corston is set to argue there is a need for a fundamental policy shift, with much greater emphasis on community-based rehabilitation programmes and less on incarceration. The report is expected to be a watershed moment for the prison service, leading to significant changes in the way women prisoners are treated.

'We are looking to this report to set out a clear, unequivocal case for a reduction in the needless imprisonment of women,' Lyon said. 'We hope it will present the strategic blueprint for responsible reform.'

The review will also highlight the tragic circumstances that result in many vulnerable women ending up in prison. Susan's story is again instructive. Her mental health deteriorated dramatically as she was moved around fostering agencies and bed-and-breakfast accommodation. Then, at 15, she was placed in a specialist care centre where, with intensive supervision, she started to stabilise her life and self-harm more infrequently. On her 16th birthday, staff hired Susan a dress and bought her a cake. Her mother refused to come to the party. Her father was in prison at the time.

Then Susan's local authority stopped paying for her treatment. She was placed in a council flat on a sink estate, despite warnings from social services teams that the area was riddled with drugs. Unable to cope on her own, Susan hooked up with another teenager. In 2003 the pair kidnapped another girl, tied her up and cut off her hair as they demanded money. Susan was found guilty and sent to prison, where she spent almost 22 hours a day in a small cell. She self-harmed on an almost daily basis.

A report written by a young offender treatment worker monitoring Susan when she entered the prison system noted: 'Susan seems to be a typical example of the type of prisoner with mental health problems, treatable or not, that the [prison] service does not seem able to deal with, however hard they try.'

On 11 September 2005, Susan was rushed to hospital for a blood transfusion, having slashed herself repeatedly. She came close to death. Susan is now in a specialist psychiatric unit where she is said to be making progress.

Susan's desperate life before being moved to the unit is recorded in a bulging file presented to the government's Treasury solicitors, who have launched an official inquiry, the first of its kind, into allegations that she was failed by a series of public agencies.

'She was allowed to slip through the net and nothing was done until it was far too late,' said Frances Crook, director of the Howard League for Penal Reform, which is backing Susan's case. 'People used to pay to gawp at mad women in Bedlam. Now we simply use the criminal justice system to treat people whose behaviour ranges from the bizarre to the dangerous.'

Susan survived. Just. Others were not so lucky. Sarah Campbell, an 18-year-old former heroin addict who suffered from clinical depression, committed suicide in January 2003, a day after she started her sentence for manslaughter at Styal. Her mother, Pauline, said Sarah was terrified about returning to the prison, having spent six months at Styal on remand. 'Every time I visited her [while on remand] I saw a marked deterioration in her mental and physical state,' Pauline said after her daughter's death. 'She didn't receive the care she needed to treat her addiction and she was kept locked in her cell for 23 hours a day.'

Many of the women currently residing in Britain's prison system have much in common with Susan and Sarah. 'The rates of mental illness among women in prison are horrendously high,' said Cathy Stancer, director of the campaign group Women in Prison. 'The majority suffer from at least one mental illness. Most come from extremely chaotic backgrounds.'

The Howard League's files are littered with such cases. 'These women don't come from nice families,' Crook said. 'They come from families who inject them with heroin, who prostitute them, who drop them on their heads.'

Two women have already killed themselves in British prisons this year. 'We went to Holloway prison the other week,' Stancer said. 'All the staff talked about was the number of women they had to cut down every night because they were wrapping ligatures around their necks.'

Those women who have been inside say suicidal urges are common. 'During the two and half years of my incarceration I was to discover the depths of despair one can fall into,' one former woman prisoner told the Prison Reform Trust. 'I learnt about self-harm, physically and emotionally; I learnt how to survive, yet at the same time how it feels to want to die every day. Prison is not a place for the mentally ill, and too many women are there already that should not be.'

Campaigners warn suicides and self-harm will become more frequent if the government fails to take action after Corston publishes her review. Over the last decade, the number of women in prison has increased by 173 per cent, placing acute pressure on the prison service.

'Staff say they find it very difficult to look after women with support needs,' Stancer said. The statistics tell the story. One in five women prisoners has been in local authority care; 40 per cent of those on remand have used heroin; more than half have suffered domestic violence; and a third have been sexually abused.

Recently pressures on prisons have been greatly exacerbated by the use of 'indeterminate sentences' - custody without a fixed release date. This new form of sentencing is handed down by judges in cases where the offender is classed as being a risk to themselves or society. Campaigners argue indeterminate sentences are simply a custodial solution to a mental health problem.

The decision to lock up more and more women has been regularly attacked by penal reform groups. They point out two thirds of women in custody are actually on remand. Of these, fewer than half receive a prison sentence, while one in five is acquitted. Fewer than 10 per cent of women remanded into custody are charged with violent offences.

And far from helping those inside go on the 'straight and narrow', prison contributes to their problems once outside, according to campaigners. Rehabilitation charity Nacro found almost 40 per cent of women prisoners had lost their homes as a result of imprisonment. Each year the living arrangements of some 8,000 children are affected by the imprisonment of their mothers, according to the government's Social Exclusion Unit.

Given such factors, penal reform campaigners say it is hardly surprising reoffending rates among female prisoners now stand at 65 per cent.

The Howard League says it is often councils that are to blame, claiming officials often do not pick up the warning signs that teenagers are in trouble and do not intervene promptly enough. The league cites the current example of a 17-year-old heroin user and former prostitute.

Her mother argued she should have been classified as a 'child in need' by social services when she came out of prison. Concerned her daughter would simply end up in bed-and-breakfast accommodation, her mother took her in, despite having severe problems of her own. With a lack of support from social services and desperate to feed her drug habit, the daughter turned to crime. The teenager is now back in custody.

Among the desperate stories there are rays of sunshine. The 218 Project in Glasgow, a community-based programme that offers help and support to women offenders and was visited by Corston, is considered a success and is likely to feature highly in the review's recommendations of what should be done.

But campaigners say these types of holistic programmes, which offer everything from advice on housing to getting a job, are rare. Unless this changes they warn there will be more Susans and more suicides as vulnerable women continue to be lost in the prison system.

On the desk of Chris Callender, a solicitor with the Howard League, there are a number of gifts Susan has made for him. There is a small, carved wooden tree, a Christmas bauble, a photograph frame and a coaster made out of plastic beads. Tiny trinkets of thanks. Callender looked at the objects with pride and some anger. 'We're all she's got,' he said.

· Some names have been changed.

In figures

4,334women are in prison
64 per cent of women offenders serve sentences of 6 months or less
1/3 of those have been sexually abused
37 per cent of women offenders attempt suicide before prison
70 per cent of women offenders suffer from two or more mental disorders
5 the number of times women are more likely to injure themselves in prison than men
55 per cent of women test positive for class A drugs on arrival in custody