Basic Regime and Mental Health

I can certainly confirm from first-hand experience that prisons do accommodate a significant number of prisoners who live with mental health problems. As a rule, prison healthcare provision is pretty limited at best and, in the worst cases, is both neglectful and sometimes negligent. The situation with mental health services is generally even worse. In some prisons, inmates actually need to self-harm or make a suicide bid in order to even get a referral to mental health staff.

However, what seems to be lacking from the debate is a recognition that imprisonment itself not only makes existing mental health conditions worse, but that the increasing use of longer sentences, an ageing prison population and increasing use of the Basic regime (effective solitary confinement, elimination of supportive human contact, prohibition of most personal property and very restrictive access to showers, payphones and money to purchase phone credit and stamps) are all contributing to deteriorating mental health among prisoners, particularly those who are already vulnerable.

Since 1 November 2013, when the new Incentives and Earned Privileges (IEP) system - PSI 30/2013 - came into effect, it has become much easier for prison staff to place prisoners on the Basic regime. Checks and balances to guard against abuse of the system have now been reduced or eliminated. As more prisoners are placed on the harshest regime, self-harm is on the increase. Moreover, the suicide rate has also increased to the point that it has more than doubled in 2013-2014, a worrying trend that has been flagged up by the Prisons and Probation Ombudsman.

Cell door from the inside

Perhaps the most disturbing element of the new IEP system is the clear determination to pressure prisoners who are maintaining innocence into making false confessions. These are mandatory as a condition of prisoners being able to undertake certain 'offending behaviour' programmes. Without a confession they are ineligible or unsuitable to participate in the courses. Without courses, many prisoners can't follow their sentence plans and the punishment for not following the sentence plan can be demotion to the Basic regime.

Had the current arrangements been in place in the past, prisoners such as Stefan Kiszko, Stephen Downing, Victor Nealon, Sally Clark and many others whose convictions were subsequently quashed, could have all faced many years on the Basic regime solely because they refused to confess to 'crimes' that none of them had committed. It is perhaps hardly surprising that under such pressure mental health deteriorates rapidly - a well-documented consequence of solitary confinement and social deprivation.

What is also worrying is that there appears to be little or no recognition that, as a society, we are doing nothing to improve mental health among prisoners, the vast majority of whom will be released back in local communities at some point. The human - and economic - cost of deteriorating mental health among prisoners is something that should concern us all.