Prisons and the mentally ill: the need to look beyond punitiveness

By Siddhartha Bandyopadhyay

20 January 2020

Tougher criminal justice sanctions are often advocated by politicians who say this reflects public opinion on how to treat criminals, but this is only part of the story.

Many do support cost-effective, rehabilitative options over punishment. Indeed, this seems to be reflected in opinion polls suggesting a large majority of the population not only support prison but advocate harsher prison conditions. Yet, just as many support rehabilitation and when presented with evidence around the cost of prison, a vast majority support looking for cheaper alternatives to prison. This suggests that a move towards criminal justice reforms can be politically viable and gain public support if the public is presented with adequate information about the criminal justice system.

One particular issue that may influence popular opinion is the existence of systemic inequality in the criminal justice system. For instance, data from a recent report by Justice shows that 39 per cent of people detained by the police, 29 per cent of people on community sentences and 90 per cent of people in prison suffer from mental health issues. This suggests that either prison is severely damaging for mental health or people with mental health issues are more likely to go to prison (or both). Either of these suggest that the simplistic vision of people in prison being the so-called ‘bad guys’ who should stay there, is deeply flawed and we need to re-examine our understanding of who goes to prison.

Indeed, the number of self-inflicted deaths and self-harm incidents in prison has been called ‘appalling’ in a recent report by the Public Accounts Committee. In the face of these facts becoming widely known, it is likely that popular support for prisons will fall, given the strong support there already exists among the public for rehabilitation.

In addition, there is growing evidence that inequality starts at birth and early childhood. Work around ACEs (adverse childhood experiences)suggests a strong correlation between adversity at childhood (e.g. witnessing abuse in the family, living with parents who are addicts, divorced parents, experiencing neglect and abuse) and several negative outcomes in adult life. People with ACEs also face a higher risk of mental illness and criminalisation. Further awareness around ACEs would strengthen the case for a response that treats the underlying trauma and not criminalise those with ACEs.

Government responses as always have been mixed. On the one hand, steps towards building more prisons, increasing police numbers and tough statements coming from the Home Secretary suggest a move towards enforcement and criminalisation. Yet, the recent setting up of violence reduction units across the country explicitly advocate a whole system public health approach with emphasis on primary, secondary and tertiary prevention.

The last government’s announcement states that ‘The Violence Reduction Units will bring together different organisations, including the police, local government, health, community leaders and other key partners to tackle violent crime by understanding its root causes’.

With an increased mandate, one certainly hopes the new government does not reverse course on this and instead focuses on preventative activities that have the potential to lower inequalities in the criminal justice system. These preventative steps by themselves may not be enough without measures that reduce inequality in society. Nonetheless, they are steps in the right direction by trying to keep vulnerable people out of the criminal justice system.


Siddhartha Bandyopadhyay is Professor of Economics and Director of the Centre for Crime, Justice and Policing, University of Birmingham

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