Howard League blog · 7 Apr 2022
The mental health consequences of imprisonment during the pandemic
This blogpost is the second in a series on Howard League members’ experiences in prison during the pandemic. It focuses on the mental health impact of lockdown restrictions, as part of a survey carried out in February and March 2022. We are hugely grateful to these members for taking the time to write about their, often very upsetting, experiences and for giving us permission to share them with you.
Our first blogpost discussed what our members in prison, and those with a family member in prison, told us about the pandemic restrictions. People explained that the restricted regimes in prison had become increasingly out-of-step with the response to Covid in the outside world. Omicron had struck just as prisons were beginning to return to normal, and staff shortages have meant that regimes are still inadequate.
This blogpost reports the mental health consequences of two years of confinement and isolation. Though a few older people explained that they had not minded or had even preferred the restricted regimes, most members described a significant and potentially long-term cost to their wellbeing and mental health.
A mental health crisis
The responses described widespread mental ill-health during the pandemic, with little support from professionals or trained peers. Family members had been unable to help relatives whose mental health was deteriorating in prison and the suspension of visits had affected their wellbeing too.
In our response to the Prisons Strategy White Paper, we highlighted research which shows that people can struggle with social interactions after a long period in prison segregation. We suggested that this might also apply to people confined during the pandemic. In her survey response, one member explained that this had been her experience:
It has had an impact on my mental health, I now suffer from anxiety and struggle to go to places around the jail where there are groups.
Another woman felt that such a long period of isolation had created a “Mental Health crisis”. She described prisons as “warehouses of misery inhabited by human beings” and explained that mental health provision was:
… almost non existent. Prison officers not trained to cope with ever increasing poor mental health of prisoners. Lack of medically trained staff. Dementia patients left in limbo between prison + social care, screaming, banging on doors, all adding to trauma of longterm restrictions in free association, exercise, education.
Alongside the mental health impact of prolonged isolation, people described the difficult process of accessing support during the pandemic, noting that they had often had to wait a long time.
One man explained that although he had a medical assessment on arrival, he did not receive the necessary medication for his mental and physical health and struggled to access healthcare. He described spending 23 hours in his cell with little ventilation during a heatwave. At other times, he had been refused exercise or access to washing facilities even when it was his turn. Overall, he had found prison:
very lonely & sometimes frightening … very disorganized with many officers informing me of different news & information to other officers & was very misleading, this was also the case [with] the healthcare.
Another man told us that in his prison, “[m]any struggled with their mental health with some self-harming and not having anyone to talk to when in trouble”. He had struggled himself and had needed to deal with his own mental health problems alone, unable to rely on support even when he asked for it.
At the same time, he explained, people had checked in on those in neighbouring cells and he had personally bought extra canteen for others. As he put it:
While I struggled with my own demons it felt right to help others and not look for a reward, this is the first time I have said to anyone what I did because I may have got in trouble, but it was the right thing to do if it helped.
In the outside world, the pandemic initially led to a surge of mutual support and care for others. This response suggests that in some prisons too, people looked out for one another as best as they could despite the difficult circumstances.
A few people – all older – told us that they had not minded the restrictions or had even preferred the relative calm of lockdown. As one put it: “I have felt no pressures from the restricted regime. I am retired and can cope with more isolation.” However, most people had found the pandemic very difficult.
Several people described how they, or others in their prison, had coped with the loss of social contact and meaningful activity. One man described prison as “a living nightmare” and explained that keeping himself busy was a crucial part of staying well. Lockdown had made this much harder, though not impossible:
Pre-lockdown I used to be out of my cell all day doing a wide variety of purposeful and leisure activities; [Therapeutic Communities] therapy, IT tutor, Shannon Trust mentor, prison band guitarist, prison choir member, Christian Fellowship groups and services, gym, football, weekly family visits, etc, etc – ALL *STOPPED*
Even my cataracts eye surgery was cancelled so I had the worry of steadily going blind with no end in sight (pardon the pun). In and out of prison I’ve always been a very sociable + busy person, so suddenly having nothing to do and serious isolation and worry for family + society to cope with, it was a real test of character. I’m pleased to say I’ve coped very well over the past 2 years, staying positive, physically + mentally well, and keeping myself busy.
Not everyone managed to cope so well. As the responses quoted in the previous section show, many people struggled with mental ill-health. Two men explained that in their prisons, people had tried to escape the monotony of lockdown by using drugs, alcohol, prescription drugs or psychoactive substances. The relationship between lockdown and substance abuse was also described in a recent Independent Monitoring Board report. One member told us that during the restricted regimes:
Mental health was punished & physical health was a joke … Prisoners were buying medication & swapping & mixing pills to get them through the day, a lot of debt has accrued.
The government has committed to tackling substance misuse, drug debts, and the violence which can be caused by debt in prison. But as the Howard League has previously warned, people will be drawn to substances as a means of escape if there is no alternative. The problem cannot be solved solely by an increase in gate security and drug recovery wings. Instead, Her Majesty’s Prison and Probation Service must move towards meaningful regimes with far more time out of cell.
As prisons ease restrictions, the mental health impact of long-term confinement must also be recognised and addressed through accessible support. There needs to be recognition that a return to regime and spending time with other prisoners and staff will be challenging for many people, as the member who now finds herself struggling with anxiety around groups explained.
Unless prisoners and staff are properly supported in the return to regime, there is a real danger that, far from ending, the mental health crisis caused by the pandemic will have just begun.