Consensus on women in prison, but where's the action?

There has been more inexplicable delay in the government’s plans for women in criminal justice. It renders urgent the question of how to address women’s health issues and the harmful impact of incarceration. Liaison and Diversion schemes are already in place for some cases in some parts of the country. They can and should be expanded.   

Women in criminal justice are at increased risk of poor mental and physical health often because of adverse events in childhood such as neglect and sexual abuse. Where it exists, a model of diversion provided by the NHS exists to facilitate health care from the point of arrest, from police custody and from the courts. 

The case for diversion is clear

For women, early intervention has the greatest chance of improving health and life chances for women, for children and for the wider community. For reducing the costs of crime to communities, diversion to community sentences is more likely to reduce reoffending. For children, ending the unimaginably life shattering impact of a mother’s imprisonment makes the cost of continued inaction especially wicked.

Select Committees have repeatedly pressed governments to address the conditions leading to women’s offending. Successive ministers of justice accept these authoritative recommendations. Yet again and again, they miss opportunities to translate life saving, cost saving, crime reducing evidence into policy and practice. The population of women in prison has risen to levels double the rate of the early 90s for a number of reasons. Women continue to be criminalised for non-violent, low risk, drug related crime. At the same time, increases in sentence length and rising re-conviction rates mean the population continues to rise. 

Prison isn’t working

Despite being less than five per cent of the prison population, women’s prisons account for over a quarter of the reported incidents of serious self-harm.

Over half of all women in prison are said to have attempted suicide.  Since the publication of the Corston Report in 2007, which called for alternatives to custody, almost 100 more women have taken their own lives in prison.  

Many women leave prison still beleaguered by the debt, mental and physical ill health, or substance abuse problems they entered with and facing the additional burden of having lost their homes and their children.  The Prison Reform Trust estimates that some 18,000 children are separated from their mothers each year because of imprisonment, often permanently.

By any measure, this level of inertia in government policy ignores a degree of human suffering and misuse of public resources that would be incomprehensible in other parts of public life.  

Diversion services

Baroness Corston’s report was the first to reveal the extent of the warehousing of women in prisons ill equipped to meet their needs, especially for recovery from drug and substance use. Hers and subsequent reports from Health and Justice Select Committees, Chief Inspectors of Prisons, the Prison and Probation Ombudsman and academics identify many women whose needs would be better met through diversion to health services such as:

• Women with severe mental health problems.
• Women whose incarceration would lead to worsening mental or physical ill health.  This is especially likely for women who may be re-traumatised because of health harming behaviors related to early childhood abuse.
• Women who are pregnant or primary carers for children where the crimes committed were non-violent. Women’s prisons are often located far from home, making it difficult for families to see each other. Barriers to maintaining family relationships lead to maternal distress and have devastating long-term impacts for children.
• Women whose crimes were related to domestic violence, rape or abuse.  Women are highly likely to be victims as well as offenders. 
• Women who are addicted to drugs or alcohol.  Sentencing decisions are sometimes made with the expectation that treatment in prison will lead to sustained recovery.  The government’s own research shows that this is not the case. There is also still an alarmingly high risk of death from drug overdose immediately following release from prison.  
• Women with serious physical illnesses or complex disorders requiring ongoing specialist care.   
• Women with learning disabilities, especially where incarceration would be profoundly confusing and distressing and unlikely to address behavioural issues.
• Women at the end of life.   
• Young women, where incarceration has been proven to disproportionately increase criminality.  Diversion will aid early diagnosis of mental health problems that may be associated with risks of criminality.   
• Black and minority ethnic women especially where frank discrimination contributing to their incarceration will create mental distress.
• Foreign national women committing minor crimes or where crimes are related to coercion or trafficking.  This is especially important for women who are primary carers for children with few social networks of support. Sentencing to custodial units, including for remand, with little language or cultural support is isolating and creates mental distress.
• Women remanded who are unlikely to be given a custodial sentence especially where this is likely to cause delays in health assessment. 

After the Corston Report: Consensus achieved

What is encouraging about these recommendations is the consensus reached. Politicians drawn from all parties reviewing a broad range of evidence all call for a more effective, more human rights response. They conclude that prison is rarely appropriate for women’s offending noting that costly management through criminal justice is ineffective and harmful. They recommend that prevention and early diagnosis through health and social care would substantially reduce the number of women in prison, keep women safe from harm, vastly reduce risks to children and cut the costs of crime to communities. 

What more can it possibly take to prompt the ministerial leadership to take decisive action?

Alison Frater is an independent consultant in public health currently working to improve the health of women in the criminal justice system. She is a Visiting Professor in the School of Law at Royal Holloway University of London, a trustee of Clinks and chairs the National Criminal Justice Arts Alliance.