The ups and downs of working in a prison mental health team

Ben Ross, winner of the Adult Social Worker of the Year award 2012, shares the rewards and challenges of helping prison leavers to settle back into the community.

What my job involves:

I am part of the mental health team at HMP Nottingham. This is a busy remand prison containing 1,000 men aged over 18, sentenced and unsentenced, from courts in Nottinghamshire and Derbyshire. Rates of mental disorder among prisoners is much higher then the general population and, in many cases, complicated by childhood trauma, drug and alcohol problems, homelessness and social isolation. Many of the men have no positive relationships, little in the way of educational achievement and no experience of employment. They don’t have any stability in the community in terms of housing, finances, health care and positive relationships with other people. For many, the prison gate has become a revolving door of repeated remands and short sentences.

I am still shocked by how many men tell me they prefer to be in prison than outside because it meets their basic needs of shelter, warmth, structure, predictability and human relationships with staff and other prisoners. My job is to try to support people to succeed in the community. This involves helping people with practical issues such as housing, finances and accessing physical and psychiatric health care, as well as encouraging people to be more optimistic about their futures. I also help people who have just arrived in prison to try to ensure their existing accommodation, benefits and support services are in place when they leave. Mainly, though, I’m supporting people who have been released from prison to resettle back into the community.

Best part of the job:

A visit I have planned later today to see a 37-year-old service user who has been out of prison for over nine months, having spent much of his childhood in local authority care and virtually the whole of his adult life in prison, usually for burglary. When I telephoned to set up the appointment he was pleased to tell me that, for the first time he can remember he has a suntan, because he hasn’t been in prison over the summer months. He is living independently for the first time and has been doing some occasional gardening work, having answered an advert in a local shop. He’s drug free and talking about a lifestyle which does not involve returning to prison, he has reconciled with family members who he thought had given up on him, his mental health is much more stable and there have been no instances of self-harm or suicidal thoughts for several months.

Biggest challenge:

There are practical challenges to helping prison leavers settle back into the community without reoffending. For example, they are released with a discharge grant of £46, which is intended to last until benefits are in payment. However, it can take several weeks to receive a payment and the scrapping of crisis loans last April made it more difficult to find a legitimate source of income in the meantime. For men who are homeless on release, it is becoming harder to find suitable accommodation. One of the cities in the area I cover has reduced its hostel/supported accommodation by 80% since April and many local authorities don’t feel a duty to house prison-leavers.

One of the biggest challenges we face is that our clients don’t fit neatly into the specification of many community-based services. They may have a mental health problem, as well as a drug or alcohol problem, an offending history, no accommodation, no GP and, sometimes, limited motivation to engage. This complexity is all too often used as a reason to exclude prison leavers from mainstream services.

Another obstacle is the lack of belief that many service users have that change is possible. A lifetime of experiences of trauma, rejection and social exclusion does not make for people who have much faith in themselves or trust in others. Possibly the biggest challenge is trying to encourage the people I’m working with to maintain a focus on a different future for themselves when things are not going well and when reoffending and returning to prison, self-harming or just disengaging from services has been their way of managing adversity in the past.

Why I became a social worker:

In my mid-20s, I volunteered with the Citizens’ Advice Bureau and, while I was there, we set up a monthly advice session for young men in a local young offenders institute. This made a big impression on me. These men were there because they had broken the law and frequently harmed others through theft or violence – many had also experienced deprivation or trauma as children and had little sense of belonging in society. Yet most of them had quite conventional goals in life, in terms of some stability in housing, finances, work and relationships. The problem very often was that they had few positive experiences from their past to draw on to help them succeed and little confidence in their ability to achieve their goals. This raised all sorts of questions in my mind about criminal responsibility, how and why people change their values and behaviour and how, as a society, we respond to people who offend. So, I decided I wanted to train for the probation service. Its underpinning ethos was to “advise, assist and befriend” on the basis that changing people’s attitudes and behaviour was most likely to come about through a consistent, positive relationship with a person who could challenge, encourage and support them. Since then, I’ve worked as a social worker in drug and alcohol services, in a forensic mental health team and, for the last three years, in the mental health service at HMP Nottingham.

The one thing the government could change to make my job easier:

I don’t want the government to make my job easier; what I hope for is a change in approach that reduces the number of people with mental health problems in prison. This needs some properly joined together thinking, including improved resourcing of community mental health services, diversion from prosecution for people who are mentally ill where appropriate, a sentencing policy which encourages the use community sentences in preference to short prison terms and adequate support for people with mental health problems being released from prison. The Ministry of Justice’s figures put the cost of keeping one person in prison for a year at over £37,000. According to the Mental Health Foundation, over 70% of the prison population have two or more mental disorders. Around 60% of prisoners released from HMP Nottingham are reconvicted within a year. There must be a more rational way of responding to offending by mentally disordered offenders than incarcerating them in prisons and disrupting already tenuous community ties.

The Social Worker of the Year Awards 2013 are now open for entries. Find out more and apply

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