Ageing in Prison
(Part one below)
Part Two: ministry to elderly lifers
Nelson Wing, Norwich prison, holds fifteen prisoners and combines custodial care with expert nursing: therefore a kind of hospice behind prison walls. It's a facility where some very ill patients either get better and move on in the prison system to what is called a category D prison, an open prison where there is much more freedom than in other categories, or they die there - eleven have died since the wing was opened three years ago.
When this unit was first opened I was asked if I would like to be a volunteer visitor on behalf of the Chaplaincy. I've never been a prison chaplain though I've worked with sex offenders in a prison for three months. I have also, as an extension of my work with the Samaritans, visited a lot of prisoners in penal establishments all over England helping with their particular problems of a sexual and gender identity nature.
Now my Thursday visits were to begin. I had no specialised preparation for working with older prisoners. The first day was not auspicious. I was greeted by a fierce-looking nursing sister who asked why I was there. I explained, flourishing my security pass. "I don't know why you bother - if I had my way I would keep them locked up and throw away the key". Nursing staff in such an environment receive an excellent salary - how could she give of her best to her patients when she so despised them? I didn't feel brave enough that day to confront her.
My visit was `cold calling' though I had been asked to look out for a particular prisoner whom a friend, a retired Bishop, had visited in another part of the prison before this unit opened. I've got to know J. well by now. He always seems glad to see me. In fact if I miss a week he wants to know why. There are currently twelve in the unit including hardened criminals who have been in prison up to forty years. One has done a degree in criminology. He wants to do a second degree on `The phenomenon of being a lifer'. The powers that be won't let him have access to the Internet to do some research. The team of visitors, one by one, coming in on a daily basis are trying to
help in an advocacy rote with the prison education department.
To read or not to read?
The educational spread is wide. Another prisoner, T., co-authored a book called `The Invisible Crying Tree'. It is a fascinating account of a developing friendship between T., a hardened con who has been in seventeen prisons, and a welt-educated farmer on the outside, Charles Morgan. When the friendship began T. could hardly read or write. The proceeds from the sate of the book helped set up 'The Shannon Trust' that helps other prisoners who are not literate (the 'Toe by Toe' system) and also eventually provides funds for lifers who are about to be released.
Then there's what one might call the 'scribe at the market gate'. B. has had his legs amputated. He uses a PC to write letters for those who can't write and types up menu sheets for the kitchen. He has a flair for spreadsheets. This year he has received a number of knockbacks. Due for possible release he was allowed home leave. I am not quite sure what happened, one version is that he went into a pub (forbidden for someone on day or home release) and was mugged. The other version is that he had more than one pint and was so unsteady with his wheelchair that the police arrested him. Either way he's lost all his privileges.
Some of the others, once tong ago fully grown, rough, wetl-built men are now physically shrunken and wizened. The highlight of their week is their tobacco allowance; recently there was great excitement when their weekly pocket money was doubted. One whizzes around in his wheelchair like a cheerful schoolboy, he's always smiling. Another has the richest vocabulary we ever heard -'f' this, 'f' that etc. Women visitors avoid him. The exponents of 'Toe by Toe', T. and R., who has the Master's degree, have tried to teach him to read and write. He adamantly refuses, establishing his independence by being different and being proud of it.
The birthday boy
One of my tasks is to keep a record of birthdays and make sure a card is sent. Our oldest inmate, P., had his 88th birthday a month or two ago. P. was a clockmaker. He collects old CDs and DVDs and with his own private money sends away for the parts, makes clocks out of them then gives them as gifts to all the staff and fellow cons. He's a lovely man. On the wall of his cell there is a large poster of birds: he used to do a lot of bird watching. Sadly he is developing Alzheimer's. He knows this and easily forgets what we talked about. He's due for a 'day out', escorted of course, and he's saved up to make the most of it. Some days I think that he is uneasy about leaving his cell that has turned into his sanctuary. The bustling City of Norwich may be too overwhelming.
Then there's G., from Liverpool originally. He was a pub and club singer, a contemporary of the Beatles. He's made a CD in prison recording such favourites as 'Danny Boy' and 'The Lord is my Shepherd'.
The end of the line
I've seen new arrivals at death's door revived by wonderful nursing care in what I can only call a resurrection awakening. Conversely, in spite of all the support, others die quickly or within a month or so. Recently I was asked to say a few words about a lifer who, on arrival, was not expected to live much longer. Most of his stomach had been removed; the cancer was very invasive. He was very frightened and though mobile, he spent most of his time in his cell. His wife came once a fortnight. She used the time she still had with A. to plan the downsizing of their home and removal into smaller accommodation. A. showed me the estate agent's brochure; he wanted to be reassured his wife would be settled. He was reticent about himself. On the wall of his cell were two small watercolours: he had painted them. There was obvious talent there, now sadly too late to develop.
METHADONE IN PRISON
There is a radical change taking place in the way in which drug addicts are treated in prison. Traditionally an addict entering prison would be detoxified- the classic detox. Even men coming in on a Methadone prescription would be detoxed as well. Recently a group of prisonsers challenged this in the courts and won their case under human rights legislation. Alongside this ruling was the growing realisation that a man de-toxed in prison and not helped to address the underlying issues related to his drug use would almost certainly return immediately to drug use on release and in a number of tragic cases die through over-dose.
Out of this unsatisfactory scenario IDTS has been born. Standing for Integrated Drug Treatment Service it aims to provide methadone in a strictly controlled environment alongside weekly reviews of each client and also runs alongside metadone prescription, interventions such as counselling, anger management, and substance misuse issues. Once travelling this road the only logical end is when all drug users inside and outside prison are on methadone 'medication'. At HMP Doncaster the numbers on this regime has recently passed 200, 15% of the prison. The number of drug workers has increased to beyond 20.
Those in favour of methadone point to the benefit of stabilisng chaotic lives and reducing the dependency of an addict on criminal activity to fund drug purchase. This view uses the word medication rather than 'drug use' and I have noticed a subtle shift in perception in the men and women we support as they move onto medication. It is possible to lead a reasonable working life on methadone.
The views against the use of this herion-substitute include its addictiveness - some say that it is harder to get off methadone than heroin. Methadone served up as a repeat prescription at a chemist and without any kind of intervention simply mirrors the tragedy of other drugs such as prozac dished out without any kind of review or aim to address long-standing root causes.
IDTS attempts to improve the treatment of drug users by addressing health needs, aiming to challenge behaviour, de-criminalise the use of drugs, greater openness about issues surrounding drugs.
Men are being maintained on doses as high as 120 ml of methadone per day but an average maintaining dose would be 50 -60ml. The IDTS programme aims to review the levels each week and in consultation with the client to reduce the amount slowly. If this is done too quickly the client destabilises and will 'top up' methadone with heroin or other substances.
The new world of methadone in prisons is an uneasy one. Men on methadone are less likely to want to engage in programmes and are often fixated on their daily dose. The sheer mechanics of moving 200 men safely and securely to their daily treatment is very challenging. Privately many of those involved in the programme are uneasy and feel as if litigation or the threat of it has been a backward step in the treatment of drug addicts.
As a Christian I can see the benefits of the resources which are being poured into helping people who have got themselves into a hopeless spiral of drug use. As a Chaplaincy team we work with a number of those on methadone in the prison. I can't say that any of them enjoy being on drugs. For many it is an escape from the pain of abuse , neglect, the total lack of love suffered as a child; when in pain everyone reaches for the pain killers, don't we? We believe in God's power and in prayer. We have been challenged to get closer to those on methadone in the prison. We honour the work that the drug team does in the prison, they work heroically in an often depressing situation but we will also seek to bring the perspective of faith to bear.
Women in prison
Ilona who spent 18 moths volunteering for Goole's Sobriety Project as part of her sentence is noiw in part-time paid work working for a hotel and animal home, she is eligible for parole in Autumn has written an account of her journey through the system. A journey that has taken her from large, brutal establishments to the supportive. rehabilitative environs of Askham Grange.
It is Ilona's belief that high security institutions may protect the public from dangerous criminals but women's prisons do little to assist the process of re-settling offenders.
In September 2004 I started an eight year prison sentence.On arrival, I was ushered into a grubby reception, and locked in a room with a number of other new detainees. It was like a cattle market.I was then led to another dirty room where three officers - holding an old blanket in front of me ordered me to strip. When they were satisfies I wasn't concealing contraband I was ordered to get dressed.After this humiliation, another two officers emptied my personal belongings onto a table and rumaged through my things as though they were at a jumble sale.Next came the reception duty doctor. Am I on drugs? 'No'. Am I on medication? `Yes'.I told him about prescription medication received through my GP The duty doctor replied, telling me the medication would be stopped until I was seen by the prison doctor. I was then sent away with a plastic cup and told to give a urine sample. That was that. No physical examination. No more questions. I had been dismissed.The inmates called Y Wing 'Beirut'! It vas like a war zone.
Alarms sounded day and night. Drugs were readily available. Bullying was part of everyday life. threats of aggression were constant. 'Decrutching' - where a woman, suspected of concealing drugs in her vagina, has them forcibly removed - was commonplace. Some women even set fire to their cells.I had a sense of foreboding; a feeling of being thrown to the wolves. We were sometimes locked in our cells for 24 hours a day. If an argument broke out, rather than deal with the two women involved, the whole wing would be locked up.
There was absolutely no privacy. I had to share my cell with another woman and we had to do everything in front of each other: use the toilet, change our sanitary towels, wash ourselves. There was no curtain or divider - just a toilet and a sink in the corner of the cell. It was and goes -against any notion of when I arrived on Y Wing nothing was explained to me. No one told me where or how I got my food, mail, phone calls, how I went about getting work, what choice of work or education was on offer. You have to rely on the other prisoners to pass on this kind of information.
One good thing was that I had been placed in a prison close to my family. I was allowed one visit a week which helped me, emotionally during those early days.
After a while I had settled in. I'd been moved from Y Wing to a self-catering house, started a number of courses, and was progressing positively.
Seven months into my sentence, after I had finished the normal offending behaviour programmes - enhanced thinking skills, anger management and so on - I was told I was to be moved to another establishment 25 miles away. Why?! I didn't understand. I felt I was being punished but apparently the decision was down to 'numbers'.
Many women dreaded the news that they are the next to go. I was frightened of being moved. I thought of how Jews must have felt waiting and wondering if they were going to be sent to a concentration camp. How long before they came to `ship me out' from familiar surroundings, from everything I'd been working on? How far would I be sent from my family?
Moving to a new establishment and being put back on a wing was upsetting and unsettling. It set me back in my personal sentence plan. The wing situation is not good. Sometimes there would be up to half a dozen 24 hour watches on one wing. A 24 hour watch is what happens when a prisoner is at such a risk to herself that an officer has to be present at all times. They record everything that happens, everything about her mood, who she's spoken to, when she took a shower and when she goes to the toilet. Despite this scrutiny, every night the alarm would sound - the signal that one of these women had attempted suicide.
Life on the wing was very hard. It was not acceptable to flush the toilet during the night, the walls were so thin everything could be heard. If someone snored they'd have problems with their neighbours. I heard everything my neighbour did - all bodily functions and daily ablutions.
Drugs were easily available. Bullying and intimidation from prisoners and staff seem to be an acceptable form of behaviour in prison. Prison doesn't work. I had to take every possible opportunity to get what I could from the system. Even then, I felt like i was fighting a losing battle - the prisons
I attended didn't do the courses I wanted, or that I had already started elsewhere.
There is nothing to be learnt by being locked up with a bunch of raging drug addicts that don't want to be rehabilitated or with prison officers that intimidate and bully.
Small units with more specialised civilian staff can work. They encourage women to rebuild their lives. Prisoners can even do many of the jobs that the officers and OSG's (Officers Support Group) are paid to do. The change I noticed when I was moved to Askham Grange was immense. Prisoners are treated with respect and there is a culture of trust.
Women need help and support, not the outdated military regimes of many prisons. I only succeeded because I am stronger than most of the poor shattered women 1 met.
Of course l believe some people shouldbe locked up. Yes, there are some extremely good officers. But there is also widespread unfairness - some of it is due to the new Prison Service Orders. I believe the government is breaking its own code of practice when it comes to fair treatment.
We must be allowed access to our families and partners, have support from housing agencies and employers if we are to be successful upon release. Isn't this what we all want? -`
Ageing in Prison
part one: Setting the scene post- Pierrepoint
The Norwich CCOA group meets once a month to reflect on new initiatives in the care of the elderly locally and to pray for people known to the group members. Among the local contacts is the Prison Chaplaincy at HMP Norwich where two of the group are visitorsThree years ago the prison set up a special unit (Nelson Wing) for elderly and infirm lifers; it is a welt-run hospice behind bars. There is accommodation for up to 15 prisoner-patients, their ages between fate fifties and late eighties. Sentenced to life formurder or a violent crime several have already spent up to forty years
behind bars. Some had naturally become so institutionalised that if ever released they would find it very difficult to adjust to the outsideworld. It is certainly a challenge to get to know them, there can be great suspicion of one's motivation, "Another do-gooder, I've seen them all" was the first comment on meeting one new arrival.
Extremely helpful on embarking on such a ministry are the words of Russian novelist Dostoyevsky in 1861. "Every man whoever they may be and however low they have fallen, requires, if only instinctively andunconsciously, respect to be given to his dignity as a human being. The prisoner is aware that he is a prisoner, an outcast, and he has noposition in respect to the authorities, but no bonds, no fetters, can
make him forget that he is a man. And since he is a human being,it follows that he must be treated as a human being. God knowstreatment as a human being may transform into a man again even one in whom the image of God has long been lost."
There are 81,000 people in UK prisons, the highest number in Europe, and more life sentence prisoners in the UK than the remainder of Western Europe put together. In March 2007, 2,010 prisoners over 60 were held in gaols in England and Wales including 1,036 over65. The number of sentenced prisoners aged 60 and over rose by 169% between 1995 and 2005. This UK increase is not explained by demographic trends, `an elderly wave'. The increases are due to harsher sentencing policies that have resulted in the Courts sending a large proportion of criminals of 60 and over into prison to serve
longer sentences. This is particularly so in the case of sex offenders and drug traffickers.
A most infamous figure in the history of the British penal system in the last century was Albert Pierrepoint, Public Executioner. A Prison Governor once said, "A man who wants to be an executioner must be in a class by himself." Pierrepoint was, during a period of nearly thirty years, in charge of the execution of 433 men and 17 women.
In 1955, to the amazement of the officials of the Home Office, he resigned. He seems to have had a Damascus Road conversion. In his autobiography 'Executioner Pierrepoint' he wrote, "During my 25 years as an executioner I believed with all my heart I was carrying out a public duty, I conducted each execution with great care and a clear conscience. I never allowed myself to get involved with the death penalty controversy." He continues, "I now sincerely hope that
no man is ever called upon to carry out another execution in my
country. I have come to the conclusion that executions solve nothing and are only an antiquated relic of a primitive desire for revenge which takes the easy way and hands the responsibility for revenge to other people."
Pierrepoint disagreed with the opinion that the death penalty can be a deterrent. The last execution in the UK was 23rd August 1964. It wasa simultaneous execution - one in Manchester, the other in Liverpool.
From time to time in the media the debate on reintroducing hanging arises and then closes down again. However there is a growing school of thought about what one might call `problem obliteration', out of sight, out of mind. The implications of locking people away, ostensiblyfor the rest of their lives, have not occurred to people.
Dr David Wilson, Criminologist at Birmingham University, in a recentbook `Death at the hands of the State' suggests older offenders being sentenced to a period of imprisonment in England and Wales are effectively being sentenced to death. His hypothesis is the UK criminal system has rapidly become the State's own death penalty. He maintains
a large number, usually unreported, kill themselves shortly after release they are too poorly equipped to face life on the outside having served a period in jail.
I came across examples of this last point in the 1970's when l was Deputy Director of the Samaritans in London - remember the last public execution was in 1964. Among the many distressed and fearful people who came to
our centre was a 69-year-old 'ex-con' who had spent more than half. his life (37 years) in and out of prison. Every time he was discharged from prison he quickly committed a misdemeanour to get back inside. A local magistrate got so angry with him, calling him a time waster, that he would not send him back to prison. In fact nothing would make the magistrate change his mind. He warned him -"that's not a licence to do something
really dangerous". The sad tittle man; obviously ten years older than his real age, said that he had no family, or friends and he had spent the small pittance the prison gave him on discharge. All that was left to him was suicide. We contacted the local probation service to see if they could findhim accommodation. He never returned.
How does it feel to be in prison?
One example: " I used to think prison life must be endless boredom and monotony with nothing much to worry about except the basic problem of making time pass quickly. But now I've discovered it's not that. You have plenty of worries here all the time though they may seem trivial in the normal world they are not at all trivial in the prison context. In
fact you're always having to chase after something, hunt for something, keep an eye on something, fear for something, hold your ground against something. It's a constant strain on the nerves, someone is always twanging on them, exacerbated by the fact that on many important instances you cannot behave authentically and must keep your thoughts to yourself"
(President Havel)
Erwin James, a lifer for more than 20 years, in the latter part of his sentence wrote a regular newspaper column from within a prison. He explained how he, six foot two inches tall and sixteen stone, soon figured out on his arrival in prison the best survival strategy. This was to try to appear tough. Appearance mattered. Looking like one could handle oneself in a fight ensured a generous measure of respect. So he
embarked on a vigorous in-cell( fitness routine of press-ups, sit-ups and running on the spot until he was drenched in sweat every day without
fail. He wrote: "Within a few weeks I had established a way of living that was almost revitalised in sleep, read, exercise, wash, eat, read, sleep. I had no idea how long., this experience was going to last but i knew that through it all my first priority was going to be survival" Erwin continues: "You have to be careful how much of your real self you reveal in these places if you want to survive, otherwise you'll be eaten alive no matter how big and tough you might took. There can be a lot of anger just below the surface. It's brought on by stress. I get lost in rage. I have forty adjudications for fighting, wrecking cells,
refusing work, attacking screws (prison officers), wrecking everything and anything. There's an awful shame and no forgetting in murder."
And here are the words of another: "I don't know a single lifer who in the still dark hours, does not twist and turn under the weight of his crime. You kilt someone, it comes back to haunt you. But this isn't every minute of the day. We live as normal a life as we are able; we enjoy good TV, a funny joke, a nice brew. Our conscience doesn't dull our human qualities. The weight of the blood on our hands does not ease with the years. Perhaps the older we get the more we appreciate the enormity of what we have taken."
Supposing you are in prison for the first time and you are an older person? "I'd never been in prison before, they took me on the Wing, it was four floors high and I was on the top floor. The noise was tremendous; it just seemed to echo around me. I ended up sharing the cell with a younger chap: at least it meant I wasn't on the top bunk"
The age definition used to define older prisoners varies considerably between the ages of 45 and 65 upwards. In the last decade the phenomenon of the increasing number of older/elderly/infirm prisoners
and offenders is being documented. Here are some of the findings: -
1. Older prisoners experience the same as younger prisoners with respect to coping, entry-shock, adaptation and psychological survival.
2. They have the same need to engage in worthwhile activities as their younger counterparts. They need to feel that they are part of something. Yet that something is not always there for them as it is for younger groups.
3. Older prisoners therefore are more vulnerable because they
find it difficult to cope with the physical and mental stresses
and other demands of serving a sentence in an environment
containing large numbers of younger people. They are, as it
were, housed in an institution designed with young people in
mind. For instance if your favourite music is 1970's and 1980's
and most others around you go for, say, Jacko, Robbie Williams, Rap.
4. Older prisoners are likely to be serving longer sentences, 20% are lifers.
5. They are more likely to have been convicted of a violent or sexual offence if they are men. 17% have committed violent offences; approximately 50% have committed sexual offences. Drug offences are the most common types of offences committed by female prisoners.
6. Older prisoners are likely to have been in prison before (50%)
7. They are often more vulnerable because they find it difficult to cope with the physical and mental stresses of prison life.
8. They have not benefited from prison programmes, which are
usually not geared towards the needs of older prisoners especially offending behaviour, education, vocational and employment programmes:' Why do I need to do ail these courses at my age?
Are they really expecting me to get a job when I am released?'
9. They age up to ten years more than their biological age whilst in prison
10. They have poorer health than their peer's in the community.
11. They have a multiplicity of healthcare issues: longstanding
chronic illness or disability (80%); mental disorders (50%);
diagnosis of depression (30%). In general they pose fewer
problems for prison staff who call them `wallpaper people'.
Result, their needs are forgotten or neglected
12. They may not have family or community links. One third
had not received a letter during a three-month period.
13. They are harder to resettle because they are more likely to
have become institutionalised. Also they have a huge range
of different housing needs, especially older sex offenders
and those with disabilities.
Michael Butler
Sentencing
Judges are highly critical of the proposed Violent Offender Orders. These are similar to the Sex Offender Orders which contain draconian requirements regarding geographical restriction, constraints regarding criminal associates, etc. These orders can extend for several years beyond the end of prison and/or community sentences. The National Probation Service has met challenging targets in relation to enforcement of community orders and post-release licenses and achieved significant annual improvements in performance. The consequence of this has been a dramatic increase in the number of offenders returned to custody for failure to comply with supervision requirements. Last year, there were approximately 8,000 prisoners incarcerated for technical breaches of orders and licenses. These are effectively life sentences for persons convicted of serious violent or sexual offences for which the maximum sentence is ten years or more and where the judge assesses that the offender poses a risk to public safety. The difficulty with these sentences lies in the setting of the tariff (i.e. the minimum term to be spent in custody to satisfy the punishment element of the sentence). For instance, if an offender is convicted of grievous bodily harm the determinate sentence might be 3 years. But, if the judge imposes an IPP, then the offender cannot be released until their risk to the public is assessed as being significantly reduced. However, the tariff for the offence might be set at 3 years and it would be expected that the offender would be a candidate for release on license at any point after that, as long as the risk they posed had been reduced or eliminated.
If however, there are no opportunities for the offender to address their risk factors prior to the tariff date, then they remains in custody until they have completed whatever courses, programmes, etc., that are considered relevant to their offending behaviour.
This was the background to the case in Hull, where the prisoner successfully sued the Government for not providing the opportunities to address his risk factors and hence he had to remain in prison long past his tariff date. These sentences are contributing significantly to the rising prison population, with over 3,000 inmates currently subject to IPP's.
Prisoners can be released up to 18 days prior to their normal release date if they pose no risk to the public. They are subject to license conditions but have had little chance to plan for their resettlement. There has been an anomaly regarding their access to benefits in that they cannot 'sign on' until they have finished their sentences. Hence they are often having to rely on a discharge grant, which is nowhere near adequate for their needs for the 4 week (and sometimes more) period between release and their access to benefits.
The Government have come up with a couple of short-term solutions that have proved to be inadequate and inconsistently administered. Some offenders released under this scheme have re-offended and been returned to prison. This scheme had an immediate effect in lowering the prison population by about 1500 or so, but the numbers have recovered since its implementation.
There have been two tenders issued to design, build and manage new prisons. It will take well over a year for the bids to be submitted, assessed and for the work to be completed and the prisons become operational. This is further evidence that it will not be possible for the Government to build its way out of the overcrowding crisis. It needs to be remembered that a significant proportion of the 80,000 currently in prison are sharing two to a cell and there is still a lot of slopping out going on.