Coping in the chaos: Pentonville’s neurodiverse unit is changing prison life

A radical and caring prison experiment has changed both prisoners and wardens. Nick Jones visited London's oldest prison.

Nick Jones

Nick is the senior editor of Seen & Unseen.

An arched gateway to a prison sits behind a low raised wall. No windows are visible

First opened in 1842, Pentonville Prison serves a large part of central and east London.

Ben Sutherland via Wikimedia Commons

A London prison has seen a reduction in violence among prisoners and improved staff morale thanks to a new neurodiverse unit.  Pentonville prison’s new unit identifies and treats prisoners with autism, brain-injury, learning difficulties and even dementia.

Jo Davies, Pentonville’s managing chaplain, helped set up the programme after conducting many regular prisoner reviews with colleagues. She noted that there was an apparent higher incidence of autism among prisoners than the general population.

Prison is a challenging environment for those with autism. Routines are imposed, vulnerabilities are exploited by others. Frustrations can boil over into violent and self-destructive behaviours. Non-verbal behaviour also makes each interaction with other prisoners and staff a potential flashpoint leading to protesting behaviours or withdrawal.  All against a backdrop of a harsh white noise. Metal doors slam, Conversations and challenges are shouted, all constantly echo through the four open floors of each wing of the prison.

Other neurodiverse conditions are present in prisons. An ageing prison population even has prisoners suffering from early onset dementia. Some forget the circumstances of their imprisonment.

Teaming up with prison officers and support staff like psychologists, doctors and teachers, chaplain Davies notes that “now staff make it their business to work out how to work with these prisoners”. The unit has capacity for 45 prisoners in single cells. They share a common area for eating and other activities. Staff spend 10 weeks assessing the prisoners who can then benefit from up to 12 weeks of additional support.

Ruth Hipwell, who leads the new unit, says: “it’s good to have a place in prison for those people who can’t cope.” Support ranges from little things like teaching a prisoner how to make a cup of tea or providing earplugs to reduce noise, to helping prisoners make better plans for coping and learning – both in prison and outside.

On the wall of the unit is a timetable of events, illustrated by pictograms. Sessions include how to handle familiar tasks in the unfamiliar environment of prison: how to buy things or use the telephone, getting clean clothes and even how to handle being unwell.  Other sessions include accessing learning and getting a job.

Robbie*, a prisoner in the unit says:

“It relaxes you. It’s wicked. The difference is the support.”

The unit started work in October 2022 and the difference it made was spotted fast. It transformed staff, recalls Hipwell. “They have found their purpose. We have a level of multi-agency integration others can’t match.”

Ian Blakeman, Pentonville prison’s governor, identifies additional benefits. “It frees up staff time and staff export skills to other parts of the prison.” These positive effects also help him keep good staff. A major challenge in London’s competitive labour market.  Other programmes reinforce this change in culture across the prison range from addiction treatment to rebuilding family relationships affected by gang affiliations.

Pentonville now has the lowest self-harm rates in the country and is the least violent prison of its type in the UK.

With prisons a low political priority, it’s even more remarkable to learn that Pentonville’s neurodiverse unit required no additional budget. Its win-win results are a flicker of hope in a bleak landscape. Times columnist Matthew Parris recently wrote:

“Every generation looks back and spots an outrage. Today, when we think of slavery, child labour and lunatic asylums, we wonder how our ancestors could have been so cruel. What will horrify our own successors is our disgraceful prison system.”

In response to Parris’s column, Jonathan Aitken, a former prisoner and now a chaplain at Pentonville who works with the neurodiverse unit, wrote to the Times.  

“The real disgrace lies not inside our prisons but in the failure of both public and private rehabilitation efforts to help prisoners into jobs, housing and law-abiding lives after their release. The good work done by prison officers, managers and governors is underreported… We are on a roll of improvements… But such advances are like clapping with one hand if they are not met by comparable efforts to rebuild the lives of prisoners after they walk out of the gate. Correcting the failures in this area should be a high priority for our politicians and for our society.”

Column

Change

Character

Psychology

23 May 2024

4 min read

Look out for the outliers

Seeing the good qualities in others lifts them, benefits us, and makes the world better.

Roger Bretherton

Roger Bretherton is Associate Professor of Psychology, at the University of Lincoln. He is a UK accredited Clinical Psychologist.

A office worker wearing headphones looks out of a hectic and loud office space around which people are moving

Nick Jones/Midjourney.ai

I was talking to someone the other day. She is a website developer and she’s just changed jobs. She is not a loud person, but anyone who meets her knows she is a person of quality, of depth and presence. She emanates a humble confidence. In her old job, she worked in a quiet, fairly sedate, office where she was given the space and the time to bring all her creativity to bear on whatever brief she was given. She was known and appreciated.

But her new job – the job she started last week – is a bit different. Her new colleagues are loud and outspoken. Silence is unknown in their office. They like to work to a soundtrack. The drum and bass keep thumping, and the banter never stops flowing. She’s finding it hard to fit in with her new team. And things weren’t made any easier when, after a few days, her new boss took her aside for a pep talk.

What was the problem? She was ‘too quiet’.

It hurt to hear that. It broke my heart to think that anyone could be so blind. How shortsighted do you have to be, to view the grace and peace someone carries as a problem to be solved? In a world of distressing noise and clamour, she is precisely the kind of person every office needs to temper the insanity.

I’m not worried about her. She’s bright and innovative. She’ll work it out. Either her new boss will see sense, or she’ll leave. And if she does, the queue of employers looking for someone just like her stretches round the block. She’ll be okay.

But it got me thinking about the kind of psychology I study. In my research, she would be called an outlier. One of those people in a team or a family who don’t quite fit in. Not because they are weird or awkward, but because they possess some positive quality the rest of the gang don’t have. They are the creative exuberant in a team who prefer doing things by the book. The hilarious joker in a pack who like to take things seriously. The conscientious worker trying to get on with the job in an office that would rather play now and work later. The kind one in a family of cutthroat competitors.

At the top of the list of reasons for wanting to leave work are the words: I am not appreciated.

The thing is we all have a unique contribution to make to the world, a one-off fingerprint of strengths and abilities never to be repeated in anyone else. In research these have been called Signature Strengths, the unique combination of positive qualities that make you you. And the weird thing is that we don’t have to try that hard to be them. If you are naturally kind, or wise, or grateful, or disciplined you won’t be able to stop yourself being that way. They come effortlessly to us. And if someone tries to stop us being the loving thoughtful faithful person we know ourselves to be, it is like losing a limb. If we find ourselves in a context where the most beautiful things about us are unwelcome – like my friend the website developer – it is like being rejected, right to the core.

But here’s the cool thing. If we can live by our Signature Strengths – if we can wake up each morning and ask the question, how can I use my unique positive qualities in a new way today? – it leads to remarkable improvements in wellbeing. Multiple studies have shown that those who live like this, thinking about how they can bring what is best in them to the opportunities and obstacles of each day, report increased happiness in living. Not only that, but they also show reduced anxiety, stress and depression. It turns out being good is good for us. Who knew.

That’s not the whole story though. To really be our best, we need other people to spot these strengths in us. If they don’t, we feel confined, unable to be ourselves in some way. When I ask people what it is like not to be able to bring their best qualities to the people around them, they come up with some pretty dark images. It is lonely, isolating, a desert, a fog, a prison, like being trapped in a cage. And when researchers ask people why they consider leaving their current job, their answers often reflect something like this. Work-life balance and salary are no doubt important, but often, at the top of the list of reasons for wanting to leave work are the words: I am not appreciated. Something good we wanted to give has not been received. We feel unseen.

So that’s why I say: look out for the outliers. Who is it in your family, your workplace, your neighbourhood, who goes underappreciated? Who do you know who has something good to give, but needs some help to give it? Because if we can learn to see those invisible beautiful qualities in the people around us, we not only give them the joy of being known, we also invite more light and flavour into the world. Life becomes a little less grey.

I just hope my friend’s new boss can learn this while he still has the chance. It is tough for her to feel so misunderstood, but it’s worse for him. She can move on, but he has to remain in an office deprived of the humble compassion she would have brought to it. It’s a question worth asking. What gift of beauty and goodness are we excluding from the world because we failed to see past the packaging?