Article
Change
Freedom
Mental Health
3 min read

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 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.” 

Article
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Loneliness
Mental Health
5 min read

What Bobby Brazier, Jo Marsh and Eleanor Rigby have in common

A public health campaign asks influencers if they are lonely.
a young man looks pensive as he answers a questuon while sitting in a fancy room.
Bobby Brazier at 10 Downing Street.
NHS.

‘Loneliness. It’s a part of life. Let’s talk about it’  

That’s the new slogan offered by the NHS in partnership with the Department for Culture, Media and Sport. As part of their campaign, they recently invited young influencers and TV personalities to Downing Street to do just that – to talk about loneliness.  

With those aged between 16 and 29 now twice as likely to report feeling lonely as those over 70, these celebrities were tasked with answering a few of the questions most asked by people within that age group. Their questions went along these heart-wrenching lines:  

Why am I so lonely?  

Is it normal to feel lonely?  

Will I always be this lonely?  

And while their answers to such questions were a little ‘meh’ (whose wouldn’t be? They were given seven seconds to answer some of humanity’s deepest questions), it doesn’t much matter, their answers weren’t really the point. Rather, viewers were presented with a handful of popular, successful, lovable (looking at you, Bobby Brazier) and happy looking people doing something notoriously difficult: admitting loneliness.  

And I think that may be the point.  

I am of the firm opinion that admitting to feeling lonely is one of the hardest things a person could do. I have certainly never had the bravery to do it.  

I remember watching Greta Gerwig’s 2019 adaptation of the beloved 1868 novel, Little Women, for the first time; I was always going to love it, I had decided as much before even stepping foot in the cinema. But there was one scene that felt as if it literally took my breath away. I was left winded in row C.  

It is toward the end of the film, and Jo Marsh, the feisty, strong and independent protagonist, is giving a feminist monologue  for the ages (albeit to her mum) as she stands in the attic of her childhood home. Jo speaks of women’s minds and souls, their ambitions and talents, she explains how sick she is of being underestimated, getting more impassioned with every word. That is, until she tearily ends her speech by declaring – ‘…but I’m so lonely.’ 

This isn’t in the book.  

This final line was written by Greta Gerwig specifically for this adaptation. And the only person who seemed to be more taken aback by Jo’s words than me (an owner of more editions of the novel than is cool to admit), was Jo herself, who instinctively clasped her hand to her mouth as if she couldn’t believe that she’d just said such words aloud.  

As far as filmmaking goes, it was genius. As far as human nature is concerned, it was, well, true. 

Not only do we find loneliness acutely painful, but we also tend to find it near impossible to admit to, so much so, the government currently feels the need to step in. Why is that, I wonder? Why does ‘lonely’ seem to be the hardest word? 

Those who admit to their own loneliness are wading into profoundly vulnerable waters. 

Part of it is certainly because there is a social stigma attached to feeling lonely. Ironic, isn’t it? How loneliness has social connotations. Nobody wants to be Eleanor Rigby, nor Father McKenzie, nor any of ‘the lonely people’ that Paul McCartney so pities, for that matter. It’s one of the only Beatles songs you wouldn’t want to have been written about you. Loneliness feels like a failure somehow, and so we struggle to admit it, even to ourselves. A failure because, we’re supposed to be self-sufficient, independent, free-thinking, emotionally-sturdy individuals (which is the operative word, of course). That’s what individualism has taught us, isn’t it? And so, how do we reconcile that with the piercing pain of isolation? How do we admit that there’s a deep crack within us that can’t be papered over by success, or wealth, or another episode of our favourite podcast? How do we go about admitting such a lack? A lack, which despite individualism’s best efforts, has us naturally wondering why it’s there in the first place; are we unpopular? Unattractive? Unlikable? Or worst of all, unlovable?  

Those who admit to their own loneliness are wading into profoundly vulnerable waters. And most of us are utterly unwilling to follow them there, lest we be spotted by a budding Paul McCartney and our loneliness be immortalised.  

And then, of course, there’s the other side of the coin: what does our loneliness say about the people who we are in relationship with? Nobody wants to unleash the panic and guilt tucked away in that can of worms (which, I must note, is unnecessary panic and guilt - there could be any number of reasons you’re feeling lonely, despite your very rich relationships).  

And so, we just don’t say the word. And that’s what appears to be making the NHS and, rather randomly now that I think about it, the Department for Culture, Media and Sport so nervous.  

We need to admit when we’re lonely. We have to pull a Jo Marsh and say it out loud. We must give language to the lack that we feel.  

To be known and loved is my deepest and truest need.

One of the things that I find myself most consistently thankful for when it comes to my Christian faith (you know, apart from the most obvious aspects…) is that it gives me such language. At the risk of sounding annoyingly self-centred, it dignifies the feelings that I find hard to even acknowledge. It offers explanation, and therefore, a comfort that I could never find anywhere else; a comfort rooted in truth.  

It may sound nuts, but I have come to understand the reality of loneliness, not through influencers on a sofa in Downing Street (although that’s great), and not even through Jo Marsh’s monologue (which is even greater), but through an ancient Hebrew poem. This poem tells me that to be alone is ‘not good’.  

Not good. Not right. Not as it should be.  

That’s God’s point of view at least – that to be alone, properly, completely and permanently alone, goes against the very fabric of the world. It is at odds with human flourishing. I’ve come to deeply value how concrete that is. I’ve also learnt to relax into the knowledge that not only is loneliness ‘normal’ (referring to one to the questions referenced at the beginning), it’s natural, in every possible sense of the word.  

To be known and loved is my deepest and truest need. I was designed for relationship, with God and with people. And therefore – with all the complex ways that life unfolds - to be lonely, is to be human.  

So, with all of this in mind, I’m tempted to end where we began, to come full circle and once again borrow the government’s words: 

‘Loneliness. It’s a part of life. Let’s talk about it.’