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.” 

Explainer
Addiction
Change
Mental Health
11 min read

Resolutions: the addict’s guide to making a change

Don’t give up on giving up something. Lauren Windle explains how to arm yourself best for success.

Lauren Windle is an author, journalist, presenter and public speaker.

Three signs attached to a fence read: Don't Give Up, One Day At A Time, and Your Mistakes Don't Define You.
Road side encouragement in Lehi, Utah.
Ann Schreck on Unsplash.

I remember the talk we had on ‘giving things up’ every year in my primary school. The same doddery old vicar from a local church tottered down to tell two-hundred children what it meant to sacrifice something we enjoyed in order to feel better down the line. He explained that he could give up kippers, but that would be no sacrifice, as he didn’t even like kippers! How we laughed. 

We were young for a lesson on restraint, but down the line, it would prove to be the biggest challenge of my life. The concept is huge for 4-11-year-olds but, as adults, we all know that sacrifice comes with rewards – although many of us resist the idea. It’s very unsexy in a world of ‘you do you boo’, but the fact is, discipline is making a comeback. I read plenty of self-development, smart-thinking and spiritual books, and am gob-smacked by some of the wisdom on offer. The greatest minds of our day are now suggesting taking a full day of rest every week. They are extoling the virtues of honesty to our neural pathways. And they are encouraging fasting as a route to greater mental and physical health. This advice is so sage that it almost sounds biblical. 

The world is finally catching up with what the birthday-boy Jesus has been saying for so long. A life of prayer, meditation, bounded connection, outward-focused living, honesty, non-judgement and discipline will lead to the peace and sense of fulfilment that so often eludes us. 

We’re not so different you and I. We are all weak. We all live in a world tailored to give us short-sharp dopamine hits when our soul yearns for sustained, hard-earned rewards. 

As an active drug addict, I had none of this peace. I didn’t want it. Live fast, die young. The highest of highs faced by the lowest of lows that could be chemically rectified. My assumption was that everyone was miserable, I had just found something to get me through. If anything, I was the one who was winning. But from the cage I had built around me, there was no way to see the freedom I could be enjoying.  

It was on 22 April 2014 that I finally gave up cocaine and alcohol after handing over every good thing in my life in service to their attainment. I thought I was trading the misery of addiction for the misery of abstinence. But, what I would slowly learn was that the incredible weakness I had exhibited could be transformed into a strength of such magnitude, it exceeded any dream or hope I had for myself. I had decided to deprive myself for long-term good of my life and unlike Father Brown and his kippers, the cost would be great. 

I have a degree in neuroscience. This surprises both people I meet at dinner parties and other students who were on my course – one of which asked if I was lost on my way to beauty therapy. Since getting sober I have added a Master’s in Addiction Studies from King’s College London to my resumé and five years of heading up a recovery programme for people struggling with all sorts of addictions. I have mentored, coached and sponsored scores of people to freedom. In the process I’ve learned a thing or two about ‘giving things up’. 

The best time is right now. Before you’ve had one last ‘treat day’, one last party or one last flutter. The best time to make a change is the moment you realise you need to. 

There are two points I’d like to address before we get into the nitty gritty. Firstly, yes this is relevant to you. This isn’t an addict’s sob story where you get to voyeuristically bask in my pain before returning to your cushty life safe in the knowledge that you’ll never sink so low. Addiction is at the top end of a scale of idolatry that we all teeter on the brink of. If you think you can’t relate to my story, turn your phone off for three days and note how you feel every time you go to reach for it. We’re not so different you and I. We are all weak. We all live in a world tailored to give us short-sharp dopamine hits when our soul yearns for sustained, hard-earned rewards. We all have something we could afford to give up or moderate.  

Second, New Year’s Day is not the best day to give something up. Neither is the first day of the month, or next Monday, or even tomorrow morning. The best time is right now. Before you’ve had one last ‘treat day’, one last party or one last flutter. The best time to make a change is the moment you realise you need to. That said, I do know plenty of people who gave up smoking for Stop-tober and never looked back and there are plenty of resolutions that have resulted in lasting change. Also - we are conveniently placed at the start of a new year, so let’s strike while the iron is hot. 

If you have decided to give something up this year, here is how I, a recovering addict, believes you can arm yourself best for success.

Set clear goals 

Leave the shades of grey to E. L. James. When it comes to making a positive change in your life this is a black and white business. ‘To be on my phone less’, ‘to read more’, ‘to drink less’… these are too vague to be achievable. Instead try: ‘to turn off my phone at 9pm and not turn it back on until 9am’, ‘to go to bed half an hour earlier and read 10 pages of a book’ or ‘to only drink on two days a week and have no more than three drinks.’ 

I once worked with a woman who set herself some simple goals around food: not to eat while she was cooking, not to eat in the supermarket, not to eat in her car and not to eat in her bedroom. This is far easier to attain than just a generic diet.  

If you want to change your clear goals, you absolutely can… after a three-day cooling off period. If you want to up your drinking days to three per week, do it. But it will start next week, not this one when you’ve already drunk on Wednesday and Thursday and someone brings round some beers on Saturday night. You want to turn on your phone an hour earlier every morning, definitely do. But that will start in three-days-time, not on a low day when you’re fighting in bed and decide ‘what’s the harm?’ 

It's half about the lower screen time/alcohol consumption etc. and half about your ability to play by the rules, to exercise discipline and to make a decision today that will benefit you tomorrow. This is about looking after yourself as you would someone else who was your responsibility. You must enforce boundaries to help your charge develop well. Only this time, your charge is you.  

Tell people 

Social pressure is a helpful tool. Did you know those flyers that they drop through your door saying: ‘90% of your neighbours have completed their tax return by now’ are far more effective than the ones saying: ‘File your tax return’? How others perceive us matters to us. 

Research shows that the more people you tell about your new resolution, the more likely you are to keep it. If you’ve announced to the Jones’ that you won’t be drinking and then pour yourself a cheeky snifter, you don’t just disappoint yourself but you run risk of a loss of respect from those you informed of your decision. Keeping up with the Jones’ can be a powerful motivator. 

Expanding on that premise, and taking it from a threat to an encouragement, there’s also evidence that doing things in a group greatly increases everyone’s chances of success. If you’re reducing phone time, why not set up a WhatsApp group where you drop a message to your comrades just as you turn off your phone. That way everyone will have a record of the time each person logged off, you could then catch up in the morning and say how you used the time instead. If your plan is to exercise more, head to the same class every Tuesday morning with a friend and grab coffee afterwards. If you’re making pledges around food or alcohol patterns, why not agree them with your partner as you’re likely to share many meals together? 

For the sake of your friendships though - make it clear to whoever you tell if you expect them to challenge you if you fall short or if you want them to leave you to it. Don’t expect a friend to police you without their prior agreement. Equally don’t expect them to stand by as you break your resolution without saying anything, unless you’ve made it clear you don’t want their intervention.  

Observe yourself 

There will be times when sticking to your resolution is easy (usually the firs two days of January). But unless you’ve gone for the kippers option, there will be times when it is incredibly hard. Observe yourself in those moments, ask yourself questions and understand what it is about those times that present a challenge.  

Many people reach for their comforts when they’re happy, hungry, angry, lonely or tired. How do you respond when you feel these emotions? What brings you most comfort? Is there a healthier option that could support you instead? 

You see, if you’re giving up something that has become an idol, that takes your attention and satisfies that dopamine craving when you most want it, you’ve left a vacuum. The void could mean you are more drawn to your crutch of choice than ever. Or it could mean that you select something equally unhelpful to get you through. Identify these crevices as they arise and come up with a plan to protect yourself in those moments.  

I’ll kick you off with a few examples: 

  • You would usually pour yourself a glass of wine to mark the end of a working day? Get outside for a walk. 
  • You would usually fiddle on your phone on the commute? Bring a book with you.  
  • You get distracted during prayer/meditation time? Take a notepad with you, jot down any thought and then get back to your practice.  
  • Connect with friends over booze at the pub? Host a games night.  
  • Give yourself a little treat of chocolate or cake after a long day? Get a nice selection of teas and hot drinks.

Personalise the above as required.

Don’t beat yourself up 

Lifestyle changes involve failure. Sadly, most things that are worth having involve accepting some level of failure. It doesn’t make you weak. It doesn’t make you evil. It doesn’t make you anything other than human. ‘The measure of a person isn’t how they fall, but how they pick themselves up.’ – said some over-quoted person like Gandhi, Theodore Roosevelt or Marylin Monroe probably. 

 Discipline is a muscle that needs work, and if this is your first time seriously embarking on something like this, you’re in the equivalent of the beginners’ Zumba category. Slipping up does not signal the end. It signals a slip. If I were cycling from London to Brighton and I fell off my bike around Horsham, I wouldn’t pick it up, walk it back to London and start again. I get to remount the bike exactly where I fell. I get the benefit and experience of the last 30 miles of road. It is an opportunity to strengthen my resolve and recommit myself, not to give up until next year.  

Use the tools 

There are an outrageous number of tools available to help you in your quest for progress. Don’t be too proud to use them. There are tracker apps, accountability programmes (like covenant eyes for those who want to cut out porn), books, podcasts, charities, anonymous meetings, medications, therapists, doctors, family, friends, churches and many others who can be with you. They can help while you mull on any challenges and strategize solutions that will help you grow.  

Self-efficacy is key 

There’s a study that I promise exists, even though in my in-between-Christmas-and-new-year haze I can’t find the reference for it. It was research on cannabis. Formerly cannabis was most commonly found as a secondary addiction for those whose primary focus was cocaine, heroin, Benzodiazepine or alcohol. But with the increased potency of street-level cannabis and the invention of synthetic-cannabinoids like Spice, more people are dying at the hands of marijuana, and therefore there are increasing budgets for research. 

Unlike heroine, Benzos or alcohol, there is no medical intervention to support those coming off cannabis. So the study looked at the primary factors that supported long-term abstinence from the drug. The strongest predictor of successful recovery was self-efficacy i.e. participants who were most likely to get and stay clean were those who started the process by saying they believed they could. 

 You can make any positive lifestyle change you want but it takes time and perseverance. But if you make a declaration believing you probably won’t stick to it or that you’ll see how it goes – you’ve lost before you’ve started.   

It won’t feel good 

There’s an unspoken expectation that taking steps towards better, more nourishing clean-living feels good. Some people think that they will start waking up before their alarm, well-hydrated, with enough energy for a quick round of squash before a bracing ice bath and hearty breakfast. This is not my experience. 

There are times when, in order to stick to my resolve, I had to just stay in bed. Not moving or facing the outside world. There were times when the agony of rejecting my crutches felt unbearable. Anything felt better than continuing on that difficult path of discipline. Achievement, to-do lists and even the notion of ‘a calling’ are reserved for those lucky enough to be functioning that day. The rest of us just have to survive. 

The feeling of pain won’t last. It never does. For some it will be a few days of discomfort, followed by smug boasting that they ‘don’t even think about caffeine anymore’. While for others, the loss will sting and it will take time before they feel any benefit. But those benefits are coming. They are worth holding out for. In a world of 10-15 minute Deliveroo meals, let’s take an hour to cook ourselves a good dinner. In a world where every movie is a few remote clicks away, let’s read a book. In a world where you can plough on, getting things done, let’s boot one thing off our checklists and pause to pray instead. In a world of quick solutions, let’s take the long, restrained route. Let’s allow the process to run its course. Let’s become better, stronger people who are more equipped to carry life’s burdens and help others along the way too.