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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.” 

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Auden and our anxious age

While the tropes of trauma are still with us, how to not die in our dread?

Jack is a graduate of Peterhouse, University of Cambridge and Blackfriars, University of Oxford. He works in local government.

An outdoor vigil is lit by people holding up mobile phone lights.
Oxford's peace vigil.
BBC News.

Faces along the bar

Cling to their average day:

The lights must never go out,

The music must always play . . .

Lest we should see where we are,

Lost in a haunted wood,

Children afraid of the night

Who have never been happy or good.

This week, we mark the 85th birthday of W. H. Auden’s poem ‘September 1st, 1939’. He describes four solitary drinkers in New York on the cusp of the Second World War. September 1st, 1939: Hitler invades Poland. Those four faces struggle to find meaning in their lives.  

In a later, much longer poem of 1947 (first UK edition, 1948) Auden built on this theme, having lived through the War, to identify an ‘Age of Anxiety’. He wrote, ‘We would rather be ruined than changed / We would rather die in our dread / Than climb the cross of the moment / And let our illusions die.’  

I have been reflecting on this of late, especially in light of a recent night vigil for peace, remembrance, and unity at Bonn Square, Oxford, where I live. This took place on 7 October, the anniversary of the Hamas attack on Israel in 2023: the darkest day in Jewish history since the time that Auden wrote his poems.  

In an Age of Anxiety, Auden wrote, ‘the world needs a wash, and a week off’. The gathering in Oxford was especially poignant because some 250 people chose to go out in the rain, on their Sunday-evening time off, and in the darkness, to hear prayers and readings from different communities. It was as if the world was awash with people coming together.  

The Bishop of Oxford the Rt Rev’d Dr Steven Croft said, ‘Our purpose is simply to be together.’ People simply had to do ‘something in the face of the helplessness that we all feel, in the face of these terrible events’. Louise Gordon, co vice president of the Oxford Jewish Congregation, described people ‘clinging to hope’. Imam Monawar Husain stressed that togetherness as such is a ‘symbol’, a symbol of hope.  

Symbols abounded. Candles were lit. In ‘September 1st, 1939’, Auden described ‘Ironic points of light’ which  

Flash out wherever the Just 

Exchange their messages: 

May I, composed like them 

Of Eros and of dust, 

Beleaguered by the same

Negation and despair, 

Show an affirming flame. 

The crowd spontaneously joined in with the protest song ‘Where Have All the Flowers Gone’, which was first sung in 1955.  

It is striking that so many of the tropes and themes concerning what has gone wrong with the world, from our perspective, were already apparent and received clear expression from 1939 through to the mid- to late-1950s, in terrible events, then in thought, poetry, and protest song, in an age of anxiety.  

If there are similarities between Auden’s age and our own, then we should be encouraged by that. 

Sociologists described the ‘lonely crowd’ in 1950. This suggests that people seek more approval and acceptance from others as the physical distance between them diminishes and society becomes increasingly geared toward consumption. The capacity to come together for peace, remembrance, and unity becomes far less likely. 

Philosopher Max Picard lamented the loss of the ’World of Silence’ in 1952: the capacity to be still. And later, in 1958, the word ‘meritocracy’ was first used to describe a dystopian world in which merit (IQ + effort) reigns, replacing previous relational bonds, a sense of togetherness, exemplified in the gathering in Oxford in 2024.   

C. S. Lewis, in Oxford in the late 1950s, identified friendship as a kind of love which is regarded 'in the modern world'  as 'quite marginal; not a main course in life's banquet', which is especially true if we bypass the banquet and spend our time at the bar (or, worse, online, at home). Louise Gordon, at the vigil, also spoke of the way in which people were counterculturally 'clasping hands in friendship'. 

When sociologists today describe the ‘lonely century’ (Noreena Hertz) or when so many sigh over our inability to sit, or stand, in silence, in some sense at least they have not identified anything new. War crimes are, sadly, all too familiar to us. And recently, the lawyer Stephen Toope identified an ‘age of anxiety’ today.  

It is not as simple, however, as saying that we have been anxious for the last seventy years. Auden’s age was also one of creativity of which the Anglosphere has been proud, for instance, around the foundation of the National Health Service in 1948. His generation stared into the abyss. They did not die in their dread.  

If there are similarities between Auden’s age and our own, then we should be encouraged by that. Lamentation is as old as love, and the choice is as stark as he put it in his poem 85 years ago: ‘love one another or die’.  

The notion of vigil is equally old. Today, vigils are held for peace, remembrance, and unity. In Christian liturgy, however, a vigil is specifically a watch during the night, looking forward to the dawn of a new day. ‘As the night watch looks for the morning’, likewise the people wait for Christ, their saviour.  

That silent watch is far removed from the solitary ‘faces along the bar’ who ‘cling to their average day’. Horrible events such as those which took place on September 1st, 1939 or October 7th, 2023 bring people together in common purpose, simply to be together and to cling instead to hope for a better tomorrow.  

Anxiety is replaced by hope.  

Candles are lit. It may well rain. But song will be sung. And people of good-will, having climbed ‘the cross of the moment’, will show what Auden described: that great ‘affirming flame’.