Friday, March 20, 2015

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Prisons and Paranoia

Alex Cavendish looks at some aspects of mental health in British prisons. Alex Cavendish is an author and academic: a social anthropologist, former prisoner and an active participant in the debate surrounding crime, prisons and probation. He blogs at Prison UK: An Insider's View.

I’ve previously written about mental health issues in our prisons, but in this post I wanted to explore the specific problems of paranoia – including delusional thinking and irrational fears – that can be made much worse by experiences in custody. Having worked as an Insider (peer mentor) supporting fellow inmates who exhibited serious symptoms of paranoid delusions, I thought I could share a few thoughts on the subject.

"Just because you're paranoid..."
Paranoia is often simplistically described as an irrational anxiety that ‘everyone is out to get you’. I’ve certainly lived in close proximity to a number of prisoners who share that fundamental world-view.

Many cons believe that they have been the victims of circumstances beyond their control. Some have come to regard any form of authority with deep suspicion and resentment, even naked hatred. Others suspect that people around them are watching them, spying on them or even reporting what they say and do to the prison authorities in order to cause them grief, especially those on parole sentences since a negative mark on their records can mean a ‘knock back’ (Parole Board refusal) and even more years inside.

In my view, imprisonment can play a key role in fuelling paranoia mainly because prison can be a harsh and unforgiving environment that does little or nothing to encourage any sort of trust between human beings, whether prisoners or staff. Moreover, the experience of being confined to a small concrete box for many hours of each day – in some cases up to 22 or 23 hours – can give inmates plenty of time to stew on perceived slights or injustices, as well as to plan their vengeance.

Paranoia thrives in cells
A wrong word or even a look from another prisoner – or a member of staff – can set off a chain reaction. What is even more frightening is this may not be immediate. Some cons will lie on their bunks over-thinking situations for hours or even days before coming to the conclusion that they have been slighted, mocked or insulted. Once they have arrived at that point, trying to convince them that they are mistaken or have misinterpreted something innocuous can be very risky as this can merely add fuel to the fire of their delusion that everyone is against them or talking about them – including whoever is trying to help.

I remember reading a book about Cat-A (high security) prisons that referred to lifers treating each other with exquisite courtesy and politeness at all times lest a fellow con should come to believe that he had been disrespected – “made a mug of” – and, therefore, feel obliged to respond by inflicting some horrendous act of violence on the perceived ‘offender’ in order to ‘straighten out’ the situation.

Paranoia can impact on almost every aspect of daily life inside and, on occasions, lead to conflict and, sometimes, real violence between prisoners, but also against members of staff. In this present era of chronic overcrowding, staff shortages and scarcity of mental healthcare in our prisons, it’s perhaps unsurprising that the number of violent incidents that are recorded has risen. The latest figures issued by the Ministry of Justice (MOJ) reveal that in the year ending September 2014 there had been 15,763 incidents of violence, including fights (up from 14,207 in the previous 12-month period), while attacks on members of staff rose from 3,178 to 3,470.

When it all kicks off
Of course, a fair amount of violence is connected to the rampant drugs trade in our prisons – including punishment beating of debtors, bullying and clashes between rival gangs – but the sharp rise in the levels of self-harm also point to worsening mental health among prisoners. Recorded incidents during which prisoners had self-harmed in the 12 months ending September 2014 were also up to 24,748, compared to 23,240 in 2013-2014. This data suggests that in general prisoners are at much greater risk of harm from themselves than from other cons or staff.

It is also true that paranoia and anxiety can be made much worse by the use of certain types of drugs – particularly some of the new synthetic substances that are commonly available inside our nicks. Whereas most real cannabis tends to make users drowsy and feel ‘chilled’, some of the so-called legal or herbal highs can cause the opposite effect. Seeing people under the influence of these drugs as they stagger red-eyed down prison landings and corridors, or vomit all over washrooms, can seem like you’ve found yourself on the film set for one of the Walking Dead zombie episodes.

The 'walking dead'
When I was in Cat-B prisons I saw on many occasions how rampant paranoia can trigger violence. I’ll give one example of a lad who was prone to this sort of thing. I’ll call him Smithy (not his real name).

He was a young man in his early 20s who had many complex problems, including coping with the stresses of his sentence through regular bouts of self-harm. In his case he cut his arms with prison razor blades to the extent that he was almost always wearing plasters and bandages. He also lived with various bizarre forms of obsessive compulsive disorder (OCD) and had a tendency to get himself into confrontations with staff, as well as occasional punch-ups with other cons.

Pretty much everyone on the wing was convinced that Smithy was gay. It wasn’t his job as a barber, nor his occasionally effeminate mannerisms, that raised these suspicions, but that fact that when he was either drunk on prison-made hooch or under the influence of drugs he became what might fairly be described as ‘physically over-familiar’ with his mates.

To be honest, no-one on the wing really cared much about Smithy’s sexuality. Prisoners these days can be surprisingly broad-minded. He gave a good haircut and didn’t over-charge for these services (in fact he wasn’t supposed to be charging anything, but such is life in the nick!)

A quick trim from the barber
However, Smithy was absolutely paranoid that people might believe that he was homosexual. One wrong word on that particular subject could easily trigger an explosive reaction and he wasn’t a small bloke, having bulked up in the gym.

One weekend he was cutting hair on the ‘twos’ (first floor landing) during association when he became convinced that someone, somewhere on the landings above had shouted “fat poof” aimed at him. Who knows whether they had or not, but Smithy was absolutely convinced that he had been publicly insulted, his fragile body image slighted and his masculinity mocked. Given his particular rag-bag of obsessions and anxieties this promised to escalate into a really violent situation.

Then a fellow con, probably out to make mischief, managed to convince Smithy that the person responsible for the homophobic abuse had not been a con, but a screw, a Mr M________ who happened to be on duty at the time. Unlikely as this allegation was, Smithy instantly became convinced that Mr M________ had indeed been the source of the insult and stormed off to his own pad (cell) in an absolute rage to plan his revenge.
Up on the landings

Unaware of the trouble that was brewing, I went down to Smithy’s pad to fix a time for a haircut. I found him sitting on his bunk, fists clenched, eyes wide and glassy. I quickly realised that this wasn’t a good time to be making an appointment for his barbering services and instead tried to find out what the problem was in order to calm him down before someone got hurt.

“That cunt M________ called me a fat poof. In front of everyone. I’m gonna kill the bastard!”

At least I now knew the trigger that had started this particular bomb ticking, but defusing it would be another story. Smithy’s paranoia was so all encompassing that trying to convince him that this was pretty unlikely wouldn’t be easy. Unfortunately, at that precise moment, the screw in question pushed Smithy’s cell door open and asked if he was OK. I thought that at that point Smithy would launch himself from his bunk and start bashing a member of staff – never a particularly good idea, but at that moment Smithy wasn’t thinking rationally.

“Smithy’s a bit upset Mr M, mind if I chat to him for a bit?” I said indicating by my eye movements that he had best clear off quickly. By this stage I was physically holding Smithy down on his bunk using both hands while he screamed verbal abuse at the bemused officer.

Screws running to an alarm
The screw – one of the more decent blokes in what was a rotten and dysfunctional establishment – took the obvious hint and made himself scarce. Eventually, after a marathon session of standing in as an emotional punch-bag, I managed to convince Smithy that he’d been the victim of a practical joke by one of his own mates who just wanted to see him  ‘kick off’, maybe even with the aim of seeing him lose his job as wing barber and then get carted off down the Block (segregation unit), all for the sake of having a cheap laugh.

Some cons cope with the mind-numbing boredom of imprisonment by stirring up trouble in the hope that someone will lose their rag and have a fight on the wing. It can easily become a bit of a rather sad spectator sport for prisoners who have nothing better to do than hang around the landings leaning over the railings, shouting and catcalling the lads having a scrap. Even Smithy was well aware of this, so I could see the possibility that this was true slowly crossing his mind.

Once the realisation dawned that he might well have been set up by another con, he calmed down and on that occasion no-one got hurt, including Smithy himself. He even made me a coffee and by the end of association he was taking it all as a joke.

Mr M_______ looked around the cell door again to check that everything had been sorted. He didn’t even write Smithy up for swearing his head off at him, which I thought was quite decent of him in the circumstances. By prison standards that was a good result, but all too often these situations can spiral out of control and violence can be the result.

Perhaps predictably, Smithy did eventually lose his job as inmate barber – one of the most coveted posts on the wing owing to the opportunities for taking backhanders from cons wanting to jump the long queue for haircuts – because of a later run-in with a different screw. I suppose this does go to show that just because Smithy was paranoid, it didn’t mean people were not out to get him.