In the next of her series of blogs, our Women’s Involvement Advisor Lilly Lewis sheds light on women’s mental health in the justice system, and explains why the Government needs to take urgent action to improve their mental health and wellbeing outcomes.

This month in my role as Women’s Involvement Advisor I have been working on One Small Thing’s response to the Government’s Mental Health and Wellbeing Plan Call for Evidence, and highlighting what needs to change to better support the mental health of women involved in the justice system.

If we don’t speak up, we won’t see the changes that are needed for us to improve services and outcomes for those with poor mental health in the justice system. It is important to advocate for changes as many women in the justice system have lost their voice or been silenced by abusive partners for so long. I spent a lot of my time in custody working with and listening to other women who had suffered traumatic histories of abuse at the hands of men. This often resulted in poor mental health and left women traumatised.

I believe it is fair to say that a high percentage of women, even if they did not have poor mental health before they entered the justice system, will develop it when going through the process. When you’ve experienced trauma, it can be difficult for you to process what is happening to you, and the experience of the justice system can be further disorientating and traumatic.

As early as the point of arrest can have a detrimental effect on your mental health. It causes stress and anxiety. This needs to be recognised by the authorities and if a woman is arrested, being locked in a cell in the police station can have a detrimental effect on your mental health. Being locked in a cell in an area that can sometimes be extremely noisy with people banging and screaming is extremely traumatising.

Worsening mental health can be prevented by those working in the justice system being trained to work in a trauma informed way. Those who are working with women, especially the police, should have trauma informed specialists for women in custody in police stations. I have heard women in police stations who are clearly being affected by trauma being called chaotic, aggressive and drunk.

Women who have been arrested and placed on bail should be referred to mental health services or women’s centres for support as the process can sometimes be extremely long. Women can also feel shame and do not feel they can discuss what is happening with family and friends who may know nothing about the situation. I was on bail for one year before being charged and then another year after I was charged before attending court. I didn’t tell my parents until the night before sentencing. In that time, I took two attempts on my own life and was sectioned both times under the mental health act.          

The way I think we can recognise mental health issues, and intervene earlier is by being more aware of what the signs of poor mental health look like and how it can appear differently for different people. If we are supporting people who are involved with the justice system either in a professional capacity or a friend or family member, we need to understand that no matter what, their mental health will be deeply impacted in a negative way. We need to have the tools to help that person get support and advice, even if they don't recognise that their mental health may be suffering.

To support this, mental health services require more money and far more resources. The wait time for support is extremely lengthy and people struggling with their mental health can’t wait. People will often self-medicate with alcohol and other substances. This is even more prevalent in the justice system when a woman’s situation and surroundings can change very quickly causing her mental health to deteriorate very quickly.

To support people living with mental health conditions to live well when they are incarcerated the first thing we need to do is address the problem, and for prison staff to work in a trauma informed way. If mental health needs are identified in women in prison this should be the priority to be working with, before English or Maths. Prisons need to have more mental health workers and therapeutic approaches such as yoga, mindfulness, and meditation. The antidepressant drug mirtazapine is given to so many women for stress and depression, but they don’t get much help beyond that. It’s not always about needing medication- sometimes you need a therapeutic approach. We need to work with people to help them to help themselves through choice, trust and collaboration.

Importantly, we need to ask more questions. When we ask questions, we need to really listen to what people are saying. I am trained as a Samaritan Listener and as I was providing this support in prison, I learnt that listening is one of my best skills. I don't think it’s possible to prevent all mental health issues, however it is possible for us to respond better and prevent people from getting to the point of crisis. 

The Government Mental Health and Wellbeing Plan should ensure that all agencies and professionals supporting women in the justice system undergo trauma informed training so they can create an environment where women who have experienced trauma can feel safe, and develop trust. Any professionals working with people with poor mental health should also understand the principles of working in a person centred way, with a focus on listening to who you are working with to fully understand their values, views and wishes.