Mental ill health in prison: Pact CEO Andy Keen-Downs features on BBC Radio 4’s File on 4

This week, award-winning current-affairs radio programme File on 4 revealed that nearly half of all prisoners living with severe mental ill health who need hospital treatment are refused the help they need. As part of the episode, Pact CEO Andy Keen-Downs was interviewed about the reality of living with mental ill health in prison, and whether more needs to be done to ensure mental health is taken into consideration when individuals appear in court charged with an offence.

In the first episode of the new series, File on 4 revealed findings from a Freedom of Information request submitted to 54 mental health trusts in England. Nineteen responded to say that in 2020, almost half of mentally unwell people in prison who were assessed by a psychiatrist as needing hospital treatment were refused a transfer to a secure hospital. Although the Department of Health declined to comment, it insists that it is working to reform the Mental Health Act, which will include new provisions to ensure people in the criminal justice system receive the right care in the right place at the right time.

Speaking to reporter Annabel Deas, Andy Keen-Downs stressed the unsuitability of prisons for those experiencing severe mental ill health, and the urgent need for courts to consider effective assessment and diversion for those charged with offences to ensure that prison is only used as a last resort.

"A prison cell is the worst possible place for you to be if you're ill already. You will get more ill in prison and you are at risk of losing your life." Andy Keen-Downs, Pact CEO

Among the programme’s interviewees was Angela Gray - the mother of 18-year-old Annelise Sanderson, who took her own life at HMP Styal, Cheshire, in December 2020. Following years of trauma and mental ill health, in June that year Annelise had appeared at Wigan and Leigh Magistrates Court where she admitted stealing a pair of trainers, damaging a foil blanket provided by emergency services and assaulting police officers and a paramedic. Earlier that day, she had poured petrol on herself and tried to drink it. Rather than being provided with support for her mental health, magistrates gave her a 12-month prison sentence.

When Annelise arrived in HMP Styal, staff noted that she was disruptive and acting strangely, and her emotional state was compounded by being unable to receive visitors due to COVID-19 restrictions. Despite records showing Annelise reporting that she had been depressed and previously attempted to take her own life, regular welfare checks designed to protect those at risk of suicide or self-harm did not take place. In September, she was prescribed anti-depressants, but was not seen by a psychologist or a psychiatrist and was discharged by the mental health team on the 17th of December. Five days later, she was found dead in her cell.

Annelise was the youngest woman to die in prison in the UK since 2003, and Angela feels that more could have been done to prevent her death. Sadly, families across England and Wales are facing similar challenges, while the prison system is struggling to care for severely ill individuals that it is neither equipped nor designed to support. Pact is calling on the Government to change course, and instead of building 20,000 extra prison cells, to invest money in providing care for people who, through no fault of their own, risk dying behind bars.

You can listen to the episode again this Sunday (15th May) on Radio 4 at 5pm or online on BBC Sounds at https://www.bbc.co.uk/sounds/play/m001748d