Funding and extending what works in prison

At a time of so much negative coverage, the October issue of The Psychologist drew together some evidence-based ambitions to create a different future for those who have been incarcerated because of their crimes.

Atrium Clinic has been delivering a range of therapies in London prisons and in the voluntary sector nationwide for returning citizens, both men and women, for over 20 years. We use our clinical data from this cohort to plan, review, clinically supervise and refine our services and have seen improvement year-on-year. We have worked with thousands of men in six prisons and found that the biggest barrier to engaging with therapy is the mental health stigma. 

Once they engage with our high-level therapists, they achieve better than community expectations in terms of their clinical outcomes, even though they enter our services typically with moderate to high severity of distress. Those with suicide ideation respond well to the intervention and in Black and ethnic groups, neurodivergent men do above average in terms of clinical outcome.

Talking therapies work for men when we are creative and supportive. Further, our data shows that when men get the mental health support they need, their risk of violence to others reduces as well as the risk to themselves. We'd love to continue the therapeutic work beyond the gates to sustain these returning citizens. Men often ask, 'Please can we see you outside', but funding continues to follow the system and not the person.

We need more resources for specialist therapy services like ours, where we train to the highest standards to manage the greatest risk. An investment, in mental health for men and women in prison, marks the end of a historic failure to meet their needs before they got there and alongside maintaining family connections, rehabilitation, training for employment and the prospect for housing in the community is a vital ingredient in changing lives. We believe in bringing our most dedicated and skilled clinicians to those clients who need us most. We know and can evidence what works. Let's fund and extend what works.

Dr Sara Ireland 
CEO and Clinical Lead 
Atrium Clinic and Therapy Centre

Editor's note: I was deeply saddened to hear that our October cover artwork had caused distress to some members, who felt it was an 'apparent example of unconscious bias' which 'fed in to the usual stereotypes of Black men being prisoners'.

The image was sourced through Koestler Arts, a charity that showcases prisoner art through awards and exhibitions. It was important to us that the cover showcased 'insider art' (and we interviewed their CEO in the 'Culture' section).

We felt the chosen piece relates directly to a specific article in the issue (taking chess into prison), as well as speaking more broadly to themes of rehabilitation and reform (individual and system). In this way, I genuinely believe the artwork counters negative stereotypes, and I think it would have been very unfair to the artist to pass over their directly relevant effort simply because Black people are depicted in it.

I also believe – even if this wasn't in my thinking in selecting the image – that we don't begin to acknowledge, understand and address the disproportionate representation of Black people and other ethnic minorities in the prison population by airbrushing them out of the picture. That's a topic we've considered in our pages before, and we hope this edition is another positive contribution to the discussion around justice and reform. As the cover says, 'we need a reasoned, evidence-based debate'.

I'm happy to engage over email at [email protected]. But please don't assume we don't think about these decisions, or care. I was aware that some would experience the image as 'heavy to see', and 'in your face'. I will admit that could and perhaps should have been higher up my list of considerations. I apologise for any distress caused, but I hope this context goes some way towards explaining why we made the choice.