Mental health presents major challenge for prison

Prisoners at HMP Northward

(CNS): Life at HMP Northward can be very challenging for all inmates and staff because the country’s prison is no longer fit for purpose, bursting at the seams and massively under-resourced. But one of the most pressing difficulties is the incarceration of prisoners with, in some cases, very serious mental health challenges who should not be in jail. Both prisoners and prison staff agree that the mentally ill do not belong in Northward and the need for a secure unit in Cayman to house these very vulnerable individuals must be a priority.

As HMP Northward marks its 35th anniversary since its opening, the management flung open the doors of the jail house this week and invited the press for a ‘warts and all, no holds barred’ tour of the facility, as well as meetings with inmates on the Prison Council.

While the management and inmates may not always see eye to eye on what the priorities are for the future of HMP Northward, there are a few key points, such as the pressing need for a new prison and the incarceration of inmates with mental health problems, where they are in agreement. Several inmates spoke of the challenges they see the mentally ill prisoners facing and prison officers agreed.

Northward is not unique in this regard, as prisons around the world are often the last stop for the mentally ill and even sophisticated and well-resourced western societies commonly fail these members of the community.

However, Cayman’s prison has no proper facilities within its walls or means to segregate its mental health patients, and while a small number of the most challenged patients are isolated in what amounts to a caged area in the grounds of Northward, most are living among the broader, crammed prison community.

While some of those diagnosed with mental health problems are segregated on 23-hour lockdown in the high security unit, others remain on the remand wing and some in the exceptionally crowded main B-wing, where almost 70 men are currently house in a condemned cell block.

Prison officers told the press Wednesday that keeping inmates suffering from mental health problems is very difficult for staff because it is hard to create sentencing plans for them and they create very challenging security problems as they can be a danger to themselves and others.

One officer also noted that some of the inmates with a poor level of mental health are exceptionally vulnerable to manipulation and exploitation by other inmates. While some prisoners are very tolerant and try to help and support those with mental health difficulties, it is a serious challenge for everyone at the prison, given the significant numbers.

There is a broad spectrum of problems among the inmates, including prisoners suffering from serious addictions due to years of self-medication with drugs and alcohol for undiagnosed issues. Depression that can impact inmates during their sentencing, and there are also those who have very obvious and serious psychotic disorders.

However, the exact numbers of inmates with mental health problems is hard to define. While there is counselling available and the government’s leading psychiatrist, Dr Marc Lockhart, is a frequent visitor and is medicating a number of prisoners, inmates told CNS that not all those that are suffering from mental health problems are being treated because they have not even been diagnosed.

“No one is addressing the scale of the mental health problems here,” said one inmate, who is certain that government is simply ignoring the extent of the problem.

Prison Director Neil Lavis explained that opening the prison up to the media for a day was to try and dispel some of the myths and show the hard work of the prison staff in the face of massive challenges, including the problems of mental health.

Lavis said the prison system receives people after every other system in society has failed them and does so in extremely difficult conditions with limited resources. As a forgotten place, he said the Corrections Week and anniversary provided an opportunity to show the excellent work at the prison in very trying conditions.

Check back to CNS for more from the prison, including inmate’s perspectives, funding challenges, the new conditional release law and the efforts prisoners are making to contribute to the community.