‘My world has collapsed’: life in prison with serious mental illness | Mental Health

Mall people with serious mental illness end up in jail cells – then struggle to be transferred to hospital. The Guardian speaks to a woman jailed for setting fire to a cushion and a prison officer who runs a unit for the sickest prisoners.

“I should have been in the hospital”

Shell Ball can’t remember exactly what was going through her mind when she set fire to a cushion in her Crewe home in 2019. But she was struggling to cope with the death of her fiancé, Gary, who had started drinking heavily again after losing a baby. “I got really drunk and I really don’t know why but I set fire to the corner of a cushion. Upstairs they heard me screaming and called the police,” she said.

It was the start of a nightmare that would see Ball – who was diagnosed with anxiety, depression, PTSD and borderline personality disorder – jailed and then twice called back to jail after attempting suicide. In total, she would spend almost a year and a half behind bars and lose custody of her youngest son – all for setting fire to a cushion, as a cry for help.

Ball, 38, was held in a police station over that fateful weekend, charged with reckless arson. The following Monday she went to court and was remanded to HMP Styal, Cheshire – just a week after Gary died. Ball was inconsolable. “I cried for two weeks. I just couldn’t stop crying. My world had fallen apart and now I was in jail,” she said.

When her case was heard, she wrote a heartfelt letter to the judge explaining what had happened in her life, from being raped as a teenager to losing a child and a partner – but she still was returned to prison. “[The judge] said, “I know you had no intention of hurting anyone that night but yourself,” but he gave me two years.

Ball began self-harming as it gave him “some release” from the hopelessness of his situation. “There is no light at the end of the tunnel. A lot of people in prison are the same and that’s why people are killing and self-harming,” she said.

While she was in Styal, at least one woman died. “About 90% of the women there had mental health issues – that’s probably why they were there in the first place,” she said.

The prison put her on a plan for those at risk of self-harm and suicide. But she only had the chance to speak to a psychiatrist on the phone just before her release. “It was unnecessary.”

She struggled to cope outwardly as she had received no sustained treatment in prison and was called back after two suicide attempts. Ball appealed to the parole board, but was rejected: “How can I be recalled for attempting suicide? How is this criminal?

Ball was finally released in August 2021 and regained his life. But she believes she should never have been sent to prison: “I don’t consider myself a criminal. I wanted to hurt myself. I wanted to die. I should have been hospitalized and given the help I needed, which would have caused a lot less pain.

Testimony of a prison officer: “It’s inhuman”

“A lot of officers avoid talking about it [mental health] because they classify it as the most dangerous part of the prison. You might open a door one day and the man in front of you might be nice as hell. You could open the door an hour later and he’d come out punching.

“Self-harm is pretty high. We don’t allow them to have razors or sharp objects. But that doesn’t stop people. We’ve seen people ripping up tiles from shower walls and self-harming with them We had a guy who tried to cut his jugular a few months ago.

“We see it as containment rather than a form of treatment. We keep them locked up for the most part. We let them out for a little association and we take them outside to exercise. But in hospital wards, they are absent all day. It’s a much more relaxed environment. There are nurses to care for them.

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“In prisons, we can’t always give them the same drugs they were prescribed in the community because some drugs aren’t allowed inside the prison walls. Opioid medications are banned as they become commonplace.

“A lot of these people end up in prison because of their mental health. I’m looking at my board right now: of the eight I have in the unit today, there’s only one that I would say doesn’t fit into that category. There is one for carrying a bladed item. Another for harassment. He stood in the street shouting. He suffers from psychosis and hears voices. Another person attacked a neighbor for playing music too loudly. And many of them are cared for in the community anyway, even before they come to us. They are sick. It’s inhumane [to put them in prison].”

The officer, who wishes to remain anonymous, works in a mental health unit in an English prison.

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