Written evidence from the POA, the Professional Trades Union for , Correctional & Secure Psychiatric Workers

1. The POA is the largest in the criminal justice sector, representing over 30,000 prison officers, operational support grades and workers in Secure Psychiatric Hospitals.

2. It is widely acknowledged that many suffer from poor mental health, whether due to incarceration or as a pre-existing condition – or both. However, it is less well understood that managing and caring for increasingly disturbed and often violent offenders in the current prison environment undermines the mental health of prison officers and other staff, too.

3. The crisis of mental health in our has intensified in recent years, with rising numbers of prisoners suffering from a variety of conditions, ranging from depression to serious personality disorders. An aging prison population is also causing an increase in dementia. With mental health problems getting worse, it is more important than even that prison officers receive adequate training to support the mental health of all those in their care.

4. The Covid pandemic and prison lockdowns have brought with them new pressures on mental health, especially in the female estate, where prisoners are more likely to rely on peer support and social networks. However, anecdotal evidence from POA members suggests that many male prisoners, especially those vulnerable to bullying, have found that less association time with large numbers of other prisoners has been beneficial to their mental health, and the POA is in favour of smaller groups supervised by more staff as restrictions are lifted.

5. Before the pandemic and lockdowns, violence, especially against staff, had reached record- high levels, with assaults against workers more than tripling since huge staff cuts from 2012 onwards. The impact of this violence on the physical health of prison officers is obvious, but its invisible impact on mental health is also of grave concern.

6. It is accepted that prisons are inherently violent places to live and work, because they are places where large numbers of often violent criminals are forced to stay against their will by the threat of violence. However, rather than accepting that violence in prisons is therefore inevitable, this should instead mean that all reasonable steps are taken by Government and management to minimise violence in prisons. Unfortunately, this is not the case. Violence remains out of control, with no credible strategy in place to reduce it.

7. Violence against prison staff affects mental health in numerous ways. Beyond any immediate or lasting pain following an assault, many officers suffer from post-traumatic stress disorder after one or more traumatic incidents. New therapies including EMDR (Eye Movement Desensitisation and Reprocessing) are welcome, but these interventions often come too late (leading to unfair and unnecessary loss of staff through either Ill health retirement or medical inefficiency) and there are still too many barriers to accessing help – and far too many prison officers needing it.

8. The constant fear – or even expectation – of being attacked takes a huge psychological toll, too, with many members feeling the need to be “hyper-vigilant” for potential danger during their shift. Shamefully, female officers face an increasing threat of sexual assault, while spitting and “potting” (where prisoners throw containers of urine, excrement and even ejaculate over officers) are on the rise too. Families also suffer, leading to more pressure on mental health. Can you imagine how it feels for our members when their children are too scared to hug them due to visible injuries?

9. In no other profession would such high levels of violence be tolerated. In the High Court in 2018, Ministry of Justice barrister Daniel Stilitz QC described the strangulation (to the point of unconsciousness) of a at HMP Lindholme as “deeply regrettable” but “business as usual in a prison”. This rare insight into the mind of Government betrays pure contempt for the loyal workforce who keep prisoners and the public safe from behind high walls. This feeling of not being valued, despite the risk prison officers take daily, adds to the burden on their mental health.

10. Additionally, the Government’s decision in December 2020 to reject the Prison Service Pay Review Body’s key recommendation of a £3,000 pay rise for frontline prison officers on Band 3 Fair and Sustainable grade literally adds insult to injury and has also had an adverse impact on mental health. Many prison officers are forced to work excessive hours to earn overtime in order to survive financially, with this constant “long hours” culture further exacerbating adverse mental health conditions of staff.

11. The soaring levels of violence, self-harm and suicides have an appalling effect on staff mental health – symbolised best perhaps by the fish-knife given to all new recruits for them to cut down prisoners who have hanged themselves.

12. Before the pandemic, the POA conducted a mass membership survey on “work-related wellbeing”, run by Dr Gail Kinman, Visiting Professor of Occupational Health Psychology at Birkbeck University of , and Dr Andrew Clements, Lecturer in Occupational Psychology at Coventry University.

13. The survey report (attached and available at https://www.poauk.org.uk/media/1888/poa- survey-of-work-related-wellbeing-1.pdf) revealed that “POA members continue to report lower wellbeing than average for all of the Health and Safety Executive’s work stressor categories”, with “wellbeing levels for demands, control, manager support, relationships, role and change management categorised as red (indicating urgent action is required) and peer support as yellow (showing a clear need for improvement)”. It also states that “members who report poorer wellbeing in relation to the HSE work stressor categories tend to be at greater risk of mental health problems and burnout and have less job satisfaction, more work-life conflict and stronger leaving intentions”.

14. The report found: “The use of psychoactive substances has become a serious problem for many POA members” and that “exposure can lead to serious health problems” – which includes mental health problems. Two-thirds of respondents reported personal exposure at least once or twice a month, with almost one in five experiencing this daily. It is scandalous that POA members are expected to carry out such a dangerous job with the added risk of intoxication from second-hand Spice smoke. 15. The following are comments from POA members quoted in the report:

(a) “Over the years, prisoners have become more demanding, staffing levels have reduced, and our workload has increased. This is not a safe or healthy environment for anyone to work in.”

(b) “When you experience violence on a daily basis, whether it is verbal, intimidation or physical, it has a detrimental effect, which you are not always aware of. It affects your physical and mental wellbeing and people often turn to alcohol or prescription drugs to mask the problem.”

(c) “I was involved in a major incident a few years ago when colleagues nearly died after being attacked. I received counselling afterwards, but the stress still builds up and remains for months. I need more help as I believe I have PTSD.”

(d) “I can’t talk to my family about work issues as it would be too upsetting for them. My work is all about self-harm, violence and death. They would worry too much about me if I told them the truth.”

(e) “I was seriously exposed to psychoactive substances several years ago and suffered from breathlessness, heart palpitations and high blood pressure. On several occasions, I have witnessed staff suffer severe reactions, which has sadly led to a number of them resigning due to the mental health effect this had on them.”

(f) “The job of a prison officer can wear you down. I suffer from anxiety and stress. It kind of sneaks up on you until you realise you have it!”

(g) “I have been a prison officer for 35 years and have been diagnosed with Trauma Induced Reactive Depression. There is no cure.”

(h) “I have wasted 20 years of my working life doing a job nobody appreciates. I’ve ruined my physical and mental health and I’m in the process of destroying my relationship due to work-related stress. I think I have PTSD, but I’m too afraid to see my GP because once I’m labelled at work there’s no going back.”

(i) “Because I am constantly working with violent and aggressive prisoners, my tolerance levels have diminished hugely over time. This affects my relationship with my teenage sons who sometimes I treat as YPs [Young Prisoners]. I know this is wrong, but you find yourself switching into work mode.”

16. The POA is calling for urgent action from the Government to protect the physical and mental health of prisoners and staff. There are no simple solutions, but clearly significant financial resources will be required to tackle this escalating crisis – which is due in part to the huge cuts to prison budgets and staffing since 2012. 17. A key component of any strategy to reduce must be the introduction of measures to encourage prison officers to stay in the job for longer, such as the pay rise recommended by the pay review body and bringing the retirement age back down to 60. Without measure like these, officers will respond to a violent and stressful workplace by voting with their feet and leaving the service they love, to the detriment of all.

18. The POA would be pleased to give oral evidence to the Committee on the matters above or any other issues relating to mental health in prisons as part of this inquiry.

May 2021