Locked up in lockdown: the devastating effect of Covid on the prison population

One thing we have learnt about Covid-19 in the last year is that it thrives in cramped, indoor spaces – and nowhere is this more the case than among jail populations.

The statistics are stark. There were 7.6 confirmed cases of the virus per 1,000 prisoners in England and Wales during the first wave, compared to 4.9 per 1,000 in the community, according to research published in The Lancet Respiratory Medicine in March.

It should come as no surprise, then, that there were a record number of deaths in prisons in England and Wales in the first three months of this year. The Ministry of Justice (MoJ) says the bleak figure of 154 deaths overall was driven primarily by those with coronavirus as a contributing factor. 

Yet while the coronavirus death toll in prisons from the start of the pandemic in March 2020 to the end of March 2021 has been high – 116 are suspected to be due to Covid-19 – it is significantly lower than initially expected.

The MoJ points to Public Health England modelling published in April 2020 which warned there could have been as many as 2,700 deaths in prisons as a result of coronavirus in a worst-case scenario. There were fears at the onset of the pandemic that the poor health of inmates compared with the general population, combined with crowded, barely ventilated prison buildings, was a potential recipe for a disaster. 

Prison policy has never been politically ‘sexy’

The relatively young age of the prison population compared to the general public could be one reason why this did not come about. But what actions did the prison estate take to avoid a much greater loss of life? And what could other consequences be?

The impact of the pandemic on the nearly 80,000 people in prisons nationwide does not get the attention it deserves, according to Bob Neill, chair of the House of Commons Justice Committee. 

The Conservative MP for Bromley and Chislehurst tells The House: “Prison policy, sadly, has never been politically ‘sexy’, for want of a better word. It doesn’t get the attention it ought to have, either in the public or media debate.”

Statistics on how the virus has struck the prison estate are hard to come by. In response to a Freedom of Information request from The House, the government refused to say how many prisons had recorded Covid-19 outbreaks and how many outbreaks in the community were thought to have originated in prisons. 

In order to contain the spread of the virus, prisons across the country enforced strict lockdown rules that confined inmates to their cells alone for 23 hours a day. Family visits were halted, as were education and therapy sessions. 

A report last February by the Prison Inspectorate found that while the stringent measures had effectively suppressed the illness and helped avoid a scenario akin to Public Health England’s dreadful projection, it came with the cost of “profound” damage to the mental wellbeing of inmates.

We saw a sense of hopelessness and helplessness becoming ingrained

Prisoners felt “chronically bored and exhausted” and bereft of a sense of purpose, the report says, and were not having enough social interaction.

“In our fieldwork we saw a sense of hopelessness and helplessness becoming ingrained,” says chief inspector of prisons, Charlie Taylor.

The government rolled out video call technology to help prisoners stay in touch with relatives during their solitary confinement but campaign groups like the Howard League For Penal Reform say access varied across the prison estate, and in any case the scheme did not amount to sufficient social interaction.

Frances Crook, the Howard League’s chief executive, says the long-term damage to the mental health of prisoners “is going to be devastating” and predicts some will “not be able to socialise or communicate” as a result of interaction with other people being reduced to nearly non-existent.

Peter Dawson of the Prison Reform Trust fears the impact on mental health will be lasting and severe: “The international evidence on solitary confinement, which is effectively what the prison population in our country has been suffering, is that those conditions cause permanent harm after just two weeks,” he says. “People have been under those conditions with little or no break for the last 15 months.” 

The severity of the lockdown measures led to situations such as those at HMP Coldingley, a men’s prison in Surrey, where early in the pandemic Taylor found that prisoners in cells without toilets, which made up around two-thirds of cells at Coldingley, had resorted to using buckets having been made to wait several hours to use the communal toilet.

There is particular concern about the impact of solitary confinement on child prisoners and young offenders, whom campaign groups say may find it even harder to return to society.

“Locking child prisoners in their cells for up to 23 hours per day, without access to rehabilitation, education or family visits, was not only hugely damaging for mental health, it was dangerous,” says  David Lammy, shadow secretary of state for justice. 

He tells The House: “The less opportunity offenders get to turn their lives around inside, the more likely they will reoffend when they are let out.” 

In October, Professor Nils Melzer, the UN special rapporteur on torture and other cruel, inhumane or degrading treatment, warned that the treatment of children in detention in the UK during the pandemic had been “extreme and inhumane” and risked lifelong mental health damage. 

There are around 500 children under the age of 18 in youth detention and 4,000 18 to 21-year-olds in adult prisons. Many children, including some as young as 12, have been confined to their cells for all but 40 minutes a day. 

Melzer says the use of solitary confinement should be “exceptional” and “in most cases there should be different measures to stop the spread” of the coronavirus.

“These kinds of stress factors are likely to affect this young generation for decades to come. If they spend a year like this it could affect their whole life,” he warns.

For the child prisoners whose education wasn’t stopped altogether by lockdown measures, worksheets were passed under their doors and had to be completed in their cells, according to the Howard League. One child told the campaign group that their anger-management course and art therapy had been cancelled.

This is taking place against a backdrop of a mental health crisis across the prison estate that has worsened over the last decade. The rate of self-harm incidents in prisons more than doubled from 318 per 1,000 prisoners to 741 per 1,000 prisoners between 2010 and 2020.

The MoJ says levels of self-harm have started to decrease in recent months, particularly among female prisoners, and the government hopes to continue that trend by rolling out an updated Assessment, Care in Custody and Teamwork case management system, to help prison staff support prisoners with mental health needs.

Nevertheless, the Justice Committee recently launched an inquiry into mental health in prisons, with chair Neill saying while there is now “a greater recognition and awareness” within government, “what we don’t yet see is a full and comprehensive integrated plan, and that’s right the way through from arrival at prison to discharge into the community”. 

He says mental health care provision in prisons is “variable” with prisoners “not getting the level of treatment and support that they should”. 

Dawson from the Prison Reform Trust says self-harm and suicide statistics are used as “proxy measures” for tracking the mental health of prisoners and do not reflect the complete picture of mental health across the prison estate. 

This chimes with a National Audit Office report from 2017 which described government data showing the number of prisoners with mental health problems as “poor”.

The pandemic has prompted renewed warnings that many of Britain’s prisons are not fit for purpose. 

Whatever the conditions of the buildings, there are too many people in them

The government has been forced to set up 1,070 temporary cells since March last year to create more room for solitary confinement and ease the pressure on stretched prison facilities. However, campaigners say while necessary, the move was a sticking plaster and that ministers must commit to improving and modernising the country’s prison estate as a matter of urgency. 

Some prisons were built by the Victorians two centuries ago, while others like HMP Bure in Norfolk started life as something totally different: in this case, an RAF base created during the Second World War.

They have small cells and narrow corridors, meaning inmates are tightly packed and there is often scant ventilation. Prisoners frequently report broken showers and faulty kitchen appliances. 

The dilapidation is compounded by England and Wales having the third largest prison population in Europe, behind only Russia and Turkey.

“Just as other public services were found out by the pandemic, prisons absolutely were,” Dawson says. “We’ve had prisons that were overcrowded 20 to 25 per cent over the last three decades and no government has tackled it. The level of overcrowding has never significantly altered. Whatever the conditions of the buildings, there are too many people in them”. 

The Prison Reform Trust says the government’s refusal to temporarily release up to 4,000 low-risk inmates at the height of a pandemic was a mistake. Dawson says doing so would have gone a long way to easing the pressure on prisons and would probably have reduced the number of infections. 

“The fact we have not had the number deaths we expected doesn’t excuse that political failure,” he says.

There is also deep frustration with the government decision to vaccinate prison inmates and staff by age, in line with the wider community rollout. 

The Scientific Advisory Group for Emergencies (SAGE) last month warned there would be a risk of large outbreaks in prisons until there was “universal” vaccination of staff and inmates, and recommended speeding up the vaccine rollout across the estate. 

Prisons could be breeding grounds for problematic variants of the virus that could make their way into the community, SAGE says, describing them ominously as a “potential reservoir and amplifier of infection”. 

Both the Howard League and Prison Reform Trust believe the prison population should be vaccinated as a matter of priority in order to eliminate this threat. “Staff are going in and out of prisons every day, and prisoners are entering and leaving prisons every day. In that sense, they are similar to countries where the virus is still rampant,” Dawson tells The House.

“The government is not taking the opportunity to reduce that risk and I cannot see any explanation other than it would generate difficult headlines – and that’s a very poor reason when lives are at stake.”

Prisons and probation minister, Alex Chalk, says: “Our dedicated staff kept thousands of prisoners safe and supported over the last year in extremely difficult circumstances, but our thoughts remain with the family and friends of those who lost their lives. 

“Decisive action protected people but we recognise the impact of the necessary restrictions on prisoners, which is why we rolled out video calls, in-cell education and an even greater focus on wellbeing and mental health.

“While violence and self-harm continue to fall, we remain vigilant to the challenges as we begin to carefully ease restrictions over the coming months.”

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