Many people with serious mental illnesses end up in prison cells – and then struggle to get transferred to hospital. The Guardian speaks to a woman imprisoned for setting fire to a cushion and a prison officer running a unit for the sickest prisoners.
‘I should have been in hospital’
Shell Ball cannot remember exactly what was going through her head when she set fire to a cushion in her home in Crewe in 2019. But she had been struggling to cope with the death of her fiance, Gary, who had started drinking heavily again after they lost a baby. “I got quite drunk and I really don’t know why but I set fire to the corner of a cushion. Upstairs had heard me shouting and called the police,” she said.
It was the start of a nightmare that would result in Ball – who has been diagnosed with anxiety, depression, PTSD and borderline personality disorder – being imprisoned and then twice recalled to prison after attempting to take her own life. In total she would spend nearly 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 in HMP Styal, Cheshire – just a week after Gary had 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 prison,” 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 was still sent back to prison. “[The judge] said: ‘I know you didn’t have any intention of hurting anyone that night other than yourself,’ but he gave me two years.”
Ball started self-harming as it gave her “some release” from the hopelessness of her situation. “There’s no light at the end of the tunnel. A lot of people in prison are the same and that’s why people kill themselves and self-harm,” she said.
While she was at Styal, at least one woman died. “About 90% of the women in there had mental health issues – most probably that’s why they were in 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 was only given the opportunity to speak to a psychiatrist on the phone just before she was released. “It was pointless.”
She struggled to cope outside as she had not received any sustained treatment in prison and was recalled after two suicide attempts. Ball appealed to the Parole Board but was turned down: “How can I get recalled for trying to take my own life? How’s that criminal?”
Ball was eventually released in August 2021 and has been getting her life back together. But she believes she should never have been sent to prison: “I don’t see myself as a criminal. I wanted to hurt myself. I wanted to die. I should have been sectioned in hospital and got the help I needed, which would have caused a lot less pain.”
A prison officer’s account: ‘It’s inhumane’
“A lot of officers avoid coming on to this [mental health] unit because they class it as the most dangerous part of the prison. You could open a door one day and the man in front of you could be nice as pie. You could open the door an hour later and he’d come out swinging punches.
“Self-harm is quite high. We don’t allow them to have razors or any sharp objects. But that doesn’t stop people. We’ve had people rip wall tiles off the showers and self-harm with them. We had a guy who tried to cut his own jugular a few months back.
“We see it as containment rather than any form of treatment. We keep them locked in mostly. We do let them out for a bit of association and we do take them outside for exercise. But on hospital wards they are out all day. It’s a much more relaxed environment. There are nurses to medicate them.
“In prisons, we can’t always give them the same medication they were prescribed in the community because certain drugs aren’t allowed within prison walls. Opioid-based medications are banned because they become currency.
“A lot of these people end up in prison due to their mental health. I’m looking at my board at the moment: from the eight that I’ve got in the unit today, there’s only one that I would say doesn’t fall into that category. There’s one in for carrying a bladed article. Another for harassment. He stood in the street shouting. He has psychosis and hears voices. Another person attacked a neighbour because he was playing music too loud. And a lot of these are under care in the community anyway, even before they come to us. They are ill. It is inhumane [to put them in prison].”
The officer, who wishes to remain anonymous, works in a mental health unit in an English prison.