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Modern Matron, Prison Mental Health Team

Sometimes I see former prisoners I’ve worked with who are now outside in the community.   Woman smiling at camera

They come up and say: “I was in the prison. Thanks so much for looking after me.”

I tell them: “Don't worry. Make sure you stay out of trouble.”

And they reply: “No, no, Miss. I’m not coming back.”

To hear that is so rewarding.

I am able to help people in many different ways. I get them to talk about what brought them to prison, or I signpost them to develop life-skills they can use on the outside.

I support them to access education or write reports to support their early release.

Or I help them to understand the advantage of taking their medication to prevent relapses and keep them out of trouble.

I have worked in more than 30 prisons as a locum since my first job 14 years ago.

That was in Chelmsford. I was offered a role from an agency. I thought “Well let me go, let, me try.”

But my career really started when I was working at Barnet, Enfield Haringey NHS Mental Health Trust (BEH) six years later.

I was with them until 2020 and I was supported to apply for a band 7 role. I came back to BEH as a locum last year and I am now the modern matron for the London prisons.

My key role is to ensure that the clinical work is within standards. I work closely with the team leads and nurses to ensure that our policies and processes are embedded within the team.

I find BEH is really friendly. I have lovely managers who are caring and supportive.  Everyone, including the managing director, listens to staff, and we are all treated the same.

Managers are family orientated and open to flexible working. They consider someone’s personal circumstances and will do their best to accommodate their needs and make sure it fits with the service.

When I began working in prisons, my kids were so young. It’s a long day but I was able to make it work by doing condensed hours.

In some ways prisons are like a family and you need to be able to navigate this family to put your point across.

You need to be able to communicate your concerns in a diplomatic way so people can accept what you bring.

To be a prison nurse you need to be knowledgeable; you need to have confidence and be able to speak out. Because if there is an incident the officers look to you to make the decisions.

I'm BME and most of our workforce in the prison is BME. So, because I come from the same background, I understand the cultural dynamics and where people are coming from, and this often helps me to sort things out.

I have insights into prison life.  You either like it or you don’t, there's no in-between.  You either fit with the system or you don't.

You need to have resilience because is a fast-paced environment. You need to be able to say, “I'm not happy with what you've done” and not take it personally.

But the rewards are amazing.

Outside of work, I go to the gym, and I travel a lot and I've got a lovely family that keeps me going.

Lead for Therapies and Senior Clinical Psychologist, Prison Mental Health Team

I've always been someone that likes a challenge. The people we work withMan with dog are some of the most marginalised, vulnerable, and stigmatised in our population, who have often experienced their own trauma.

I’m the lead for Therapies, and the senior clinical psychologist in a prison mental health team. I also manage a separate stream of clinical psychologists, counsellors, occupational therapists, and speech and language therapists.

Our work in prisons involves a lot of time thinking about the impact of trauma in people's histories and how it manifests in present day-to-day interactions.

We take the view that prison should not be punishing; the punishment has already happened, because freedom has been taken away. This is now a time to provide the most help and support we can, so someone doesn't feel that everyone has given up on them, and they can continue to progress with a life that feels worth living and reintegrate back into the community in a safe way.

As mental health professionals we feel extremely humbled to spend the time we have with someone, listening to their story, to try to understand what has brought them to where they are now.

We then try to think together about how we might be able to work to ease that distress, whether that is in 1:1 sessions, in groups, or with professionals in the prison. It’s a privilege being able to support someone in what can feel a very frightening, distressing and vulnerable time.

I understand the reservations people have about working in forensic services and you do need to think about your own level of resilience. These are challenging, highly emotional places to be and there can be a significant amount of distress in your daily environment.

But you do also get to see real change happening, whether these are small steps forward or substantial changes to the way someone feels able to live their life.

It is also great to work with a wider network and system of people, trying to find the best way to support someone, and given the restrictive nature of the environment, working creatively is an absolute must. 

 

You do need to think about your own level of self-care; your mental, physical, emotional, and possibly your spiritual health. These are the things that really enable you to come and do your job.

And I would always recommend having something outside of work, unrelated to the work.  I have a dog who I absolutely adore to pieces. I really enjoy getting home in the evening and taking my dog for a walk.

The work is flexible around you too. I qualified as a clinical psychologist in 2010 and have been in my current role since 2014.

I currently work in two posts. One is my lead role of therapies in the prison, and one is an academic director and Senior Clinical Tutor of a Clinical Psychology training course.

I will be quite upfront and honest and say, it's not for everyone.

But if you want to do something different, that's creative, that isn't going to fit the standard model that your training provided, prison mental healthcare might work for you.

If you could connect with people who on the surface are characterised as dangerous, violent people and find a sense of compassion, empathy, and connection, prisons could be for you.

When you apply for a job in the prison service you will be working in a unique environment, with a unique set of opportunities and a unique set of challenges.

And if you can bring your passion for that work to join a team and allow a team to support you, prison can be an incredible place to work.

Speech and Language Therapist, Prison Mental Health Team

I had always wondered what it would be like to work in a prison - there are so many misconceptions about it. Woman looking directly at the camera

When I got my job as a Speech and Language Therapist at a men’s prison, I remember friends and family asking me whether the prison officer would be in the room when I did assessments.

They were so surprised when I told them that wasn’t needed or allowed, given the confidentiality of my work.

But I don’t feel unsafe and I never have felt unsafe.

There are also many prison officers around and green buttons to press if you’re feeling concerned about your safety, although I have never had to do this.

Many of the men I work with are coming to the end of their sentences. I hear of the challenges they have faced and can empathise.

To be able to make a difference to someone’s life really means something. So, if you work with 20 people, and have success with one of them, it’s worth it.

I have worked in this role for almost four years although my background has mainly been working in community neurology teams.

When I moved to a prison I thought I would really struggle with a confined environment.

But I found it really wasn’t as restrictive as I feared – I move around the estate throughout the day and, actually, you get used to the environment very quickly.

And because I wanted a new challenge, I was keen to broaden my skillset. I am a band 7 and knew I had transferable skills that would be beneficial to this type of role.

Much of my work involves supporting autistic and neurodiverse people but there are many other conditions I also assess and support.

For instance, I may support an individual who has suffered a stroke or help someone who stammers and struggles to communicate.

I am working with someone at the moment who has just been diagnosed with autism and he is so grateful for the work we’ve done to support him. I feel a great sense of reward for the work I do.

For any speech and language therapists considering working in the prison sector, I would say you have the transferrable skills to do it – your core clinical skills can be applied to the variety of conditions you will face.

Outside of work, I am chair of my local allotment society, which tends to be more challenging than it sounds. I am also a keen runner, and about to embark on the cross-country season, which I love.

Consultant Clinical Psychologist, Prison Mental Health Team

I've always wanted to work in prison mental health care. I chose a specialist forensic Woman smiling at camera placement at Feltham Young Offenders Institute during my doctorate at UCL, and I absolutely loved it. Following qualification, I returned to work at HMYOI Feltham, as well as in secure adolescent inpatient units, and more recently in adult prisons.

Today, I am a consultant clinical psychologist and oversee the provision of our psychological therapies across Brixton, Pentonville and Wormwood Scrubs prisons. 

In the early phases of my career, I worked with young people from all sorts of difficult backgrounds, with long histories of trauma, neglect and attachment difficulties. I soon realised this was an area where I could make a difference, and I knew it was what I wanted to do.

Contrary to popular belief, prisons are full of people who are usually desperate to be helped and to connect with others on a human level. So, if you're somebody who feels rewarded by human connection, then prison work is extremely fulfilling.

Forensics is a unique environment where, as a psychologist, you can really make a difference to someone’s life at a time when they are probably at the lowest they will ever be. Supporting someone to develop trust and engage in something meaningful is so rewarding – this might be therapy, education or employment – or maybe it’s just living a life in prison that is meaningful to that individual. This might sound basic, but it really isn't. It is wonderful.

Psychologists in our prisons work within multidisciplinary teams (nursing and psychiatry) and alongside other therapists (occupational therapists and speech and language therapists), so are able to provide holistic and trauma-informed care.

Being able to bear witness to and support someone’s transition through custody and back into the community is a privilege.

Given the challenging context of prison work you do need to be flexible to work in this job (the prison always has the final say about what you can and can’t do!), but the work can also be flexible around you too. I'm a mum of two and although I’m in a demanding role, I can make it work around my family, which is really important to me. And you often can't get that with senior roles.

I take time off during the school holidays, work around the school day and can work from home if one of my children is sick. All these things sound very simple but they all  have a huge impact on my wellbeing.

We have a very supportive senior management team, who understand that work-life balance is so important in creating a sustainable role. Though my children keep me pretty busy, I have been able to work part-time in a senior role. This means I still have time to continue to do the things I enjoy outside of work – I’ve recently taken up piano lessons again!

And it’s a trickle effect – because working flexibly is supported by my senior managers, I am able to support my own staff in the same way. We won't ever jeopardise our service delivery, but 99% of the time we can make things work. For example, one of our psychologists regularly works from home one day per week, and another colleague works condensed hours.

I've been with BEH since 2010, which is the majority of my qualified professional life. When I started, I wasn't the most confident person, and I would never have imagined myself in a senior consultant role like this. But because the service is so innovative and dynamic, I’ve continued my professional development and had opportunities for leadership in every role I’ve occupied within this Trust. When this consultant job came up, I felt ready for a new challenge and was supported to apply.

I've stayed at BEH because there were always opportunities for me. I’ve ensured that   within my role I structure our service so that there are opportunities for others to progress too.

For example, when we were remodeling our service, I championed a new 8A psychology post in all of our prisons to bridge the gap between the Therapy Leads and the B7 Psychologists and to provide more opportunities for professional progression.

I knew that we would retain more of our colleagues if we created a resilient structure within which our staff could progress. 

I really enjoy supporting my staff to reach their own potential. This might be through funding training for their CPD, supporting a colleague’s special interests, or it might be supporting their creative ideas, like funding the new sensory room for the neuro-disability unit in Pentonville. Just being able to say ‘yes!’ to creative ways to deliver our services is really lovely.

Prisons are challenging in so many ways, but there's a real sense of shared working, shared ownership and camaraderie amongst staff. You work in a well-resourced service with many opportunities to work in a dynamic and responsive way.

Prison mental healthcare sometimes has a reputation for being very medicalised, but our services are changing. We’re embedding trauma-informed approaches and we've moved forwards leaps and bounds with our neuro-disability provision.

To someone considering working in a prison, I would say try it, it could very well be the most fulfilling thing you do.

Because success in a prison environment feels 100 times more satisfying.  

Please get in touch with us and set up a visit [insert a link to do this].

Prison Services Manager, Prison Mental Health Team

I trained as an occupational therapist and started at BEH 14 years ago in an acute ward.

Since then, I’ve been given many opportunities to work my way up. I'm now the service lead for the London prisons.

I ensure that the services are safe, with the right level of staff and resources to deliver the service we are commissioned to provide.

My first opportunity in prisons was as the service manager for the Thames Valley Cluster, supporting three prisons. I found I loved working in prisons because all healthcare is available in the right place at the right time.

It was daunting coming into a prison at first and I was quite anxious. I’d only ever worked in the community and my family and friends asked why I was going to work in a prison as it was unsafe.

But working in prison mental healthcare, I haven’t had any concerns with my safety, there is so much support around you from the prison staff and colleagues.

Today I manage three Mental Health Hubs and 2 healthcare units, which are similar to inpatient wards. Healthcare in the prisons is unique in providing physical and mental health care for people all under one roof.

I work with mental health nurses, occupational therapists, social workers, speech therapists and psychologists - as well as an opticians and dentists.

BEH has really invested in my career. It does so in every area of its work, not just in the prisons. There's a real family feel and very supportive culture.

Working in prisons has meant I could fulfil my passion for Early Intervention in Psychosis and that’s where I’ve done most of my clinical work.

We are able to help people who were unwell in the community but couldn’t access the right support there and have sadly ended up in the criminal justice system.

I am passionate about clinicians building up rapport with patients as it is often the start of someone’s mental health recovery, enabling them to lead the lives that they want to live.

Because I have been massively supported in my career, I am passionate about being able to provide the same support for others to progress.

Last week I was talking to a new team member and said, ‘If you don't mind me asking, where do you see your career going?’ She was really delighted that I asked her that question.

I always say to colleagues that our work is prisons is no different to working in the community. In fact, it can be better because you can see your patients more easily.

There are some downsides, such as not having easy access to the outside world to reach out if you have a personal matter, however, there are ways you can work around this and make it work for you, as I have.

But there many positives to help overcome this, such as flexible working, compressed hours and different working patterns.

My weekends are full of children's activities, which help me switch off. I think there’s something about the prison environment that means when I can, I love to be in the open air.

Prisons are a great place to work. I always tell people if they are interested to come and see what they think.

I started on a secondment, which was a great way to ‘try before you buy.’  But you could also spend a week with us or come on a visit. There are lots of options.

So, if you are interested in working with us, please get in touch. We would love to show you around.

Speech and Language Therapist, Prison Mental Health team

image of a woman with glasses looking at the camera

My role is to work with autistic men and men with learning disabilities, developmental language disorders and other types of communication needs.

I am a Speech and Language Therapist in a prison with 1,200 men who are wating for their cases to be heard or waiting to be sentenced.

So, there is a lot of uncertainty.

I’ve been here for four years. I previously worked at Broadmoor which is how I got into forensic work.

I firstly look at someone’s communication needs in prison. Part of this might be thinking about how they will manage in court.

I teach people phases such as, “Please can you repeat that, I didn’t understand?”.

If I notice problems with understanding language or social cues in everyday conversations, I will advocate for someone to have access to an intermediary.

So many times, I have been told: “I didn’t understand what was going on, so I said yes.” 

I also work with solicitors to explain, for instance, that an autistic person might look disinterested, but they are actually petrified.

I give officers strategies and try to get reasonable adjustments for autistic people.

For example, I make a communication passport about what support can be put in place. This might include allowing extra time for questions and that the person may benefit from repetition and specific answers, because vagueness causes anxiety.

In prison if there is lockdown, I might ask an officer to explain what is happening. This can prevent a meltdown from someone who was expecting to do their planned activity.

The men I work with have developmental language problems. It’s likely that they got to Year 6 at school and couldn’t engage with education. Behavioural problems started, and they went to a Pupil Referral Unit.

Gangs queue up outside these units and young men become enmeshed in the criminal world. Being excluded from school is a pipeline to prison.

The prison governor found out about my work and wanted to support men with autism and learning difficulties.  So, we now have an area of the prison for men with neuro-development needs.

As part of this, we offer training to officers who are dedicated members of staff in this area. There is an adapted regime with much more flexibility and understanding about communication needs.

The autistic men are together on a single landing, with a stable staff team that we have trained. These men are now understood, and they are very grateful for my help and are willing to work.

What makes me sad is discharging men into the community where there is so little support. In six to nine months, they can be back in prison.

Working with the men and helping them to understand their needs and normalise their difficulties is the best part of my job.

For example, a man with undiagnosed autism had a cell with ambient noise that was really bothering him. He complained and was told to go back to his cell. He refused and was restrained.

I manged to get him to the special landing. He now has a communication passport, detailing his sensory needs. He is just an autistic man who wasn’t coping.

It is so good to be able to assess someone and explain that whilst they struggle with understanding complex grammar, they are not stupid. They learn to say, “Please can you break it down? Please can you write it down?”

It’s the small things that can make a huge difference.

I love my work because no day is the same – I have a varied caseload.

I also support other professionals to make their work accessible. This includes making visual resources and supporting them to make easy read versions of their work.

I am also involved in the autism assessment pathways, offering clinical assessments and neurodevelopmental interviews to family members.

Away from work I’m a big gardener, it’s a good foil to the hard surfaces and noise of the prison.

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