Almost a decade ago the Ministry of Justice published a harrowing report majoring on certain findings of Surveying Prisoner Crime Reduction. Its take-home message is as true today as it was then: there’s no place like home.
Revolving doors
Three out of four ex-offenders who lack a place to call home get reconvicted within a year of finding freedom. That’s just one complete turn of the revolving door between cells and the streets. Countless people are going round and round and round and round.
Soggy tents
Say the word ‘tent’ and most of us think back to family holidays and school excursions. It didn’t matter that you got soaked because soon you would be back home for a warm bath, hot meal and dry bed.
Yet camping is not a happy prospect for the many NFA (No Fixed Abode) ex-offenders released across the United Kingdom (UK) every week. For many of them, camping is joyless at best yet the nearest experience they will have to setting up in a place of their own. Yet these unhappy campers are luckier than others. As over half the women released in recent years from prisons such as HMP Bronzefield know, alternatives to camping include wet benches, drafty doorways, or even worse.
tangled knots
Few people enter prison without a pre-existing tangled knot of personal problems. Rarely is it just one thing that prompts someone to commit a crime. It is more typically a series of unfortunate events: adverse childhood experiences, unhelpful adult relationships, homelessness, addiction, and health problems, to name just a few.
And it’s vital to remember that prison doesn’t miraculously undo knots. Sometimes it stops them enlarging - temporarily - but often it just makes them bigger and even more messy. And once released, how on earth can any ex-offender prioritise the unpicking of his soggy knot of personal problems whilst squatting precariously on a sodden park bench?!
A bit of Maslow
It’s impossible to over-estimate the vital role of holistic care for this particular vulnerable patient group.
Consider Maslow’s Hierarchy of Needs and it’s evident that we’re too often failing to meet the most basic of ex-offenders’ physiological needs – food, water and shelter. Without these stable foundations, how can we expect them to rehabilitate and reintegrate into society?
Caring holistically also helps to ensure that any positive work that may have been done in prison is not promptly undone shortly after release. And of course, gold standard healthcare is more likely to be achieved when patients have reliable contact addresses.
Making it personal
I’ll never forget one man I met earlier in my medical studies, when I was doing a placement in a homeless shelter…
He’d been released from prison just three days previously, straight back onto the streets. He could barely walk. He hadn’t eaten a proper meal for days. And he confessed to having relapsed into stealing already.
His leg ulcer dressings, which had been applied by his prison’s nurses, were soaked through. Yes, his nurses had tried to arrange for him to be seen in the community for follow-up dressings. But with no address and no phone, there was no way for his proposed follow-up team to get in touch with him.
And so he was looking like becoming another statistic in a sea of ex-offenders’ missed community appointments and unravelled prison healthcare interventions - until the street outreach programme I was with happened to come across him.
Glimmers of hope
That said, at last some rays of hope are starting to come through the clouds.
Rochdale Boroughwide Housing, for example, has implemented strategies of early intervention and planning prior to release, to try to secure a stable transition from prison. And St Mungo’s, a homelessness charity, has worked with both local authorities and probation services to set up a London housing clinic, which runs alongside probation hearings as well as reaching directly into prisons.
The common goal of these initiatives is to promote a planned transition.
Jamming the revolver
There is no doubt that our society needs to prioritise ex-offenders being released to places of safety and stability. This ever-revolving prison-street-prison door needs to be closed off, with clear alternative signposting towards routes that have at least a chance of leading to rehabilitation.
Miss Florence Kinder with Dr Rachael Pickering
Florence is a final year medical student doing a virtual elective with us,
and Rachael is a UK prison doctor and our medical director.
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