Careless in the community....

There have been a couple of recent TV series about prisoners, and it raises one particular issue for me, which is the institutionalised nature of so many of the inmates.

Many years ago, "Care in the Community" was the idea of the the Thatcher government to close many of the large institutional hospitals that those suffering with mental problems used to be treated. The principle was that these people could, instead, live in the community with localised support, and so not be simply removed from society, but be helped to cope with their problems within society.

Actually, there is something to be said for this - some people with more minor psychiatric problems used to end up with even more problems because they were institutionally based, and never had help in coping with living in society. The problems were that the community support was not there, the money spent - which should have been at least as much, possibly more - was actually reduced, and it meant that many did not get the help that they needed.

A number of them did end up in prisons, either because it was the only way they could get any help, or because their inability to cope in society put them in opposition to the society. It is not because all people with mental illness are dangerous criminals, it is because they are not able to cope with the society they are "freed" into.

What stuck me about the latest program "The Prisoners" is that so many of these repeat prisoners are institutionalised, and commit more crimes simply to be returned to prison - it is the only place they can go to get food and shelter, and they are accustomed to the prison life. Of course it is a rather more restrictive environment than some others, but it serves the role that so many of them need.

The problem is, by closing the psychiatric institutions, by reducing funding for homeless projects and drug rehabilitation schemes, the only institution that people who need some form on institution to live in is prison. There are some people who are best off in appropriate institutions - people who need the structure and support there to thrive. This is not to criticise them or demean then, just that in certain situations the order and structure of an institution is the best thing for them.

The problem with prisons is twofold. Firstly, they are "one size fits all" places, and are less able to focus on specific problems (drugs, psychiatric issues, social challenge). So it tends not to help them properly and specifically, and it fails - often - to rehabitualise these people to society.

Secondly, the cost of keeping people in prison is very high. The cost of providing this for those who are in need of help rather than incarceration is far too high. If this level of money was actually put into proper support for drugs, homelessness and psychiatric support, then a whole lot of these problems would be improved. And yes, some of them do need to be institutionalised and supported long term. this is not a failure of the care, it is a part of care.

Actually, proper and appropriate support for people, whatever it may be, is the humane and caring thing. Whoever the people are.