How the UK prison system fails the most vulnerable women in society – reviewing ‘The Prison Doctor: Women Inside’
In her second book, Dr Amanda Brown details her experience of working in HMP Bronzefield, shedding light on some of the most serious issues within the largest women’s prison in the UK.
Photo by Ye Jinghan on Unsplash
The most common perception of female prisons is that they house society’s most ‘evil’ women. We have all heard the names of the UK’s most notorious women many a time; Rosemary West, Mira Hindley, Joanna Dennehy. But looking beyond the very small minority of female prisoners who are sentenced to life for perpetrating the most horrific crimes, the picture of female prisons is far more complex and tragic. In her second book, “The Prison Doctor: Women Inside,” Dr Amanda Brown shares her experiences of working in HMP Bronzefield, the largest women’s prison in the UK, where almost every prisoner she sees in her GP clinic has a heart-breaking story of dealing with a life of trauma to tell.
Following on from her first book, Dr Brown’s second instalment of her biographical series details her many encounters and experiences with the prisoners she has treated, this time specifically the women imprisoned in HMP Bronzefield. She explores the complex issues affecting the female prison population, one of the most serious being homelessness. Over 50 per cent of Bronzefield’s prisoners are released into homelessness every year, which is a truly shocking statistic. Many women enter prison homeless, and because their sentence is often not long enough to give them time to secure permanent housing upon their release, they leave again unsure of whether they will have a roof over their head that same night. All too often, they quickly fall back into a continuous cycle of homelessness and reoffending.
Something I found to be most surprising was that many of the women whom Dr Brown meets long to go back to prison, and this is why they constantly reoffend; prison offers them a warm place to sleep, three meals a day, some sense of regularity in that every day is the same, and the feeling of safety that many women can simply never feel when on the streets. I found this incredibly upsetting, and it made me check my privilege even more; as someone from a stable home and a loving family, the thought of going to prison absolutely terrifies me. But for many women whose lives are bound to the streets, prison is a safe haven.
Many women living on the streets are vulnerable, longing for a roof over their head and for some form of shelter. Sadly, this often makes them easy targets of sex trafficking, which was the case for one of Dr Brown’s patients, Mirela. Abandoned by her parents and sexually assaulted at the children’s home she lived in, she was swept away by a man she met in a Romanian café. She was longing for a better life in the UK, only to get there and become subject to enforced prostitution until she managed to escape. Turning to drugs to numb the pain of her trauma, she was relieved to end up in Bronzefield and feel truly safe for the first time in her life. Mirela retained a sense of hope despite her ordeals, and secured a place in a hostel a few weeks before her release. She began to detox from the methadone she was taking to combat her drug-withdrawal, and left Dr Brown’s care with the intent to rebuild her life outside the prison walls. Despite committing a crime, I feel she is an inspiration, and an incredible example of the strength and bravery that so many women manage to retain, despite their circumstances. I do not know this woman, but I found myself wondering whether she managed to start a new life after all.
Another huge problem in both male and female prisons is drugs. It is no secret that drugs are rife within the prison system, and Dr Brown touches briefly on dealing with the “spice” epidemic in The Wormwood Scrubs (a Category-B male prison at which Dr Brown worked before she transferred to Bronzefield). “Spice” is a deadly concoction of many different substances which are combined to form a highly dangerous and addictive drug, often making its users behave erratically, abusively, violently. Hearing about “spice” from a medical perspective is even more interesting; inmates who have taken the drug are incredibly difficult to treat, as it can contain so many different substances (like traces of metal and even rat poison), and often no two batches of spice contain the same ingredients.
Despite the inevitable presence of drugs in HMP Bronzefield, Dr Brown rarely deals with ongoing drug use, but with the awful effects of years of addiction, and the desperation of many women to get clean. Women who regularly inject heroin often experience painful ulcers or other skin conditions, and the use of crack cocaine also has catastrophic long-term effects, such as losing teeth, significant weight loss, and damage to the heart and liver. Dr Brown sees countless numbers of women, all dealing with the same tragic effects of a life of addiction. A common thread that I noticed throughout Dr Brown’s accounts of working in the substance misuse clinic at Bronzefield was her description of the prisoners, who so often looked exhausted, deflated, and seemed to her the shell of a human being. But for many women who have suffered a life of pain and trauma, the numbing feeling of drug use far outweighs the risk of lasting damage.
A large majority of female prisoners have experienced some sort of trauma in their life, often abuse or violence as a child or young person. They then fall into drug addiction as a way of blocking out their painful memories. Many of the stories relating to drug use that Dr Brown recalls are truly heart-breaking, and so this book is definitely an upsetting one at times. From years of physical and sexual abuse in childhood, to coercive control and domestic abuse by a partner, Dr Brown’s patients have been on the receiving end of some of the most inhumane behaviour possible, and their addiction to drugs as a coping mechanism is very often the reason for them ending up in prison.
Because of their relationship with drugs and reoffending, many of the women in Bronzefield inevitably return for only a few weeks at a time. It may not seem as though short prison sentences are problematic, but in reality, they often pose a threat to the health and even lives of female prisoners. Women who enter prison addicted to heroin or crack cocaine will quickly start to experience withdrawal symptoms; some of them may be used to taking over £200 worth of drugs every single day. Dr Brown explains that in order to treat drug withdrawal and stabilise her patients, she must prescribe a dose of methadone, which is closely monitored over their first few days in prison and continuously reviewed throughout their sentence. However, a sentence of 28 days, for example, is simply not long enough to get someone onto a stable dosage and into a detox routine, meaning that if they turn back to drugs as a coping mechanism upon release, their chances of overdose are far higher. One woman in Bronzefield described how “a short prison sentence may as well be a life sentence”; it is incredibly scary that only a few weeks in prison could endanger a vulnerable woman’s life so much.
Throughout my reading of “The Prison Doctor: Women Inside” and hearing the many tragic stories of the residents of HMP Bronzefield, I could not help but feel that the UK’s prison system is continuously failing the most vulnerable women in our society. I am not suggesting that we should excuse the actions of these women; they committed a crime, and should face the consequences of this, but so often their crimes are the result of far bigger societal problems like homelessness and drugs.
The UK prison system has several aims of punishment; are they achieved through such short sentences for very minor offences? Deterrence means using a custodial sentence to instill fear of prison in someone in order to stop them from reoffending, but for most of the women in Bronzefield, prison is safe, not scary. Another aim of sentencing is rehabilitation, but short custodial sentences simply do not allow enough time for a woman to be truly supported through the often long and challenging process of rebuilding her life. Dr Brown states that it costs around £65,000 per year to keep a woman in HMP Bronzefield; I agree wholeheartedly with her in her argument that this money is far better spent on community rehabilitation and specialist women’s centres. There are currently around 3,600 female prisoners in the UK; instead of letting a vulnerable woman become just another one of these numbers, commitment should be given to help her turn her life around.