Why was Sarah Reed in prison, not hospital?

Image of Sarah Reed, a light-skinned Black woman wearing a cream coloured fleece top.Sarah Reed told family of alleged sexual assault in hospital, from the Guardian

It has been revealed that Sarah Reed, the woman who was found dead in her cell at Holloway Prison in London last month, having supposedly strangled herself, had been remanded following an incident in a secure ward at the Maudsley psychiatric unit in south London. Ms Reed wrote to her parents to tell them that an old white man had sexually assaulted her while in the unit and she fought back, resulting in her being charged with causing grievous bodily harm (GBH) with intent. Rather than being released back to that or another unit, she was remanded in custody. This would have been the decision of a medical ‘expert’ from the local health authority, rather than a judge or prison service official. Reed was the victim in 2012 of an assault by a police officer, who was later dismissed from the Metropolitan Police and sentenced to community service.

The incident should raise the question of why secure mental health wards exist that treat both men and women; many women with mental health problems are victims of sexual abuse and rape. We do not imprison men and women together; we should not do the same in the mental health system. (By the way, nearly all mental health wards are locked as sectioned and informal patients are treated on the same ward. Theoretically, an informal patient is allowed to leave; in practice, staff often refuse to allow them to, or threaten to section them if they demand to be allowed to leave.) The experiment with mixed wards led to a number of incidents of sexual harassment of female patients, many of which were dealt with inadequately by staff, and it has often led to women feeling unsafe simply by being confined in the same space as men. It simply should not happen.

On top of this, why would anyone imagine that prison is a suitable environment for someone whose mental state does not permit them to live at home or walk the streets without supervision? The fact that prisons are closed institutions does not make them less stressful places to be than home, the street or the shops; this misplaced assumption is commonly made about institutional environments (not only prisons but also boarding schools, hospital units and so on), and is wrong, and dangerously so. A person who is under section is already presumed to need mental health care and to receive it from mental health professionals; prison officers are not mental health professionals and convicts, by nature, are more likely to be violent than other psychiatric patients. Why was she not transferred to a women’s secure mental health unit? There are plenty in the south-east and it would have been a more appropriate use of the resources than sending inappropriately sectioned autistic people there from other parts of the country. Unlike in the mental health system, “no beds” is no impediment to imprisoning someone; they can always make prisoners share with one or two others.

Of course, it’s possible for a mentally-ill person to commit a crime for which their illness is not a defence. But it’s a fact that people in institutions are more likely to be referred to the police for property damage or fights that would result in their arrest if they happened at home, and the atmosphere and person mix of the institution, the reasons why people are there and so on may make more likely. This applies to children’s homes as well, resulting in “looked-after” children being more likely to start their adult life with a criminal record than one who was able to live with their family. Someone who is meant to be receiving treatment for an illness, which may be (as in Sarah Reed’s case) the result of trauma, should not be criminalised for failing to deal with the stresses of (enforced) institutional life as calmly and rationally as a healthy, free person — the proverbial “man on the Clapham Omnibus” — might.

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