WORKING WITH PEOPLE WHO HAVE COGNITIVE DIFFICULTIES WITHIN THE IRISH PRISON SERVICE

Tara Deehan, Counselling Psychologist, Arbour Hill Prison on the issues affecting those imprisoned with an intellectual disability.

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International and national statistics suggest that at any given time, approximately 10% to 28% of the prison population present with an intellectual disability (ID). These studies also include people who present with specific learning disabilities and who have not been formally diagnosed with an intellectual disability. It is ethically questionable whether a person with an ID should be imprisoned in the first instance. Research suggests that a lack of community support is a primary contributor to the prevalence of those with an ID within the criminal justice system. Other factors include poor educational opportunities with inadequate remedial support, especially in secondary school. There is a lack of awareness from those in the criminal justice system who come in contact with the person who has an ID, from the arresting officer through to the courts. As such, the corrective services cannot engage in ‘gate keeping’, they have to receive all people remanded and sentenced by the courts.

Ideally those with an ID should not be imprisoned in mainstream prisons. For lesser sentences, their needs should be met in community-based services; for those who are serving longer sentences for more serious offences, a specialised correctional service should apply. In the absence of such a current response, this article discusses some of the implications of having an ID and specific learning difficulties while serving a prison sentence within the Irish prison service. It is written from the perspective of one prison within the IPS estate and it may not be entirely representative of the experience of all those with an ID in the Irish Prison System.

Several factors appear to impact significantly on those with ID in terms of progressing through their prison sentence. These include coping and self management in prison; their capacity to participate in therapeutic programmes to address offending behaviour; issues with their level of insight and understanding of their offending behaviour and its impact on others; and future release concerns such as accommodation issues.

Being committed to prison is a very difficult experience in most instances. For those who present with an ID it is even more challenging because those with an ID are more vulnerable. They can struggle to integrate despite efforts by prison management to ease the transition in to prison. They may be more susceptible to being bullied or isolated. These issues are usually a reflection of their experience in the community. Prison management are thus keen to ensure that these individuals are linked in with the various services that can offer support—the chaplaincy, education and therapeutic services, including the Psychology Service and the Probation Service. Unfortunately where demand is high and resources are limited, people with an ID may experience difficulties accessing services and may not always receive the support they require.

Very often those with an ID or with specific learning difficulties arrive in prison unable to read or write. The education service within the prison provides an opportunity to achieve literacy and numeracy skills. Those who attend and progress in achieving a better education often experience a great sense of pride and accomplishment. For others, however, literacy problems pose difficulties when participating in group therapy or other programmes which require reading and writing ability. It can be a source of great embarrassment and can pose a significant obstacle to engagement with the relevant services. The potential for self-exclusion is also likely to be a reflection of their experiences in the community. Consistent efforts are made to facilitate the person so that ID should not be a barrier to their engagement in group therapy or other programmes on offer. Invariably, those who do engage in programmes experience a positive challenge and increase in confidence and self-esteem as a result.

Those who are incarcerated for serious crimes, and who are motivated and suitable for therapeutic work, will have an opportunity to address their offending as part of their rehabilitation. This also applies to people with ID, despite the potential barrier of literacy difficulties. When suitability for therapeutic work is established, they are encouraged to make sense of their offending behaviour and to reduce the chances of such an offence recurring in the future. This can prove more difficult when significant ID results in difficulties with insight and an inability to understand the background factors or triggers for the offence. In these instances, individual offence-focused needs are addressed within a comprehensive and individually tailored risk-management plan. This may involve individual support in the form of clear and concrete strategies to help the individual manage future risks. This may take the form of a behavioural programme for the individual to follow and a comprehensive network of support.

Another major concern for those with an ID is their release and reintegration into the community. Issues relating to accommodation and employment are factors for all who are released, but potential difficulties are magnified for those with ID. Indeed, prison can often be a secure and predicable environment, particularly for vulnerable people. There is a daily routine which offers a sense of structure and containment. There are workshops, education and work routines, good food which is served regularly, and in some cases people have single cell accommodation. The pre-release phase can be an anxiety-inducing period where a combination of ‘gate fever’ (anticipation of release) is often accompanied by a strong sense of fear and dread. This is particularly evident when fundamental human goods are not available, such as accommodation, work or connection with family and community supports.

For those with an ID, the question of accommodation is particularly topical. The question is open raised whether the person can live independently. Furthermore, a person with an ID who has higher offence-related needs will require close supervision and monitoring, appropriately targeted counselling and, ideally, strong family support to ensure that the risk of re-offending is reduced. For such individuals, a multidisciplinary case conference will be convened under the aegis of the prison governor, to ensure that a comprehensive plan is in place to support the person with the ID in preparation for his or her release. However, the sobering reality is that community-based services are scarce and are particularly limited for those being released from prison. Those with an ID can often fall between two stools: their specific ID may not warrant the services offered to those with more severe intellectual disabilities, yet they are not capable of living self-directed, independent lives. It is a complex and difficult issue and each individual needs to be assessed on their own merits and difficulties.

It is essential that people with an ID are treated with respect and dignity when imprisoned. In general, they are offered the same services as others, but they require specific additional supports. Certainly in prisons where there are high numbers, there is a risk that people with an ID will not have an opportunity to engage with the relevant services and address their offending or, indeed, get the support they need to ease their transition back into the community. It is the responsibility of both prison-based and community-based agencies to ensure that people with ID are safe and, very importantly, that the community is also safe from harm. The current situation for those with ID who are imprisoned is far from ideal. It is important that the various services within and outside the prison can work together to support this population of people

Tara Deehan graduated from TCD in 1999 with an MSc in Counselling Psychology. She worked with the National Association for Deaf People (now Deafhear.ie) for 5 years entailing assessment and therapeutic intervention through the medium of Irish Sign Language. She has been employed by the Irish Prison Service for the past 8 years. She delivers group and individualised treatment to support men to address and understand their offending behaviour with a view to an offence free future.

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