Viewpoint 86 - The Insiders

ITV, 28th January 1986

Second of two linked documentaries on the plight of two linked documentaries on the plight of Britain's schizophrenia sufferers looks at the particularly hopeless position of those schizophrenics - possibly as many as 13,000 at the present time - who find themselves in prison because the illness predisposes them to committing silly, attention-seeking crimes. Are prison sentences society's only solution for the mentally ill "criminal" like the man serving two years for setting fire to laundry bags? Reporter David Jones finds that very little money is spent on treatment for mentally ill prisoners and only a disproportionately small amount of it is allocated to treating schizophrenics.

Programme Guide, The Guardian

Insiders (Central), the second of two programmes on schizophrenia, offered disturbing evidence that between a third and a half of the people in prison are mentally ill. There is a close correlation between the number of mental patients discharged and the rise in the prison population. Psychiatric hospitals are being closed; prisons are being built.

The father of Lucy, a pretty, marmalade-haired girl who suffered a schizophrenic breakdown and killed herself, heard her calling out continuously "nobody loves me," when he visited her in Holloway. It was a reasonable observation. The senior psychiatrist at Parkhurst thinks the same: "Schizophrenics tend to withdraw. Unlike middle-class neurotic ladies who stand up and shout, they don't have a lot of political clout. Nobody will vote for them. The politicians don't care. Why should they?"

Nancy Banks-Smith in The Guardian, 29th January, 1986

[A review on both programmes ...]

In "Insiders" they weren't so lucky. Here the psychiatrists were a gallant lot, trying to rescue the mentally disturbed from prison where a haywire legal system had dumped them. Up to 45% of jail detainees may be mentally ill, many with schizophrenia, said psychiatrist Dr Malcolm Weller, and a tour of Parkhurst confirmed this absurdity. The prisoners were pitiful, largely passive, guilty of pointless crimes. Their stories were of strip cells, beatings, gnawing fear. The prison warders, whose own representatives were enlightened and genuinely concerned, received barely a word of psychiatry in their training. Rigid authority was everywhere: at the prison hospital they guarded their patients with the help of dogs; chillingly, one patient repeatedly called his doctor "Sir".

Then came the fall guy, Lord Glenarthur, Home Office junior minister, a man with an unmistakable "trying hard to retain a suppository" expression. We are building more prisons, he offered irrelevantly, apparently straining to recall his last briefing on the topic. Ah yes, popped up Dr Weller, 16 new prisons - to replace the 30 closed hospitals. But if they are a danger to the public, persisted the minister, and the courts sentence them to prison, we have to provide the accommodation. Market forces, don't you know. No policy, some would say.

The programme was a disturbing exposure of the failure to plan for the disadvantaged and the desperate. Community care may be on the tip of every fashionable tongue, but prison care is a likelier fate. Lucy was one victim of this folly. Another was her father, whose dispassionate narrative began to crack as he reached her eventual, inevitable suicide. And there were many more - top level neglect is a thriving concern. Ask mad, bad Kevin.

Louis Appleby in the British Medical Journal, 8th February 1986