The Adverse Effects of Imprisonment on Deaf Prisoners’ Mental Health: A Human Rights Perspective

1. The Adverse Effects of Imprisonment on Deaf Prisoners’ Mental Health: A Human Rights Perspective Ms. Amy Izycky & Dr. Manjit Gahir National High Secure Deaf Services

2. Introduction Who are we? What do we do? Clinical: National High Secure Service for Deaf Men, Rampton Hospital Research: Deaf Prison In-Reach Project

3. Disclaimer Informed consent has been gained from the case studies discussed for this specific purpose. Any identifying information has been anonymised to ensure participant confidentiality throughout.

4. Mr X. 56 year old man Prelingually deaf but diagnosed late at age 7 Attended deaf residential school Behavioural difficulties from an early age including violence to others Disclosed his sexual abuse by a member of staff Inappropriate sexual attachments to young women Poor coping skills and emotional regulation e.g. threatened girl and family with knife

5. Offending Behaviour Schedule 1 offender – physical assault on a 16 year old girl Fifteen convictions for criminal damage Six convictions for assault Reports of other assaults but not convicted Index Offences of affray and criminal damage Subsequently convicted of assault on a social worker, making threats to rape and indecent exposure Whilst in prison perpetrated over 500 assaults and made threats to kill but prison chose not to press charges!

6. Experiences in Prison Lack of communication No access to interpreters/deaf support Attempted communication via written notes No family contact or visitors Limited access to legal representation Segregation – 15 months Locked in cell 23 hours per day, not allowed association with others Alleged assaults by prison staff Numerous assaults on prison staff Threats to rape and kill female prison staff in writing

7. Mr X – Impact on Mental Health In prison – Deterioration of mental health Reported to be depressed, self-harming, aggressive, deviant sexual fantasies, risky behaviour to others Paranoid ideas about prison staff, his social worker and his family Note: no access to deaf aware assessment prior to hospital In hospital – occasional threats to kill or rape females Much less depressed, no ideas of self harm Medication reduced since imprisonment Only three episodes of seclusion in total, early in admission Most important factor – being able to communicate in BSL

8. Relevant Legislation • Disability Discrimination Act (DDA: 1995; 2005) • British Sign Language (BSL) recognised as a language in its own right (2003) • Disability Equality Scheme (DES: 2005)

9. Human Rights: Potential for Violation? • Article 3: …that no-one should be subjected to inhuman or degrading treatment • Article 5:… the right to liberty and security of person • Article 6: …the right to a fair trial • Article 8: …the right to respect for private and family life • Article 14: …the rights and freedoms set out…should be secured without discrimination

10. Article 3: …that no-one should be subjected to inhuman or degrading treatment • Anecdotally - Seclusion due to challenging behaviour exhibited as a result of lack of communication and associated frustration. • ‘ …catalogue of appalling abuses suffered by Deaf prisoners.’ (Gerrard, 2000) • Miller (2005) Secluded due to misinterpretation of facial expressions and gestures.

11. Article 5:… the right to liberty and security of person • Gerrard (2000) Prisoners disadvantaged by lack of essential equipment including visual alerting fire alarms and smoke alarms = reliance on other inmates for security. • Gerrard (2000) Isolation from inmates, attempts to communicate lead to ridicule or bullying = pretend not to be deaf, keep to themselves (42%). • Rickford & Edgar (2005) If more than one deaf prisoner, discouraged from socialising, seen as a security threat. • Rickford & Edgar (2005) Prison system based on noise. In 1996 only three had a loop.

12. Article 6: …the right to a fair trial • The right to an interpreter or other communication assistance. • Brennan & Brown (1997) 36% registered interpreters, 40% trainee interpreters, 23% BSL Level 3 qualified. • Language; Legal jargon: interpretation and comprehension, Linguistic Diversity, Minimal Language Skills (MLS), Pervasive Developmental Disorder (PDD). • ‘For individuals with linguistic incompetence, involuntary hospitalisation is an indefinite one if they lack the capacity to sign’ (Miller, 2004).

13. Article 8: …the right to respect for private and family life • Gerrard (2000) Denied right to visitors. Contact with family and friends limited and those with allowance used this quickly due to extra time it takes for text communication. • Who funds the interpreter for family visits? • Harmer (1999) Professionals adverse to the use of interpreters: disempowerment and suspicion.

14. Article 14: …the rights and freedoms set out…should be secured without discrimination • PSO 2855 recognises the DDA and recommends ‘…aids or services to improve communications…access to education facilities and programmes…access to physical education facilities.’ • Miller (2001) Only 6.5% of interpreters in prisons available 24hrs day, 11% available during business hours, 30% available 8-12hrs a day. • Rickford & Edgar (2005) Disadvantaged by lack of access to therapeutic and rehabilitative programmes, unable to access SOTP in community = Deaf prisoners spend longer in prison than hearing prisoners. • Mr Y was convicted of manslaughter and received a 4 year tariff, 18 years later he is still incarcerated having received no treatment in prison.

15. Conclusions Both anecdotal and empirical evidence exists to suggest that human rights are being violated in prison for deaf people. Experience of isolation, seclusion, lack of security and degrading treatment all have a huge impact on mental health. The most important factor that we have identified is communication. It is clear that change must happen – but how?

16. Things to come • Research: Deaf Prison In-Reach Project. Aims to identify deaf prisoners, service experience and implement mental health assessments and recommendations for best placement and service provision • Service Development: A Deaf Prison? However, proposals for improvements rejected by Home Office in 1991/2 as ‘too expensive.’

17. Questions Amy Izycky Dr. Manjit Gahir Rampton Hospital Rampton Hospital amy.izycky@nottshc.nhs.uk manjit.gahir@nottshc.nhs.uk 01777 247819 01777 247707

18. References Brennan, M. & Brown, R. (1997) Equality before the law: Deaf people’s access to justice. England: Bailes Print Gerrard, H. (2000) A Double Sentence: Deaf Prisoners in the UK. Unpublished Manuscript Harmer, L. (1999) Health Care Delivery and Deaf People: Practice, Problems, and Recommendations for Change. Journal of Deaf Studies and Deaf Education, 4, 73-110 HMPS PSO 2855 (2005) Prisoners with Disabilities. HM Prison Service. Miller, K. (2001) Access to Sign Language Interpreters in the Criminal Justice System. American Annals of the Deaf, 146, 328-330 Miller, H. (2004) A Survey of the Needs of Deaf Mentally Ill Offenders in the London Prison System and Secure Care Services. Unpublished Manuscript. Rickford, D. & Edgar, K. (2005) Deaf Prisoners. In Rickford & Edgar Troubled Inside: Responding to the Mental Health Needs of Men in Prison. London: Prison Reform Trust.