What was the overall aim of the project/intervention/research?

As professionals that work with diverse groups of people daily across the whole prison, we observe, experience and analyse the many challenges for those with neurodivergent conditions at all stages in the prison process, which can be isolating and overwhelming for prisoners.

Findings suggest the prevalence of neurodiversity may represent one in three people in prison (Coates, 2016); more recently, it appears more likely that half of people entering prison may have a form of neurodivergence which impacts their ability to engage positively in the prison regime (Criminal Justice Joint Inspection, 2021).

Many prisoners will not have an official diagnosis due to factors such as exclusion from education, homelessness or simply not having met the high standardised criteria for a diagnosis. Therefore, in a remand prison setting, implementing a neurodiversity screening system that captures reliable, useful data in a timely manner is vital as the first step to identification. It is important to highlight that having a diagnosis is not necessary to receive reasonable adjustments and support as we practice and embrace a need led approach.

What steps did you undertake? What did the project/intervention/research involve?

There are many unique challenges to successful neurodiversity screening in a remand prison setting. The average length of time a prisoner may spend in prison varies vastly, from days to months, with unknown court dates, releases and transfers happening daily. Every month there can be as many as 400 new prisoners arriving and being discharged; therefore, having a screening process that is inclusive, timely and practical is imperative. 

Our data shows that over 50% of male prisoners arriving in the last three months were in the prison for less than 30 days. With a limited and often unknown amount of time that prisoners are in a remand prison setting, we rely on the invaluable information collated through early screening to adapt the environment and resources, as long-term interventions are not always possible.

While research suggests that males are up to four times more likely to receive a diagnosis than females (Werling et al, 2016), many of the male prisoners that arrive here have not received screening, support or diagnosis for neurodiversity, even though the overwhelming majority meet the criteria for screening. Prisoner-led focus groups often show similar themes of prisoners’ neurodiversity being overlooked or not prioritised due to staff awareness and the training and resources available. 

The male prison has a higher capacity, and has three times as many reception arrivals as our female estate. This means that implementing an initial neurodiversity screening process on a prisoner’s arrival in reception (as implemented in the female estate) was not a practical operational option for us. However, the screening process is embedded in the education induction in male prisoners’ early days in custody, which means that they can complete their screening with the support of a skilled induction tutor and a Learning and Skills Champion peer mentor if needed. The information disclosed by prisoners is then recorded on our internal system, where staff can access it to use appropriate strategies and accommodations for the individual. 

Due to the sheer numbers on the male estate when the prisoners complete their screening, any prisoners that are identified or have self-declared neurodiversity are initially visited one-to-one by one of the team of peer mentors – trained SEND/Neurodiversity Champions overseen by the Neurodiversity Support Managers (NSMs). 

This team of prisoner peer mentors are vital in the screening process, as they have unique first-hand knowledge of the daily challenges and barriers a prisoner may encounter as part of the prison regime. Peer mentors often have their own experiences, some being neurodivergent prisoners themselves or having been in multiple prison settings, of the types of challenges that other 

prisoners may encounter and, most importantly, the adjustments that can be made to ensure accessibility to the prison regime, as a minimum. 

These reasonable adjustments may include:

• reader pens, overlays
• demonstrating how to use the kiosks
• requesting cell location moves, for example to avoid being in front of the pool table or kiosk due to the noise of having people outside and near your cell door
• communication strategies
• easy-read accessible documents
• use of noise-reducing ear defenders
• timetables printed out to be read by reader pens and to aid memory
• thoughtful regime, reducing queuing, large social situations and sensory overload where possible
• sensory items, fidget toys
• visual reference of the daily regime 
• use of sensory rooms.

The prisoner peer mentors are enthusiastic advocates for inclusion, developing professional relationships with staff and prisoners to effect positive outcomes and gather relevant information from prisoners with neurodiversity to help them access other departments if necessary. They allow me to manage and oversee the levels of need and escalate prisoners with more complex needs, and to reach a much larger number of prisoners more efficiently.

Early screening gives prison staff necessary insight into each prisoner’s individual needs, allowing them to implement reasonable adjustments at a much earlier point in their prison journey, and for every prisoner that is identified or indicated as having a neurodiverse need, the opportunity to have an initial check with a peer mentor champion or NSM within their first few days inside. 

What was the overall impact of the project/intervention/research for autistic people? Did you experience any difficulties?  What future learning would you take from this? What are your plans for the future in regard to this project/intervention/research?

The impact of screening being completed early in the prisoner’s journey on arrival in prison significantly improves their experience and opportunities in prison, and allows us to reflect on how we can adapt our practice and environment in line with our prison ethos of providing a safe and rehabilitative culture. 

Screening information can be used to reduce violence and improve safety and wellbeing; it enables us to collaborate with our healthcare, programmes, employment and safer custody teams so that support can be planned and proactive. Our whole prison screening process has also led to tailored staff training, with a focus on specialist areas such as industries and workshops, and the most prevalent areas of need as shown by our data. It allows prisoners with neurodiversity that are attending education or learning new skills in our industries to have individualised support. Screening information can also be used to promote the need for specialist staff and services, by showing the demand and need for these services. 

Ultimately, timely, consistent and effective neurodiversity screening has the potential to transform experiences and outcomes for prisoners with neurodivergent needs. It should increase positive engagement in a prison regime that is designed to be inclusive and accessible and that encourages interest in education and employment, which in turn reduce the likelihood of reoffending. 

By removing barriers, we ensure that all prisoners – regardless of ability and neurodivergence – have access to the same opportunities to be successful, to achieve and thrive in purposeful activity. Only when we begin to tackle this change in the prison system can we start to reflect the same approach for release and positive reintegration back into the community.