Mental illness: 'Saddest case' of woman sent to prison not hospital

Shell Ball gave birth to a stillborn baby for the second time in a row, in 2019.

With complex mental health issues which she believes are linked to being raped as a teenager, and later being a victim of domestic violence, she struggled to cope with the tragedy.

Her partner Gary struggled too. As a recovering alcoholic he relapsed, after their second baby died.

Shell, 38 at the time, was at home when the police came and told her Gary was dead. He had overdosed and died in his sleep.

A week later she was alone at home when she had a breakdown and set fire to the corner of a cushion.

Her neighbours called the police after hearing Shell make a lot of loud noise.

She was arrested for reckless arson and remanded to HMP Styal in Cheshire. Shell says she was in a "really, really bad place".

Shell wrote a letter to the judge explaining her circumstances and her diagnosis of post-traumatic stress disorder, borderline personality disorder, anxiety and depression.

But it had no impact: she was sentenced to two years in prison.

She says the judge told her "it was the saddest case he had ever come across, but he was stuck on guidelines".

An investigation by BBC File on 4 has discovered that once people with serious mental health problems are in prison, it is often very hard for them to access the help they need.

The BBC sent a Freedom of Information request to the 54 mental health trusts in England.

The 19 trusts which responded said that 48% (479) of just over 1,000 prisoners assessed as requiring hospitalisation were refused a transfer to a secure hospital in 2020. This was because of a shortage of beds.

The investigation also found some prisoners who were able to get a transfer were waiting up to 15 weeks to be moved. Government guidelines say they should be moved within 28 days.

The Department of Health said it was "working to reform the Mental Health Act, which will include new provisions to ensure people in the criminal justice system can get the right care, in the right place, at the right time".

However like Shell, these provisions were also not available for 18-year-old Annelise Sanderson.

In the summer of 2020, she was arrested for stealing a pair of trainers and assaulting the emergency workers who tried to intervene.

Her mother Angela told us that on the day Annelise was arrested, she poured petrol over herself and tried to drink it.

However, instead of being offered psychiatric treatment, she was sentenced to 12 months in jail at HMP Styal.

Once in prison, Annelise exhibited signs of being unwell. She would take off her clothes, stay up all night and forget where she was.

A draft report by the Prisons and Probation Ombudsman found that within days of being imprisoned Annelise said she wanted to die, and was sitting wearing a ligature around her neck. In December 2020, Annelise hanged herself.

Prison officer Mike (not his real name) told the BBC a large number of the prisoners he works with have serious mental health issues.

He works in a men's prison where he recently cared for a man who was found eating his own faeces.

Mike said the man was clearly unwell when he arrived in prison and deteriorated very quickly.

In response to Mike's allegations, the Department of Health said: "Healthcare providers in prison have robust processes in place to identify, assess and treat offenders with mental health needs."

However, Mike's experiences are not unusual.

A total of 312 out of the 378 members of the Prison Officers Association who responded to our questionnaire about their experiences with mentally unwell prisoners, said they dealt "often" or "every day" with inmates who they think should be in hospital rather than in prison.

File on 4 - Locking Up The Sick will be broadcast on BBC Radio 4 on 10 May at 20:00 BST and 15 May at 17:00 BST, and will also be available on BBC Sounds on demand.