The lack of adequate mental health training for prison officers exacerbates distress and challenges faced by inmates with psychiatric issues, said a former inmate with experience of being placed in a psychiatric ward during her incarceration in a Zoom session organised by the Transformative Justice Collective on 27 May.
The session, titled “Prisoner Rights and Prison Wrongs: Perspectives from Formerly Incarcerated People”, was facilitated by activist Kokila Annamalai.
Ashley, who was incarcerated sometime in March last year when COVID-19 regulations have taken effect in Singapore, said that she was required to go through about 15 days of quarantine in complete isolation.
“The only kind of interactions that I had was when the inmates who ran the prison would come and give you food, clothes, and any other information that the officers wanted to pass along,” she said, adding that she only left her cell twice for medical-related reasons.
Ashley noted that inmates can be quarantined with “people that you go in with” if they are in the same category out of three main categories: First-time offenders, drug-related offences, and prison remand.
“Unfortunately, for me, I came in with two other women who were from different categories. One was on remand, and the other was for a drug-related case, and as such, we all had to be quarantined alone,” she said.
Being quarantined by herself, said Ashley, affected her more than she thought it would.
“It’s really just you and four walls and an occasional interaction with somebody on the outside,” she said.
Inmates in quarantine were given digital tablets to write e-letters to loved ones and whoever has registered within the system as a contact, said Ashley, adding that she was given a tablet on her eighth day in quarantine.
The tablets can also be used for games and for educational purposes, she added.
However, the tablets were of “very lousy quality” and were “not updated at all”, said Ashley.
While Ashley noted that she served a short sentence of one month, she said that for the first 25 days of her imprisonment, she “did not have any kind of human contact”.
“I never realised actually how important that was. I thought, you know, it was just something you could live without. But yeah, I was not touched at all by anybody. The doctors did touch (me), but it was through latex gloves, so it’s very different. Even when the officers cuff you, they are also wearing gloves for COVID reasons,” she said.
A significant part of Ashley’s experience while incarcerated was being admitted to a psychiatric ward for three days.
“I was actually very, very angry about the whole experience initially, because I felt that I was putting there wrongfully. So what happened was that at the end of 15 days, on the 16th day, we will go out for a customary sort of interview by the officers,” she recalled.
Ms Ashley said that the officers “were genuinely quite caring and they really wanted to know about my situation”, asking her about her mental state.
“The keyword I mentioned was ‘suicidal’ … Every time I felt I had thoughts (about it), I would literally just drop … Do 10 push-ups to get rid of the thoughts in my head. That was how I coped … Basically just a lot of exercise,” she said.
Ms Ashley said that the officers had “disregarded” the times she said she was doing fine due to her mention of having suicidal thoughts.
“The lightbulb sort of lit up in their heads, and they were like, ‘Ding ding ding! We’ve got to be careful. This girl is going to hurt herself.'”
However, hurting oneself in prison is “actually really hard”, as there are not many tools at the inmates’ disposal to make it easier for them to do so, she noted.
Ms Ashley then said that she was asked if she wanted to see a psychiatrist, to which she agreed, especially because she had difficulty falling asleep.
However, she was given a consultation with a general practitioner as the psychiatrist was not available at the time.
“It’s not quite the same but not that I really had a say in this,” said Ms Ashley.
She narrated the difficulty in communicating her experience to the doctor as the doctor was not fluent in English.
“Whatever I mentioned about my experience and my thoughts, she only asked me one question, which was: “Do you moment now?” And I was like, I have no idea what she was trying to say at all,”
The communication gap persisted between Ms Ashley and the doctor despite an officer’s attempt to translate what they were saying to each other.
Eventually, the doctor opined that it was safer to place Ms Ashley in a psychiatric ward, which made her feel apprehensive.
“In my head, I’m thinking, we’ve watched all the movies about psych wards, and it’s pretty bad, right? … But I was thinking, maybe, maybe it’s misrepresented, you know,” she said.
Ms Ashley’s own experience in the psychiatric ward saw her being restrained to a plastic bed for the first 20 hours she was admitted.
“I was chained by my wrists and there were handcuffs that chained my ankles to the bed as well. I was quite hysterical. I was screaming. I was crying and I was like, I don’t belong here. You guys have no idea what you’re doing. You think this is going to make me better, but it’s only going to make things worse,” she said.
The wrist restraints, said Ms Ashley, were made of nylon. She said that they were tightly fastened to the point where her wrists were in pain as a result.
She added that she was subjected to hourly checks on the restraints, which hindered her ability to sleep due to the uncomfortable position she was in, on top of the lights being perpetually switched on.
Ms Ashley was told that she would have to see the medical doctor the following day on a Saturday and that she would have to wait all the way until Monday to see a psychiatrist.
“Because apparently mental problems, take a break on the weekends, you know, they just come back only on the weekdays,” she quipped.
Her time at the psychiatric ward — a large, open ward with 10 beds — were, as Ms Ashley described, “the worst days of my life”.
One lady — who was on remand for a drug-related case — had defecated just to “get attention from the nurses or the officers”.
“The recommendation from the psychiatrist was to remove her pants completely,” she said.
“I actually thought that would be better because the entire ward there was so, so, so hot,” said Ms Ashley, noting that only two out of five wall-mounted fans were functioning at the time.
She was told by an officer that the fans operate automatically and that if the officer had manually turned on the fans, the whole place will “short-circuit”.
Stating that the officers may not be very well-equipped to handle inmates who are housed in the psychiatric ward, especially after only a short period of training, Ms Ashley said that inmates in the ward are often “not taken seriously at all”.
“So, for ‘safety reasons’, we’re not allowed to bathe, brush our teeth,” she said. Even relieving herself was a challenging feat due to the restraints imposed on her.
“They didn’t allow me to wash my hands after that,” said Ms Ashley.
While the digital tablet and other resources provided to her during her quarantine served as forms of mental stimulation, there was “nothing” akin to such tools that were made available to her in the psychiatric ward.
“You will just waste away there … If you’re not crazy, you might have you might turn crazy there,” said Ms Ashley, adding that she was eventually brought to a psychiatrist.
“In general, the whole isolation in the psych ward and the treatment in there were awful, but at least it made the remainder of my sentence incredibly bearable,” she said.
Ms Ashley opined that Singapore, particularly in the context of her carceral experience, lags behind in dealing with mental health issues.
“It seems to be that the lack of training and perhaps maybe even being short-handed or having a lack of staff lead them to treat patients like this,” she said. “It seems that when you treat them like this, when you treat them poorly, their chances of recovery decrease even more.”
Ms Ashley said that one of the primary reasons that impeded her recovery might have been that the officers “were only concerned with us not taking our own lives” in the psychiatric ward.
“They just wanted to preserve us for as long as our sentence would be. And they would constantly tell me things like, ‘We need to keep calm. You need to be happy. You need to show that you’re stable.’ And well, I think, yeah, I was capable of that at a point in time,” she said.
Referencing a point made by Joseph, another formerly incarcerated person who spoke during the session, Ms Ashley said: “It’s the fact that these people in the position of authority, they are telling you these things and you will cling on to them. Like it’s a lifebuoy, you know, and you expect that. Whatever they say is true. And that’s what instills a sense of fear.”
“They could definitely put across in a different way and say, ‘It would be helpful to receive letters from your families and friends because it shows that you have social support outside’. So it’s just the way they put it really,” she added.
Ms Ashley was referencing a point made by Mr Joseph on how the number of family letters received by inmates in the Drug Rehabilitation Centre — which was then housed in one of the units in Changi Prison — are used as a benchmark of family support, which will affect whether they are deemed high-risk or low-risk.
For people who are supposedly in rehabilitation, such demands result in high levels of stress for inmates who do not have family members visiting them or sending them letters, he said.
“There are many inmates in there who may have relatives or friends who are not the most literate and aren’t going to be writing letters to them all the time,” Mr Joseph stressed.
Such an environment, said Ms Ashley, would dissuade those with mental health issues from getting help.
“Should you tell somebody? You tell the officers or the medical doctor that you actually need psychiatric help and then you get thrown in the psych ward. Or do you just not tell and you suffer in silence?” She said.