Inside job: beating addiction in prison

21 Feb 2018 Amyholgate

Offenders at Wiltshire’s HMP Erlestoke are being given expert training so they can offer qualified support to peers struggling with substance misuse. Nicola Rodgers reports.

It’s a clear, bright late-summer morning and I’m meeting Fiona Spence, Bristol Community Health’s Equality and Diversity Coordinator, and Penny Stanbury, Involvement Coordinator for Avon and Wiltshire Mental Health Partnership NHS Trust (AWP), for a slightly unusual road trip.

They’ve invited me to join them on a visit to HMP Erlestoke in Wiltshire to meet Mannie and Pete* – two prisoners who, with Penny and Fiona’s support, have recently trained to become peer mentors in substance misuse.

The qualification is run by the Royal Society for Public Health (RSPH) and is equivalent to a GCSE. It explores the reasons people misuse substances, the personal and social consequences of addiction and, perhaps most importantly, teaches the practical skills and knowledge to support people affected by substance misuse. At a time when drug use in prisons is often in the news, I’m eager to find
out how the pair will be using their new expertise.

On the drive over, Penny and Fiona chat amiably, catching up on this and that. It’s clear they’re genuinely excited to be returning. “When we arrived for the first session, everyone was so reserved,” Penny remembers. But by the afternoon it had all changed: “Everyone was talking and laughing. There were no barriers; we were all on an equal footing – just how peer mentors should be. It’s not very often you can be in a room and just be yourself, especially in prison.”

“We all had a commitment to learning from each other,” Fiona agrees. “In my experience, that doesn’t happen very often.” The qualification was run through InspireBetterHealth – a partnership between Bristol Community Health, AWP and Hanham Health, a local GP provider – which runs the healthcare service at HMP Erlestoke, along with four other prisons in Bristol and South Gloucestershire.

Through the gate
Tucked away in the quiet, chocolate-box village of the same name, HMP Erlestoke began life in the 18th century as a stately home and country retreat for the-then MP of Devizes. It was later used by the government’s undercover Special Operations Executive during
the Second World War, before being badly damaged by fire in 1950. Today, it’s a category C jail, housing up to 524 prisoners.

What strikes you as soon as you arrive at the prison is the level of security: the enormous pairs of double gates; the list of items you can’t bring in (perfumes, USB sticks, aerosols – even chewing gum); the rigour with which visitors are signed in and out. The staff here carry clusters of keys, and are constantly opening and securing gates as they move through the grounds.

We’ve snatched an hour in a meeting room at the prison’s health centre. It’s a simple space, with a small table pushed against one wall and a handful of chairs for us to sit on. Display cases containing models of diseased lungs and illegal substances lean against another wall. Out in the corridor, prisoners wait good naturedly to be seen.
Mannie and Pete are here already, and greet Fiona and Penny warmly. The group is soon busy catching up, Mannie asking Fiona if she’s brought her highlighter (“We always called her the teacher,” Pete grins, “She’d help us with our work and highlight the bits where we were going wrong.”).

A difficult line to walk
The shadow of addiction is everywhere in prison. Substance misuse and crime are often so intertwined in the lives of prisoners that it’s difficult to see where one issue ends and the other begins.

“My life outside was ruled by drugs and alcohol,” Pete, who’s originally from Cumbria, reflects. “I was doing a lot of bad things out there, fighting and committing crime. I spent most of my life in the army, but since I left all I’ve done is keep coming in and out of prison. I was constantly struggling with drugs and alcohol, and it was just a lot of chaos.”

Some prisoners will continue this cycle of addiction in prison, and others may even start to ‘use’ for the first time. But there’s a deep mistrust of authority figures which often prevents people seeking help. “I try to work as best as I can with everyone,” Penny reflects. “But, like it or not, I wear a badge and it changes the balance of power.”

Pete agrees: “People worry that you can’t tell healthcare staff things because you’re going to get in trouble, whereas I live here – I’m a prisoner myself. We’re on the same level as them, so they’ll tell us more things.”

But it’s a difficult line to walk. “The flipside is that, while they’re telling me things they might not tell staff, I still need to convince them that it’s the professionals who’ll actually be able to help them,” Mannie reflects. Being a good peer mentor is about supporting people to make their own choices about how they get help. “But the job isn’t done until someone is in recovery. To me, nothing else matters.”

Their new roles involve going to each wing and chatting to the guys – not trying to force anything, but simply giving them an understanding of substance misuse and its impact. Pete uses his own experiences of addiction – including in prison – to show people that an alternative exists. “It’s just about being kind, considerate, caring and not confrontational. Just a support, really.”

While Mannie doesn’t have personal experience of addiction, he has dedicated himself to becoming a counsellor since being inside. Prison has really opened his eyes to substance misuse and the sadness that comes with it. “I wanted to do something to help,” he says.

The pair let prisoners know about the services available – including the 12 Step recovery programme, art therapy and mental health support – and refer them to the people who are best placed to help.
“It’s just about listening to what they say and guiding them in the right direction,” Mannie says. “If I don’t know it then I’m sure someone else will, because it’s all about communicating.” They work closely with the healthcare team to remind people about appointments and check in with them afterwards.

The mentors will also feed into the substance misuse team’s weekly meetings to ensure the service is supporting the right people. Any prison is a challenging environment to work in, and priorities for the services which are based here often have to change. But everyone involved with the programme is committed to not only see it through to the end, but to actively create opportunities for Mannie and Pete to use what they’ve learnt on a daily basis.

Moving forward
There’s a real sense from the pair that the qualification has been a long time coming. Unbeknownst to either one, both Pete and Mannie had voiced their ambitions to the prison for mentoring training, and highlighted the need for skills like these among the prison population. What’s incredibly clear is the pair’s desire to give something back to the community in which they live, both inside and once they’re released.

Pete is up for parole in February. In the future, he hopes to be a drug support worker and art therapist, specialising in supporting people who are in active addiction and recovery, the homeless, and ex-forces. He’s been busy working with the Probation Service to find a placement, enrol on a college course and find somewhere to live. “It’s all set up,” he says. “It’s up to me now to do it.”

As for InspireBetterHealth, Penny and Fiona plan to extend the programme to other prisons in the partnership over the coming year, including HMP Leyhill and the women’s prison at Eastwood Park. “This was the first time we’ve run the qualification, so it’s fair to say it’s been a huge learning curve for us,” Fiona says. But, for her and Penny, being able to provide learners with such practical and tangible skills has made it all worth it. “It’s so important that people with lived experience get the opportunity to support others, particularly within our prison services. We can’t wait to deliver the course again.”

On the way out, I’m struck by the blossoming flower beds and carefully manicured birch trees which sit proudly between the endless fences and block work buildings (“They cut them like that so they don’t block the cameras,” someone says). But instead of looking stark, the effect is the opposite – it reminds me of the country house that once existed on the prison site.

Behind the intimidating face of the institution, and in spite of the unique challenges the services working here face, there really is something special flourishing here.


In numbers

  • 29% of prisoners say they have a drug problem on arrival to prison**
  • 31% of prisoners say it is easy to get drugs in prison
  • 1434: Estimated patient contacts by InspireBetterHealth staff in November 2017

** Centre for Social Justice, 2015


In their own words

On the media:
“They never show the reality of the alcoholic – shaking and wanting a drink when he wakes up first thing in the morning. They always just show the good times.” Pete

On addiction:
“Addiction doesn’t discriminate. Rich or poor, male or female – it makes no difference.” Mannie

“I know how it is to be in that constant struggle; the vicious circle of coming in and out of prison. Before, I never thought there was any chance of changing. But now I know there is – and I can help others to do the same.” Pete

On mentoring:
“It’s going to be a challenge. You’re challenging cultures – even out in the community, that’s hard. You have to choose your battles and hold on to your victories.” Mannie

“I think the most important thing is not thinking you’re better than someone else. No-one likes being told what to do, especially in prison.” Pete


About InspireBetterHealth
InspireBetterHealth is a partnership of local providers – Bristol Community Health, Avon and Wiltshire Mental Health Partnership NHS Trust and Hanham Health – working in five prisons across Bristol, South Gloucestershire and Wiltshire. We provide a complete, integrated service covering physical healthcare, mental healthcare, health promotion and substance misuse support.
Find out more at

* Name has been changed

This article first appeared in Community Health News, our newspaper for patients and the public. Read the latest edition here. 

Fiona Spence, Equality and Diversity Coordinator for Bristol Community Health
Fiona Spence, Equality and Diversity Coordinator, Bristol Community Health