Material pathologies: Caring for personality disorder in prison

Abstract

The British prison estate is characterised by an elaborate mental health infrastructure, an edifice often rearranged to meet the near-permanent mental health ‘crisis’ in its walls. From ‘trauma-informed’ prisons to behaviour change programmes, care for mentally ‘vulnerable’ people in prison has sedimented into the backbone of penal strategy. Much of this is developed through appeals to inclusion: of the vulnerable, disadvantaged, and traumatised people who are increasingly recognised as comprising a disproportionate number of prisoners. One category around which this infrastructure is organised is ‘personality disorder’. Since New Labour's demarcation of this ‘offender group’ in the early 2000s, they are now thought to comprise a majority of the prison population. This article, grounded in prison documents and interviews with former prisoners, looks at the disorder's operationalisation in prison. It shows the disorder to be a broad and malleable category that works to mediate between prisoners, as individual subjects, and an expanding, complex, and shifting prison structure. Prisoners are explained in terms of the diagnosis, as the category’s borders are wide and shifting enough to absorb all kinds of behaviour, beliefs, and experiences. We thus see how the diagnosis simultaneously works to dismiss prisoners’ inner lives at the very moment it claims to understand them—and how this move facilitates penal management. The article uses Althusser's work on subjects and interpellation to make sense of this situation, and prisoners’ tactical navigation of it. The material practices that make the diagnosis real are emphasised, and connected to the imperatives of prison management.