In a basement office in Camberwell, Wendy Rowley, a black woman with a long pony tail and piercing blue eyes, is talking on her phone and wondering exactly where Amy could be. Amy doesn’t seem to know where she is herself, but it sounds like she’s on a bus. From listening to the automatic voice in the background, Wendy thinks she might be near London Bridge.

Amy is 30 years old. She was born into a chaotic family in south London. When she was a child, her stepfather would violently abuse her two brothers, and he would sexually abuse her and her twin sister. Two years ago, it got too much for Amy’s sister: she took her own life.

Amy suffers from bipolar disorder and depression. She is also HIV positive. She has been charged for a string of minor offences, as have the rest of her family: they are all PPOs (prolific and priority offenders). Two days ago she was released from prison for the umpteenth time. She had been incarcerated at HM Prison Drake Hall, a women's closed prison near the village of Eccleshall in Staffordshire.

Amy didn’t know how to get back to London, so two officers drove her to a hostel in Vauxhall, which had been allocated to her by Lambeth Council. Wendy, who leads the WIRE (Women’s Information and Resettlement for Ex-offenders) project at a charity called the St Giles Trust, went to see her.

Her first concern was that Amy wouldn’t be able to medicate herself properly. She needed to take 15 different tablets a day. She was being dispensed 140mg of Methadone in prison (down to 90mg on release), was on antivirals for the HIV, and was also on temazepam and co-codamol. She looked a state - dressed like a little boy, Wendy thought - and was semi-conscious from all the drugs.

Wendy suspected the heavy dosage of Methadone had in part been prescribed by prison staff so she’d be easier to handle. She’d seen it before. Amy is like a child in some ways; for example, she only eats a certain type of pasta, or she’ll make a fuss. Wendy talked to Amy’s probation worker, who said she’d clearly end up back in prison in a couple of weeks.

The next day, at 6am, Wendy received a phone call from Amy’s mother. Amy had been discharged from hospital a couple of hours earlier and rolled up at the family home. The mother didn’t want her there, because she knew that when the family got together, they always started taking drugs. The family home wasn’t what Amy’s probation worker would deem a “safe address”.  The problem, Wendy knew, was that the hostel in which Amy was staying wasn’t exactly made for her requirements either. It was a “wet” hostel - there were people drinking and some using drugs - and Wendy’s biggest fear was that other residents would steal her medication to get high themselves.

Amy was supposed to be in there for a set period while her needs were assessed by a range of statutory workers, all of whom had very specific roles. A key worker had been allocated, but he didn’t seem to have any awareness at all of how her medication had to be administered: it couldn’t just be left to her. Amy also had to see her probation workers, but how much could be done in an hour-long meeting to address the various issues - the mental illness, the drug addiction, the need for suitable housing?

Already, Amy was telling fibs, claiming that she wasn’t actually on probation - she didn’t like the fact that Wendy got strict with her, saying that she’d have her escorted to every appointment. Wendy knew where Amy really belonged, and that was a residential mental health home. The trouble was that everything seemed geared for her to go back to prison instead.

And that leads us to the present, when Amy wandered off, and Wendy had to track her down. At the time, she was supposed to be going to a doctor in order to get a reference for her Employment and Support Allowance. It was her one and only chance: if her benefits didn’t kick in, her rent wouldn’t get paid. If her rent didn’t get paid, she’d end up a NFA (no fixed abode), and then she’d inevitably go back to prison.

Time and again Wendy had found the probation services hadn’t helped when this happened, unless she’d forced their hand and gone to the council’s Homeless Persons’ Unit. Demand is high for this service. Occasionally she’d arrive at the town hall at 9.30am and still be there after 12 hours, trying to find a place for one of her clients. Even if they did get housed, sometimes they’d still end up back in prison after being kicked out for antisocial behaviour: they simply didn’t know how to act like a normal member of society. At this moment in time, Amy’s future does not look bright.

*

I tell Wendy that her work brings into relief two issues that have interested me for years. One: the fact there is a very fine line between those serving short-term prison sentences and the mental health services; a nuance that politicians are reluctant to acknowledge to the electorate. Two: there are significant gaps in the state provision for chaotic individuals, and people like Wendy end up filling them in, with little money or time on their side.

Her project – which is set to run out of funding next year - has been a success. She deals with 100 clients a year, and just under half of them reoffend (better than it sounds - the national rate is 88 per cent), and the average number of offences halves for a 12 month period, compared with the 12 months before. But it’s just her, an intern, and two volunteers. How many gaps can they hope to plug?

She says:

A lot of the women I deal with have misdiagnosed mental health conditions. In prison they classify a lot of them under schizophrenia – but usually it’s borderline personality disorder, brought on by substance abuse or trauma. In prison they use methadone to keep them calm. The problem is it makes them very dysfunctional when they come out of custody, because everything‘s done for them. They tend to lean on us a lot. We’re meant to be a 9-5 service, but I get calls from 6 in the morning to 12pm at night – their families will have cut these girls off. These things aren’t dealt with early in their history: sometimes it feels like you’re just a band aid, patching people up before they get sent back to prison. The local authority services don’t have joined up thinking.

Wendy’s an ex-offender herself - she was sentenced to eight years inside for drugs offences. It gives her a strong insight into the lives of her clients:

I didn’t see my kids for 18 months when I was inside, because the prison was so far from London. So you miss the ongoing support from your family when you’re in jail. A lot of them find the family unit has broken down when they get out: the child’s either in foster care or has been adopted. That tends to keep them in the cycle – the women who keep custody of their children become more grounded because they want to sort things out for their families. The others: they stay in cramped houses, do sex work, and then when they’ve had enough or want somewhere to sleep they put themselves in jail. I’ve had women deliberately getting arrested because the people they’re staying with are taking advantage of them.

Wendy is critical of short-term prison sentences: “These women are deemed prolific offenders, but they live chaotic lives - drug addiction, sex work - stuff like that. I just feel locking a woman away – I know from personal experience that you have to look at the bigger picture. The kids go into foster care so that’s more money from the Government, and then quite often they get in trouble so the whole cycle starts again. Not all kids can go to grandparents. You have to think about the psychological effect. Some of these sentences are disproportionate – I don’t think someone should go to prison for not paying their council tax.”

*

In 2010, Nick Hardwick, the new Chief Inspector of Prisons, visited HM Prison Styal (a closed category prison for women). Shortly after, he said in a lecture at the University of Sussex that the self-mutilation and despair in the Keller Unit was so severe it “kept me awake at night”. He concluded: “I hope we will look back on how we treated these women in years to come, aghast and ashamed.” Descriptions like this, about this prison alone, had been repeated for a decade.

Six years before this, the previous Chief Inspector of Prisons had visited Styal and found women who had been self-harming were being detained [2] in punishment cells. One had even been punished for trying to hang herself.

Two years later, the prison ombudsman had reported into the death of six women at the prison. The report lead the Home Office to announce a review of vulnerable women in the justice system, to be led by Baroness Jean Corston. Perhaps it wasn’t expecting her findings to be so stark. Even by its fourth page, the findings were extraordinarily terse.

These were the women I saw in prisons:

■ Most were mothers. Some had their children with them immediately prior to custody, others had handed them to relatives or their children had been taken into care or adopted.
■ Some were pregnant. Some discovered they were pregnant when they had no idea that that could be a possibility.
■ They were drug users. It was not uncommon to have £200 a day crack and heroin habits disclosed.
■ They were alcoholics.
■ They had been sexually, emotionally and physically abused.
■ They were not in control of their lives.
■ They did not have many choices.
■ They self harmed.
■ They had mental health problems.
■ They were poor.

Then she went on to describe a ten-day period in one of the prisons she visited: 

“■ A woman had to be operated on as she had pushed a cross-stitch needle deep into a self-inflicted wound.

■ A woman in the segregation unit with mental health problems had embarked on a dirty protest.

■ A pregnant woman was taken to hospital to have early induced labour over concerns about her addicted unborn child. She went into labour knowing that the Social Services would take the baby away shortly after birth.

■ A young woman with a long history of self-harm continued to open old wounds to the extent that she lost dangerous amounts of blood. She refused to engage with staff.
■ A woman was remanded into custody for strangling her six-year old child. She was in a state of shock.
■ A woman set fire to herself and her bedding. The in-reach team concluded that there was a woman who was extremely dangerous in her psychosis and had to be placed in the segregation unit for the safety of the other women until alternative arrangements could be made.
■ A crack cocaine addict who displayed disturbing and paranoid behaviour (but who had not been diagnosed with any illness) was released. She refused all offers of help to be put in touch with community workers."

Perhaps the most arresting fact in the Corston report was this: women formed 6 per cent of the prison population, but made up half the cases of self-harm in custody. Corston came to a simple, stark conclusion: a system that had been designed for men was increasingly being used for women (the number incarcerated has doubled since 1995), with painful results. She concluded against imprisoning women offenders who posed no risk to the public, called for the closure of women's prisons over a 10 year time period and their replacement with some small custodial units for serious and dangerous offenders.

The analysis and recommendations received broad cross-party support, but progress towards implementing it was minimal and piecemeal. As Juliet Lyon of the Prison Reform Trust pointed out [3]in 2008: “There was no proper delivery plan and no budget, although the Lord Chancellor had advised the Justice Committee in April that he had the money to implement Corston.”

Four years later, only modest improvements have been made, in terms of incarceration and probation (here [4]is a good summary of recent progress). In the meantime, the likes of Wendy continue to fill the gaps as best they can, and the likes of Amy continue their journey round the revolving door.