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8 July 2002updated 27 Sep 2015 3:00am

Healthier behind bars

Many young criminals are malnourished. Freedom, for them, is like a concentration camp

By Theodore Dalrymple

A recent report that the prescription of vitamin supplements at a young offenders’ institution had reduced the incidence of violence and misconduct among newly imprisoned young men by as much as a third was both intriguing and encouraging.

I need no persuading at all that young men who come into prison are often severely vitamin-deficient, and indeed grossly undernourished. I see such young men every day in the prison where I work: young men who arrive in custody with the smooth magenta tongues and cracked corners of their mouths that signify vitamin B deficiency, whose rachitic ribcages protrude through their sallow and ulcerated skin, and whose arms and legs are spindly and lacking in muscle mass. If photographs were taken of these men and presented to the public as showing their condition on release from prison, everyone would conclude (and rightly so) that the prison service was running a concentration camp. The prisoners could be usefully employed as extras in a film about Serbian atrocities in Bosnia.

Upon such young men, freedom has the same physical effect as a spell in a concentration camp. For the most part, they take heroin, with or without crack cocaine and amphetamines, and by their own admission eat but little, through lack of appetite, apart from the occasional packet of crisps or bar of chocolate.

In prison, they rapidly gain weight and, within a month, look and feel healthier than they have for years (or since the last time they were in prison). Not a few of them have actually asked the courts to remand them in custody for the sake of their health, and quite a number privately confess to me their relief at being in prison. “I can’t handle it on the out,” they say, sotto voce. It is a sad and humiliating thing to have to admit.

These pathetic confessions raise a question about the value of freedom in the absence of the most minimal ability to use it constructively. It is true that de Tocqueville said that those who sought in liberty anything other than liberty itself were destined for tyranny – that is, one has to accept that the advantages of freedom are not without concomitant disadvantages, in at least some cases. But confronted as I am by such young men in their hundreds, it is hard to be entirely complacent. For the fact is that this kind of inability to deal with the world is not confined to them. I see such young men (and their female equivalents) at the hospital in which I also work, and even just walking down the street. This inability to cope with the demands of life has become a mass phenomenon.

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The social and interpersonal chaos from which these young men and women emerge is horrible to contemplate. They lack family or social support; their ethics are those of survival in a lawless feral world; they are utterly without culture, except for a knowledge of trashy popular entertainment; their level of formal education is poor. Their prospects are dismal and they know it: though they don’t know why. For some of them, the structure and predictability of prison life, although irksome in many ways, comes as a profound relief.

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Let me give an example of the kind of story I have heard thousands of times. A teenager who takes heroin has never met his real father, nor does he know who he is. His mother’s latest boyfriend is only a few years older than he, and doesn’t really want him in the house, where he is in the way. The new boyfriend is a drunken bully, and one day he beats the mother. The young man intervenes to protect his mother, but the boyfriend is much stronger than he, and drags him outside where he beats him to the ground and then smashes his head on the concrete until he is unconscious.

His mother visits him in hospital to ask him to drop the charges against the boyfriend, because she wants to continue to live with him. He is faced with the choice of living with his attacker, or going on to the streets.

The young man later says that he takes heroin to forget the world. And who can blame him for his desire for oblivion, if he is of less value to the one person who supposedly cares for him than a few moments of sexual gratification with a drunken lout? Whether or not this is the true reason he takes heroin (is there a final cause of anything?), it takes little imagination to see a connection between the world in which he lives and a desire for the fool’s paradise of drug intoxication. And I repeat: millions of our fellow countrymen are living in the same social – or should I say antisocial? – world as this young man.

So the malnutrition and vitamin deficiency that I see among so many young men and women, in conditions as far removed from famine as possible, are signs of an entire Slough of Despond about which most of us would prefer to know nothing, and from which we delicately avert our sight. I know of no greater dereliction of duty.