Working ethically around imprisonment

In response to the recent article highlighting the ethical dilemmas of the ongoing Imprisonment for Public Protection (IPP) sentencing (April 2025 issue), we ask what this means for those of us working with individuals on IPP sentences as Psychologists, our profession and our work.

Evidence presented to the Justice select inquiry into the IPP sentence (2022) highlighted the central role of psychologists and other related professions, using psychological risk assessment tools and their professional judgement, for risk assessment, a key factor in IPP legal tests for release.

As detailed in that report, multiple ethical issues are raised, not least the confidence in the reliability of risk assessment. As noted, 'risk assessment and prediction is not the exact science that it is sometimes depicted as' (House of Commons Justice Committee, IPP Sentences: Third Report of Session 2022-23, Para 90). The empirical evidence for a risk assessment may be limited by the interpretative approach required by structured professional judgement tools.

Factors likely to impact the validity of conclusions but which receive minimal attention in risk assessment include:

• Similarity of index offence and of the offender to the research underpinning the structured professional judgement tool
• Duration since index offence and associated developmental stage/maturity
• Where a high risk of recidivism is predicted with consideration of widely differing risk scenarios, but where the level of confidence in each specifically is unknown
• Widely differing contexts in which risk is assessed and where anticipated to occur (i.e., prison versus community)

It is also well documented that the IPP sentence, with ongoing detention and assessment, has been associated with significant psychological harm. Poor mental health and the co-occurrence of risk behaviour to self and others often lead to recommendations for psychological interventions by mental health professionals as part of a broader risk management approach.

However, these interventions have only partially known effectiveness in relation to risk reduction and if offered in custodial settings.

Therapeutic effectiveness requires patient readiness as well as, crucially, trust in the therapy relationship and in confidentiality. This is all significantly compromised where consent is not freely given but rather as noncompliance is viewed negatively, potentially impacting future risk assessment and ultimately release.

If, as psychologists, we cannot be confident of informed consent and, equally, whether it is clinically appropriate to seek to reduce emotional distress attributable to the IPP experience, how do we respond to the ethical implications for those of us working in this field?  

We are keen to see more discussion on the involvement of psychology in the continued imprisonment of those on IPP sentences. How can we, the Psychology profession, and those involved in decision making, such as on the parole board, increase conversation and reflection on what this means for our profession and, practically, how we work ethically in this field?

Dr Abigail Willis and Dr Alison Fogg 
Principal Clinical Psychologists 
Betsi Cadwaladr University Health Board