Research and analysis

Disabled people’s experiences of and access to justice in the UK: an evidence review

Published 28 May 2026

Disabled people’s experiences of and access to justice in the UK: an evidence review 

Andrea Hollomotz and Mark Priestley

1. Executive summary

This report reviews existing evidence on disabled people’s experience of and access to justice in the UK. The findings have been selected from a wider systematic review of evidence on the lived experience of disabled people in the UK between 2010 and 2021 conducted by the Centre for Disability Studies at the University of Leeds and Disability Rights UK.

The main focus of this report is disabled people’s lived experiences of the justice system, such as the police, courts and prison services. There are also experiences that cut across the health service and with implications for wider community services and social care.

1.1 Methodology

We identified more than 100 sources of qualitative evidence about the lived experiences of disabled people in relation to justice. Around half of these were relevant to the topics addressed in this report. The relevant evidence was reviewed and themes and subthemes were identified through a thematic analysis.

As the review focuses on secondary lived experience research, there are some limitations including small sample sizes and limited peer review. Lived experience research gives us a better, but far from complete, understanding of the issues faced by disabled people and people with health conditions in relation to their experience of and access to justice.

1.2 Summary of findings

There has been a lack of reliable statistical data about the barriers that disabled people face in accessing justice. The qualitative lived experience evidence is also limited, but it helps to fill some of these gaps.

The evidence review found that disabled people, those with long term health conditions or impairments, are over-represented among suspects, defendants or detainees in the justice system. Older prisoners are also the fastest growing subgroup in the prison estate and greater attention should be paid meeting their needs.

The criminal justice system, including its legal and rules-based norms, can be particularly difficult to navigate for people with learning difficulties, mental health conditions or neurodivergent conditions such as autism.

Male prisoners may be more fearful of disclosing a disability status, for example a hidden impairment or mental health condition, or seeking appropriate help. There remains a shortage of access to counselling and talking therapies.

There is more research about the diagnosis and cause of mental health conditions in criminal justice settings than about the experience of those who live with them.

There is a need for more research on the experience and needs of people with learning difficulties in the criminal justice system, both as victims and as perpetrators.

There are concerns about the consequence of seclusion for people on locked hospital wards.

Attention is needed to rehabilitation and resettlement programmes that meet the needs of people with intellectual and psycho-social impairments and with neurodivergent conditions such as autism.

There are unique barriers facing Deaf people at all points in the system, from contacting the police, giving evidence, or appearing in court, to prisons. These barriers are worse for those who use sign language.

There is an absence of research concerning the experience of people with physical impairments or visual impairments in the criminal justice system.

There is also a gender imbalance in the evidence base, with more studies researching the experience of male prisoners than female prisoners, and a lack of gendered comparison in study designs.

Very few studies have any analytical focus on the interaction of disability with ethnicity and race.

Overall, there remains more experiential evidence about disabling barriers than about enabling solutions.

2. Introduction

In this report, we discuss the evidence about disabled people’s experiences of and access to justice. The main emphasis is on experiences with the justice system, such as the police, courts and prison services.

The theme of access to justice is a broad one. The evidence reviewed in this chapter focuses mainly on the experiences of people who have been suspected, accused or convicted of crimes. Much of this experience is also relevant to victims and witnesses of crime, and to the wide range of professionals who support people in related contexts, such as in health and social services, or youth and education services.

There are wider implications for the accessibility of public buildings, access to information, or communication support in the delivery of public services in general. The findings may be of interest to policymakers across various departments. They may also be of specific interest to those with direct responsibilities for policing, court services, prison services, probation services, or secure health services.

2.1 Methodology 

This report focuses on evidence from the wider systemic review conducted by the Centre for Disability Studies at the University of Leeds and Disability Rights UK spanning 2010 to 2021.

For this review, we identified more than one hundred sources of qualitative evidence about the lived experiences of disabled people in relation to justice and around half of these were relevant to the topics addressed in this report. The relevant materials were evaluated through a meta-thematic analysis and key themes and subthemes were identified. Many of these sources reported the experiences of disabled people who were accused of offending criminally, but there were parallel experiences related to the control of people with ‘challenging behaviour’ in care settings, including secure settings, and experiences of adapted treatment programmes.

The evidence of experience in prison was stronger than from other settings, partly due to the relatively high prevalence of disability among prison populations. This included the experiences of male and female prisoners, with a range of different impairments and health conditions. We therefore draw more heavily on these experiences to suggest where lessons can be learned for service providers in other relevant sectors, such as those in health and social care, youth services and education. No evidence of experiences during the COVID-19 pandemic were identified in this part of the review.

2.2 Limitations 

This evidence review focuses on lived experience research. With that comes a number of limitations, including small sample sizes and limited peer review. Because of this,  generalisations of the experiences of disability become difficult to make because they are unique to the individual and vary among protected characteristics and impairment types. As a result, this lived experience research gives us a better, but far from complete, understanding of the issues faced by disabled people and people with health conditions in relation to their experiences of and access to justice. 

2.3 The policy context

The supporting policy principle is that disabled people should have equal access to justice, without experiencing discrimination or less favourable treatment in the process. This may mean that they require reasonable adjustments to the norms and arrangements otherwise in place. It is the responsibility of service providers to consider such adjustments, not only in response to disabling experiences but also in anticipation of them.^{[footnote 1]}

These principles are evident both in UK law, under the Equality Act (2010), and in international law, as represented by the UK’s ratification of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). Section 20 of the Equality Act (2010) conveys a duty to make adjustments and comprising 3 elements – to avoid provision that places a disabled person at substantial disadvantage due to disabling practices, physical features, or a lack of auxiliary aids (including the provision of accessible information).^{[footnote 2]} 

The Public Sector Equality Duty (PSED) requires all public authorities to eliminate discrimination, to advance equality and to foster good relations on the ground of disability, as for other protected grounds.^{[footnote 3]} More broadly, the general principles of UNCRPD include those of respect for dignity, non-discrimination and accessibility, among others.^{[footnote 4]} Among the specific provisions, Article 13 of the UNCRPD (Access to Justice) requires appropriate adjustments to legal process and proceedings.^{[footnote 5]} 

The UN International Principles and Guidelines on Access to Justice for Persons with Disabilities are also helpful in framing this broad context.^{[footnote 6]} 

Some policies also state where the responsibility lies with local authorities. For example, Section 9 of the Care Act 2014 establishes the local authority’s duty to assess an adult’s needs for care and support, and Section 76 sets out the local authority’s responsibilities for providing care and support to adults who are in prison or approved premises.

3. The evidence

There has been a lack of reliable statistical data about the barriers that disabled people face in accessing justice. For example, there has been no attempt to mirror the type of analysis conducted in the Lammy Review on the treatment of people from ethnic minority communities in the criminal justice system.

The qualitative lived experience evidence is also limited, but it helps to fill some of these evidence gaps. There is more evidence about some parts of the justice system than others, and more about the experiences of people with certain types of impairments than others. Lessons can be taken from one context to another, to some extent.

Past research about disabled people who offend rarely included direct evidence of lived experience and personal testimony. For example, a review of academic papers published up until July 2012 about sexual offending and intellectual disability found that lived experience research was almost completely absent, with just 3 of 80 articles directly engaging disabled people in research.^{[footnote 7]} With the exception of mental health, and more recently learning difficulties, we know remarkably little about the experiences of disabled people with different types of impairment, or multiple impairments.

Numerous studies point to the high prevalence of long-term health conditions among male and female defendants or detainees in the justice system. Most of these studies are epidemiological or diagnostic in approach and provide little, if any, evidence about lived experience.^{[footnote 8]} For example, one study without referring directly to issues relating to disability reported that:

More than a tenth of this sample (including approximately a fifth of older prisoners) had problems maintaining their personal hygiene, dressing and/or getting around the prison safely; a significant minority lacked meaningful occupation; and approaching a sixth acknowledged problems forming/maintaining relationships.^{[footnote 9]}

1 in 4 prisoners were identified as having a mental health problem, most commonly depression and anxiety. Younger prisoners were 5 times more likely to be affected by drug misuse. Older prisoners were more likely to identify problems with their physical health and memory and to need help with personal care and mobility. The authors of this report, Tucker and others, point out that:

Those prisoners whose mobility difficulties prevented them moving freely around the prison were often unable to access work or training or engage in social activities, with the resultant increased isolation putting them at greater risk of developing mental health problems.^{[footnote 10]} 

The authors observe that older prisoners are the fastest growing subgroup in the prison estate and that greater attention should be paid to meeting their needs. These needs are often disability related.

In 2017, the International Bar Association reported on Access to Justice, based on desk research and with little specific reference to experiences in the UK.^{[footnote 11]} It highlighted the disproportionate impact of financial barriers on disabled people, for example in relation to the introduction of tribunal fees or limitation of legal aid funding. This report placed a strong emphasis on physical access barriers but so far there appears to be an absence of such evidence from lived experience research conducted in the UK.

In 2019, the Equality and Human Rights Commission (EHRC) conducted an inquiry into disabled people’s experience of the justice system, based primarily on qualitative interviews and mainly focused on pre-trial experiences. The conclusions pointed to disabling barriers in system design, failures to make reasonable adjustments or to support meaningful participation, and inadequate training for professionals.^{[footnote 12]} They pointed also to the difficulties of disclosure and adjustment facing people with hidden impairments. These are familiar barriers from other service sectors, for example in health and social care, education or employment. However, the inquiry underlined the over-representation of such experiences in the justice system – notably for those with cognitive impairments, mental health conditions and neurodiverse conditions such as autism,^{[footnote 13]} as well as dyslexia.^{[footnote 14]} For example:

A maze of processes and procedures woven with complicated language means that few people understand how to find their way through. For those who are disabled or have mental health conditions, it can be especially difficult.^{[footnote 11]}11

The high prevalence of disability among prisoners is well known, and estimates vary considerably. Some have suggested that more than a third of male prisoners and potentially more than half of female prisoners might fall within that term when a full range of mental health concerns are included. Analysis of the 2011 Census showed that, of people who were sentenced to 6 months or more in a prison service establishment, 22.5% indicated that they had a health problem or disability consistent with the Equality Act definition of disability.^{[footnote 15]} Other estimates suggest that between 27% and 36% of the prison population are disabled.^{[footnote 16][footnote 17]}

Lord Bradley’s review of people with mental health problems or learning disabilities in the criminal justice system,^{[footnote 18]} Talbot’s work on offenders with learning disabilities and learning difficulties,^{[footnote 19]} and ongoing campaigns on behalf of prisoners with severe mental health problems in the criminal justice system^{[footnote 20]} have increased recognition of the needs. Surveys have indicated that disabled prisoners are more likely to report homelessness, needs for drug and alcohol treatment, and help in finding work on release. Within this portion of the population, by far the largest types of impairments are mental health and learning difficulties.^{[footnote 21]} 

A thematic review on the care and support of disabled prisoners by HM Inspectorate of Prisons found that disabled prisoners are less likely to feel as though staff treat them with respect. They are also less likely to have full access to prison facilities and to the full prison regime, resulting in more time spent in cells and less access to rehabilitation programmes and skills or education training.^{[footnote 22]} Disabled prisoners are therefore likely to have a more negative experience of prison – its ‘material, social and emotional conditions’.^{[footnote 23]} 

Our review identified a lack of evidence concerning the specific experience of people with certain types of impairments, including physical and visual impairments. There was also a strong focus on other types, including mental health and learning difficulties, with attention by some researchers to specific groups, such as Deaf prisoners. 

4. Mental health needs

Concerns with mental health are well represented within the research literature, reflecting the over-representation of mental health conditions among those encountering the justice system. However, much of this literature concerns the diagnosis and cause of such conditions rather than the lived experience of people with such diagnostic labels.

A large part of this literature focuses on mental wellbeing and temporary distress rather than long-standing impairment (in the sense of the Equality Act (2010) definition of disability). At the opposite end of the scale there is evidence concerning the detention of people on grounds of mental health rather than criminality, including in forensic health services, some of which draw more explicitly on lived experience research.

Most of the evidence came from studies of prisoners and there were very few experiential studies of access to civil, police or court services. In one report, Koskela and others interviewed 81 people with mental health conditions about their experiences of reporting crime to the police. While many of the experiences were common to the general population, they identified how challenges in social interaction and past negative experiences inhibited reporting and that these could be related to mental health. For example, as one man who was a victim of crime related:^{[footnote 24]}

I went home and told my support worker [about the attempted rape]. And she was like, you need to report it. And it was her that actually phoned the police because like I’ve had dealings with the police in the past, and it’s usually been around my mental health and I just always had like a rubbish response […] Like with sectioning me and stuff like that [they’ve] just been horrible to me.

While the experience of accessing police services might be a particularly acute one in this respect, it appears that such past experiences and anxieties influence other kinds of help-seeking behaviour, particularly among men. In one qualitative study of category B male prisoners, none of the participants self-identified as disabled, or as being affected by mental illness, yet this is unlikely to have been the case. Respondents talked about actively avoiding health professionals for fear of being labelled ‘crazy’ and the authors observed that, ‘while this affords them power and a sense of control over the system, it prevents them accessing the relevant help they need’ (p.54).^{[footnote 25][footnote 26]} 

At least 6 sources focus on provision of mental healthcare in criminal justice settings, often evaluating a specific intervention, which are intended to provide services in custody instead of in hospital. For example, one study explored staff and prisoner experiences of a newly commissioned ‘personality disorder’ service within a category B male prison.^{[footnote 27]} A brief report on the treatment needs of a random sample of male and female prisoners revealed that prisoners from ethnic minorities had significantly fewer of their mental health needs met at the point of initial assessment than White prisoners.^{[footnote 28]} This was one of very few studies that focused on evidence of intersectional experiences of disability and ethnicity.

Another paper reported the experiences of patients known to prison mental health services who were prescribed psychotropic medicines. While these reduced distress and aided coping, they were seen as a poor substitute for more intensive support.^{[footnote 29]} For instance, prisoners perceived inadequate access to counselling and ‘talking therapies’. As one patient commented:

In the long run I’d like not to take medication, but you have to in jail. They haven’t got a lot of resources, have they? It’s easier for them to give you the tablets then give you the long one year [CBT] course for everyone, they ain’t got the resources (p.435)

As an alternative to prison, a mental health treatment requirement (MHTR) may supplement a community or suspended prison sentence. For example, Manjunath and others interviewed 25 offenders under an MHTR. Most felt that this ‘helped their motivation and service provision’, despite some poor experiences of supervision and communication, and a degree of social stigma.^{[footnote 30]}

Experiences of NHS provided mental healthcare appeared more positive.^{[footnote 31]} A study of women’s access to mental health services in prison also suggested that ‘continuing to have a caring role for their families encouraged them to feel more positive and supported’.^{[footnote 32]} In contrast to the studies with male detainees, this study found that female prisoners ‘did not avoid mental health services and often once settled in the prison, they reconsidered their need for statutory support’. Such findings might mirror more widespread gendered differences in attitude to seeking healthcare.

5. The needs of people with learning difficulties 

People with intellectual impairments interact with the justice system as victims, witnesses and suspects. The evidence reflects all of these, but lived experience was not always central. For example, Gudjonsson and Joyce reviewed the evidence on police interviews and giving evidence in court.^{[footnote 33]} The review highlights the Achieving Best Evidence (ABE) guidance, which provides a structured approach to interviewing victims and witnesses, including those with intellectual impairments, and reinforces that they should not be presumed incapable of giving credible evidence. They suggest that many people understood the concept of speaking under oath but were more likely to give affirmative answers to questioning, including false confessions.^{[footnote 34]} However, there was little reference to lived experience evidence in their review. 

In another study, MacDonald and others examined the involvement of disabled adults in police custody, from a social model of disability perspective. They also found that disabled people’s voices were largely absent from appropriate adult service provision, and that greater input would improve practice.^{[footnote 35][footnote 36]}

There was one small study of the experience of witnesses with learning difficulties and their supporters in the process.^{[footnote 37]} This highlighted how court experience can become ‘a secondary source of trauma’, depending on the support people receive and the extent to which other actors in the process also understand people with intellectual impairments.^{[footnote 38]} The stories conveyed feelings of anxiety, fear and confusion. This included a fear of facing judges or defendants, which might be common among other witnesses but which are amplified for this group.

For example, as 2 witnesses put it:

Because the way they question you is like… its like they′re trying to catch you out… they′re trying to force the conversation their way all the time (…)

I didn’t feel like I had my say, I felt like I was led (…) I felt like it came down to how clever the lawyers were, the barristers were, and not to the actual facts.

Victims and carers emphasised that preparing witnesses to give evidence should include clear, accessible information on the special measures available to support vulnerable witnesses, including those with impairments and long-term health conditions – such as registered intermediaries, whose impartial role is to facilitate communication between the court and the witness – as well as the potential benefits and limitations of each measure.

Experiences of supporters in court, such as an Independent Sexual Violence Advisor, were largely positive, however, only where this was well targeted and sufficiently available before, during and after trial.

Our review identified 9 studies based on the experience of people with intellectual impairment in forensic settings, and 4 studies that engaged prisoners. The link between the lived experience of prisoners was predictive of experiences in other institutional settings, such as in education, health and social care. For example, re-analysis of data from the 1997 Prison survey of England and Wales showed how prisoners with intellectual impairments were more likely to have previously lived in institutions and temporary accommodation, and less likely to have had a job. They were also more likely to be placed on remand and less likely to be sentenced, bringing them into greater contact with community-based support services.^{[footnote 39]} 

Prisoners with intellectual impairments were more likely to have been single, homeless or unemployed before coming into prison. They were more likely to have experienced mental health problems, and 25% had thought about suicide in the last month, while 63% had attempted suicide in the past.^{[footnote 40]} Such studies make sobering reading and underline how prisoners with intellectual impairments often arrive in prison from disadvantaged backgrounds and are more likely to suffer further disadvantages in prison. These experiences are rarely framed in the context of intersectionality or experiencing multiple impairments. It is important to recognise that mental health support needs of people with learning difficulties need to be considered in this light.

A group of related papers explored the gendered experience of women living on secure hospital wards. This included both observational and interview data. For example, one paper showed how experiences of restraint echoed prior experiences of vulnerability to gendered violence.^{[footnote 41]} The regulation of women’s privacy in such contexts curtailed their explorations of sexuality,^{[footnote 42]} relationships and friendships.^{[footnote 43]} The analysis focused on practices, experiences and consequences of seclusion, which women found ‘a bewildering, distressing experience which violated their privacy’.^{[footnote 44]} Another study explored the experiences of women living in a low secure hospital unit.^{[footnote 45]} While these women wanted to live independently in the community there were also some positive aspects to the intensive support available. For example, as one woman put it:

It’s a hospital, isn’t it? It isn’t the ideal place to live, but on the other hand, I’ve got the help I’ve always wanted. So, it has been good for that, getting the help, and doing treatment… But I do hope I can leave here soon. (Laura)

The most in-depth accounts of the lived experiences of people with intellectual disability in prison were from research a decade ago.^{[footnote 23][footnote 46]} This study, for the Prison Reform Trust, found that more than two-thirds of those interviewed had difficulties in reading prison information and filling in prison forms. A similar proportion experienced difficulty in understanding or expressing themselves and felt powerless to do anything about this. As one man described when asked what he would do if he did not understand something: ‘I wouldn’t do anything really; I’d be too scared to ask, so I’d do nothing.’

One study explored what happens when men with learning difficulties leave prison.^{[footnote 47][footnote 48]} They went to ‘a surprising variety of living situations’ but seemed to have little to do. They found it hard to stay out of trouble and noted the importance of family, in the absence of appropriate support services, where staff focused on their offending rather than community living needs. Social networks were often small, especially for those living with family.^{[footnote 49]} Some men described being ostracised in their local community, including being targeted with abusive graffiti. Levels of depression, anxiety and alcohol or substance misuse were extremely high, even though most said they had felt worse in prison.^{[footnote 50]} We still know very little about the lived experiences of people with learning difficulties in prison and such findings invite researchers to look more closely at these.

6. Autism and neurodiversity

As with intellectual impairment and learning difficulties in general, there has been some growth in attention to the experiences of autistic and neurodiverse people in the justice system. But there remains a distinct lack of awareness and knowledge about their experiences. For example, among participants in a larger study of 240 male prisoners with intellectual impairments,^{[footnote 28]} Chaplin and McCarthy identified 46 with significant autistic traits, with 12 meeting the diagnostic threshold. Of these, only 2 were known to their prisons as having autism. Two literature reviews conducted in 2015 could identify only very limited insights into the presence and type of difficulties faced by people with autism in prison, and that research was generally limited by weak methodology and small sample sizes.^{[footnote 51][footnote 52]} We are aware of one subsequent PhD thesis on this topic and one in progress, which also includes experiences during the COVID-19 pandemic.^{[footnote 53]} 

A small-scale study of the experiences of autistic adults in the family justice system indicated that, despite some positive advances in professional attitudes, and the availability of special measures to support individuals to give evidence, including intermediaries, screens and live links, significant misunderstandings and a lack of reasonable adjustments persist.^{[footnote 54]} 

These resulted in a lack of equal access to proceedings, and to justice, when compared to that available in some other parts of the system. The main barriers were communicative, including a lack of clarity in questioning. The court surroundings also triggered sensitivities for some people:

[There was a] buzz constantly and then I found it very difficult to filter out the buzzing noise and it was all I could concentrate on at times. The judge himself kept bringing coffee into the hearings and I can’t bear the smell of coffee. That was not very nice, and the room was quite echoey.

There were also misinterpretations of people’s frustration, or of literally ‘telling the truth’, as expressions of inappropriate self-presentation in court. As one woman states, ‘because nobody told me! I was only told to tell the truth in court. And I did!’. Parallel difficulties were experienced in making sense of the testimony of others or differentiating perception from fact. The stress of being in court, and focusing on accuracy could also bring out autistic traits:

It’s only when I get in a high stressed environment that my autism can sometimes … kick in, and that is especially in the family courtroom, when you’re hearing the lies from the other side. You’ve got a judge who is really not interested in your rights, you know? That’s when the autism kicks in.

Such experiences raised difficult questions about personal disclosure and whether sharing information about an autism diagnosis might go in favour of the person, or against them, in judgement. There were also positive experiences of support from an appropriate adult, where available, or from family members.

7. Support for Deaf people

Although the number of studies on deaf access to justice was small, the studies often contained rich data about lived experience. They highlighted the unique patterns of experience for Deaf people across a range of settings, and the specificity of the communication barriers they face. 

One study on access to justice in Northern Ireland showed evidence of Deaf people’s experiences of interactions with solicitors, barristers, judges in civil matters (such as legal assistance with mortgages), divorce proceedings, accident claims, or writing a Will. The respondents reported communication barriers, including lack of access to sign language support, confusions about the contested meaning of ‘reasonable adjustment’ and a lack of awareness around Deaf culture. ^{[footnote 55][footnote 56]}

Focus groups with Deaf people also revealed a range of barriers to accessing police services, from initial contact with emergency services to police interviews and information provision. These barriers were experienced as cultural, technological and interactional.^{[footnote 57]} They mirrored the kinds of barriers that inhibit access to other kinds of services, such as social work and health care services, or retail services. They often arose in more intense and anxious circumstances in the justice system. Deaf people reported misunderstandings and again a lack of access to sign language support:

I’ve been to two police stations. One knew I needed an interpreter. But when I arrived at the police station there wasn’t an interpreter there. They’d told me there would be, so that was a waste of my time. Another time they did have an interpreter there and the police person could sign as well. The other one was a really poor experience, there was no interpreter, they expected us to write back and forth and that’s the problem for people having to write things.

There were technological barriers, and not all participants were aware of nationally available alternative means of contacting emergency services (for example, by SMS or live video relay interpreting). For example:

Late in the evening, if anything really bad happens, how do we contact them? How would I get through to them? It would be impossible. That’s a really big barrier … for deaf people.

Additional requirements for physical attendance to make use of an interpreter at police stations created additional access barriers of time and transport. Communication at reception desks was often challenging for example, safety glass made lip reading more difficult.

The Howard League published a report on the experiences of Deaf people in English and Welsh prisons in 2012.^{[footnote 58]} This found that reasonable adjustments for profoundly Deaf prisoners were limited, resulting in lack of access to the full prison regime for some (for example, informal, leisure and educational activity). The themes highlighted within this report included difficulties in understanding and accessing the prison regime, loneliness and isolation. They could be usefully linked with the wider literature on experiences of loneliness among Deaf people.

Subsequently, Kelly, engaged with 10 staff and 17 Deaf prisoners in 7 male prisons in England.^{[footnote 59][footnote 60]} She underlined that:

Prison as an establishment relies on sound in order to run, with tannoys, voices, bells and alarms all being central to the prison regime. As a result of this, prisoners need access to sound in order to become integrated into prison life.^{[footnote 26]}26

Deaf and hard of hearing prisoners often rely on assistive technologies. This includes hearing aids and hearing loops, flashing fire alarms, vibrating alarm clocks and minicoms, to which access was often limited or inconsistent. For example, one prisoner had missed multiple meals because he had not heard the loudspeaker. None of the participants had access to visual fire alarms.

One particularly insightful example of resource denial was highlighted by a Deaf participant who had been told that he ‘wasn’t allowed’ over-ear headphones despite not being able to wear the in-ear headphones provided because he was born without.^{[footnote 26]}

Access to sign language interpretation services was again a significant barrier for some. One prisoner in this study had not been provided with an interpreter at trial, and subsequently, “Didn’t even know what he was sentenced to, where he were going, what category he were going to be”, until this was explained several months later. The exposure of sign language users to linguistic isolation was significant. One prison accommodated 5 BSL users, yet they had been separated on different wings.

The kinds of access barriers described in this report led to a compounded sense of isolation, including a lack of meaningful contact with family and friends, or exclusion from educational activity – resulting in a kind of ‘double punishment’. All of the Deaf participants in the study also appeared anxious, lonely, fearful, frustrated, and confused during their interviews. In 2021, the authors of these studies reviewed their findings collaboratively to emphasise how Deaf prisoners had been “in a state of lockdown since well before COVID-19”.^{[footnote 61]}

Since the conclusion of our review, an evaluation of the Deaf Prison In-Reach Service, provided by the National High Secure Deaf Service at Rampton Hospital, was also published. This indicated that, of 29 cases considered, 24 people relied on sign language. This study only included evidence from administrative records rather than direct lived experience.^{[footnote 62]} 

8. Conclusions

The evidence summarised in this chapter comes from a larger systematic review of disabled people’s lived experience in the UK, over the past decade. Of the nearly 15,000 qualitative research sources identified in that exercise, more than 100 included disabled people’s experiences of access to justice. These included at least some experiences at each stage, or in each context, of the justice system. For example, it included experiences of:

• seeking legal help with civil matters 
• contacting the police 
• being interviewed 
• giving evidence in court 
• detention in secure health services 
• imprisonment 
• life after release from prison 

It included mainly evidence from people who were suspected, accused or convicted of crimes. 

From a social model of disability perspective, the main interest in these findings was about the identification of different barriers to access, and the ways of addressing them to make services more accessible. There was considerably more experiential evidence about barriers than about the solutions. The kinds of access barriers reported by disabled people were not surprising, and echoed those reported in other contexts, such as access to employment, health care, housing or education. For example, there were barriers from: 

• the design of built environments 
• the use of ‘one size fits all’ procedures 
• a failure to make reasonable adjustments 
• a lack of access to assistive technology or human support 

The experience of such barriers was also intensified, or sometimes masked, by the justice context – for example, in anxiety-raising police and courtroom situations, or in conformist cultures of male prisons.

The emphasis on prisons research was also reflected in a gender imbalance, with more studies researching the experience of male prisoners than female prisoners. There was an almost complete lack of gendered comparison in study designs, which either focused on gender-segregated prisons, or did not treat gender as a variable in the analysis of more general services. Similarly, with very few exceptions, there was a lack of analytical focus on the interaction of disability with ethnicity and race. This is somewhat surprising, given the attention paid to the latter in relation to criminal justice research, and the higher reported prevalence of, for example, mental health concerns among ethnic minority suspects or detainees. In general then, intersectionality was not a prominent feature of the research evidence reviewed.

This was particularly evidence when considering type of impairment. Some studies adopted a broad scope to thinking about disability. The majority of studies focused on one or other sub group defined by impairment type or label. The most attention was paid to people with long-term mental health needs, and to people with learning difficulties or autism. A small number of studies addressed the specific barriers faced by Deaf people in the justice system. Physical access barriers and personal assistance needs were mentioned in some general studies, such as those addressing ageing prisoners. But, surprisingly, no studies were identified concerning the experiences of people with physical mobility impairments or visual impairments (whether blind or partially sighted). We still know very little about the lived experiences of people with learning difficulties in prison. These uneven patterns of representation may reflect the national landscape of research interest and funding. For example, much of the literature on mental health was framed from a medical or psychiatric perspective rather than a disability studies and social model of disability perspective.

All prisoners are now screened for learning difficulties and disabilities on first entry into the educational services of all adult prisons across England.^{[footnote 63][footnote 64]} But inhibition of disability disclosure is still a factor to be considered in lived experience evidence within the justice system, notably in prisons, as it is for disclosure of gender identity or sexuality. Such inhibition is well known from research on disability disclosure, and the negotiation of disability identities, in employment. Useful lessons might be learned from that literature and adapted to the justice system.

1. A Lawson. ‘Disability and equality law in Britain: the role of reasonable adjustment’ 2008: Bloomsbury Publishing ↩

2. Equality Act 2010, Section 20 (Part2, Chapter 2) ↩

3. Equality Act 2010, Section 149 (Part 11, Chapter 1) ↩

4. United Nations. Convention on the Rights of Persons with Disabilities 2006, Article 3 – General principles ↩

5. United Nations. Convention on the Rights of Persons with Disabilities 2006, Article 13 – Access to Justice ↩

6. United Nations. International Principles and Guidelines on Access to Justice for Persons with Disabilities 2020 ↩

7.   A Hollomotz. ‘Sex offenders with intellectual disabilities and their academic observers: popular methodologies and research interests’ Journal of Intellectual Disability Research 2014: volume 58, pages 189-197 ↩

8. J Alves and others. ‘Health Conditions Prior to Imprisonment and the Impact of Prison on Health: Views of Detained Women’ Qualitative Health Research 2016: volume 26, pages 782-92 ↩

9. A Hayes and others. ‘The health and social needs of older male prisoners’ International Journal of Geriatric Psychiatry 2012: volume 27, pages 1155-62 ↩

10. S Tucker and others. ‘The nature and extent of prisoners’ social care needs: Do older prisoners require a different service response?’ Journal of Social Work 2021: volume 21, pages 310-328 ↩

11. J Beqiraj and others. ‘Access to justice for persons with disabilities: From international principles to practice’ International Bar Association 2017 ↩ ↩²

12. Equality and Human Rights Commission. ‘Inclusive justice: a system designed for all’ EHRC 2020 ↩

13. See also, C Gormley and N Watson. ‘Inaccessible Justice: Exploring the Barriers to Justice and Fairness for Disabled People Accused of a Crime’ The Howard Journal of Crime and Justice 2021: volume 60, pages 493-510 ↩

14. S Macdonald. ‘Biographical pathways into criminality: understanding the relationship between dyslexia and educational disengagement’ Disability & Society 2012: volume 27, pages 427-440  ↩

15. Office for National Statistics. ‘2011 Census Microdata Individual Safeguarded Sample (Regional): England and Wales’ 2014: UK Data Service, SN: 7605 ↩

16. Her Majesty’s Inspectorate of Prisons. ‘HM Chief Inspector of Prisons for England and Wales Annual Report 2016-17’ HMIP 2017 ↩

17.   C Cunniffe and others. ‘Estimating the prevalence of disability amongst prisoners: results from the Surveying Prisoner Crime Reduction (SPCR) survey’ Research Summary 4/12 2012: London, Ministry of Justice ↩

18. K Bradley. ‘The Bradley report: Lord Bradley’s review of people with mental health problems or learning disabilities in the criminal justice system’ 2009: London, Department of Health ↩

19. J Talbot. ‘No One Knows: Experiences of the criminal justice system by prisoners with learning disabilities and difficulties’ 2008: London, Prison Reform Trust ↩

20. National Federation of Women’s Institutes and Prison Reform Trust. ‘The Care not custody coalition’ 2018    ↩

21. C Cunniffe and others. ‘Estimating the prevalence of disability amongst prisoners: results from the Surveying Prisoner Crime Reduction (SPCR) survey’ 2012: Ministry of Justice ↩

22. Her Majesty’s Inspectorate of Prisons, ‘Disabled Prisoners: A short thematic review on the care and support of prisoners with a disability’ 2009: London, HMIP ↩

23. M Tonkin. ‘A Review of Questionnaire Measures for Assessing the Social Climate in Prisons and Forensic Psychiatric Hospitals’ International Journal of Offender Therapy and Comparative Criminology 2016: volume 60, pages 1376-1405 ↩ ↩²

24.   S Koskela and others. ‘The Experiences of People with Mental Health Problems Who Are Victims of Crime with the Police in England: A Qualitative Study’ British Journal of Criminology 2016: volume 56, pages 1014-1033 ↩

25. S Cobb and J Farrants. ‘Male prisoners’ constructions of help-seeking’ Journal of Forensic Practice 2014: volume 16, pages 46-57 ↩

26. see also J Mitchell and G Latchford. ‘Prisoner perspectives on mental health problems and help-seeking’ Journal of Forensic Psychiatry & Psychology 2010: volume 21, pages 773-788 ↩ ↩² ↩³

27. J Hadden and others. ‘An exploration of staff and prisoner experiences of a newly commissioned personality disorder service within a category B male establishment’ Journal of Forensic Practice 2016: volume 18, pages 216-228 ↩

28. N McKenzie and others. Assessing needs for psychiatric treatment in prisoners: 3. Comparison of care received by black and minority ethnic prisoners and by white prisoners. Social Psychiatry and Psychiatric Epidemiology 2019: volume 54, pages 883-886 ↩ ↩²

29. L Hassan and others. ‘Staff and patient perspectives on the purpose of psychotropic prescribing in prisons: care or control?’ General Hospital Psychiatry 2013: volume 35, pages 433-8 ↩

30. A Manjunath and others. ‘Serving a community sentence with a mental health treatment requirement: Offenders’ perspectives’ Criminal Behaviour and Mental Health 2018: volume 28, pages 492-502 ↩

31.   M Jordan. ‘Patients’/prisoners’ perspectives regarding the National Health Service mental healthcare provided in one Her Majesty’s Prison Service establishment’ Journal of Forensic Psychiatry & Psychology 2012: volume 23, pages 722-739 ↩

32. J Sims. ‘Is mental health care in women’s prison adequate?’. Nursing Times 2013: volume 109, pages 12-15 ↩

33. G Gudjonsson and T Joyce. ‘Interviewing adults with intellectual disabilities’. Advances in Mental Health and Intellectual Disabilities 2011: volume 5, pages 16-21 ↩

34. G Gudjonsson and others. ‘The Risk of Making False Confessions: The Role of Developmental Disorders, Conduct Disorder, Psychiatric Symptoms, and Compliance’ Journal of Attention Disorders 2021: volume 25, pages 715-23 ↩

35. S Macdonald and others. ‘‘The silence’: examining the missing voices of disabled people in police custody’. Disability & Society 2020: volume 36, pages 19-37 ↩

36. see also, T Jessiman and A Cameron. ‘The role of the appropriate adult in supporting vulnerable adults in custody: Comparing the perspectives of service users and service providers’ British Journal of Learning Disabilities 2017: volume 45, pages. 246-52 ↩

37. T Beckene and others. ‘Experiences of going to court: Witnesses with intellectual disabilities and their carers speak up’ Journal of Applied Research in Intellectual Disabilities 2020: volume 33, pages 67-78 ↩

38.   see also, R Howard and others. ‘“I’d trust them if they understood learning disabilities” support needs of people with learning disabilities in the Criminal Justice System’ Journal of Intellectual Disabilities and Offending Behaviour 2015: volume 6, pages 4-14 ↩

39. A Ali and others. ‘Prisoners with intellectual disabilities and detention status. Findings from a UK cross sectional study of prisons’. Research in Developmental Disabilities 2016: volume 53-54, pages 189-97 ↩

40. E Chaplin and others. ‘Characteristics of prisoners with intellectual disabilities’ Journal of Intellectual Disability Research 2017: volume 61, pages 1185-95 ↩

41. R Fish and C Hatton. ‘Gendered experiences of physical restraint on locked wards for women’ Disability & Society 2017: volume 32, pages 790-809 ↩

42. R Fish. ‘‘They’ve said I’m vulnerable with men’: Doing sexuality on locked wards’ Sexualities 2016: volume 19, pages 641-58  ↩

43. R Fish. ‘Friends and family: regulation and relationships on the locked ward’ Disability & Society 2016: volume 31, pages. 1385-402 ↩

44. R Fish. ‘‘Behind This Wall’ - Experiences of Seclusion on Locked Wards for Women’ Scandinavian Journal of Disability Research 2018: volume 20, pages. 139-51 ↩

45. E Williams and others. ‘The subjective experiences of women with intellectual disabilities and offending behaviour: exploring their experiences of ‘home’’ International Journal of Developmental Disabilities 2018: volume 64, pages 132-143 ↩

46. J Talbot. ‘Prisoners’ voices: experiences of the criminal justice system by prisoners with learning disabilities’ Tizard Learning Disability Review 2010: volume 15, pages 33-41 ↩

47. G Murphy and others. Offenders with intellectual disabilities in prison: what happens when they leave? Journal of Intellectual Disability Research 2017: volume 61, pages 957-968 ↩

48. P Chiu and others. ‘Life after release from prison: The experience of ex-offenders with intellectual disabilities’ Journal of Applied Research in Intellectual Disabilities 2020: volume 33, pages 686-701 ↩

49. see also, A Davis and others. ‘Am I there yet? The views of people with learning disability on forensic community rehabilitation’ Journal of Intellectual Disabilities & Offending Behaviour 2015: volume 6, pages 148-64 ↩

50. see also, A Hollomotz. ‘Successful Community Resettlement of Men with Learning Disabilities Who Have Completed a Hospital-Based Treatment for Sexual Offending’ British Journal of Social Work 2021: volume 51, pages 150-69  ↩

51. C Robertson and J McGillivray. ‘Autism behind bars: a review of the research literature and discussion of key issues’ The Journal of Forensic Psychiatry & Psychology 2015, volume 26, pages 719-736 ↩

52. C Allely. Experiences of prison inmates with autism spectrum disorders and the knowledge and understanding of the spectrum amongst prison staff: a review Journal of Intellectual Disabilities and Offending Behaviour 2015: volume 6, pages 55-67 ↩

53.   PhD research in progress, D. Tomkins, A positive change? The experiences of offenders with autism detained in prisons applying for Autism Accreditation ↩

54. George, R, Crane, L and Remington, A. ‘‘Our normal is different’: autistic adults’ experiences of the family courts’. Journal of Social Welfare and Family Law 2020: volume 42, pages 204-20 ↩

55. B Elder and M Schwartz. Effective Deaf Access to Justice. Journal of Deaf Studies & Deaf Education 2018, volume 23, pages 331-340 ↩

56. M Schwartz and B Elder. ‘Deaf access to justice in Northern Ireland: rethinking ‘Reasonable Adjustment’ in the Disability Discrimination Act’ Disability & Society 2018: volume 33, pages 1003-24 ↩

57.   K Lumsden and A Black. ‘‘Sorry, I’m dead, it’s too late now’: barriers faced by D/deaf citizens when accessing police services’ Disability & Society 2020: volume 10, pages 1-20 ↩

58. D McCulloch. ‘Not hearing us: An exploration of the experience of deaf prisoners in English and Welsh prisons’ 2012: London, Howard League for Penal Reform ↩

59. L Kelly. Suffering in Silence: The unmet needs of d/Deaf prisoners. Prison Service Journal 2017, number 234, pages 3-15 ↩

60. L Kelly. ‘Sounding out d/Deafness: the experiences of d/Deaf prisoners’. Journal of Criminal Psychology 2018: volume 8, pages 20-32 ↩

61. L Kelly-Corless and D McCulloch, ‘Why deaf prisoners have been in a state of lockdown since well before COVID-19’ The Conversation 13 April 2021 ↩

62.   L Race and others. ‘Deaf Inside: Service Evaluation of the Deaf Prison In-Reach Service Provided by the National High Secure Deaf Service at Rampton Hospital’ International Journal on Mental Health and Deafness, 2022: volume 5, pages 1-14 ↩

63. Ministry of Justice. ‘Prison Education & Library Services for adult prisons in England Policy Framework’ 2019: London, MoJ ↩

64. H Wakeling and L Ramsay. ‘Learning disability and challenges in male prisons: programme screening evaluation’ Journal of Intellectual Disabilities and Offending Behaviour 2019: volume 11, pages 49-59 ↩