Inside Britain's toughest jail for women

It is one of the most notorious jails in the land. But with its long sterile corridors, its daily cases of self-inflicted burnings, cuttings, poisonings and head-banging, and its record of suicide attempts, you would think the modern, low, red-bricked building in a well-to-do area of north London was a psychiatric hospital.

It is one of the most notorious jails in the land. But with its long sterile corridors, its daily cases of self-inflicted burnings, cuttings, poisonings and head-banging, and its record of suicide attempts, you would think the modern, low, red-bricked building in a well-to-do area of north London was a psychiatric hospital.

But it is not. This is Holloway prison for women and, on the outside at least, with its grass verges, far removed from the foreboding Victorian institutions of popular imagination.

Inside it is a different story. The Independent on Sunday was this week granted rare access to the jail where, according to reports last year, five suicide attempts a day are prevented. We found an institution where prison staff with the skills of paramedics and therapists are desperately trying to contain the self-inflicted damage of seriously disturbed women who have a history of psychiatric trauma.

Louise pulls back her sweatshirt sleeve to reveal row upon row of deep scars criss-crossing the back of her arm. The swollen flesh has not healed properly after years of daily cutting. Serving a five-year term in Holloway, she was brought up by her alcoholic mother to believe that "real" women do not cry andstarted cutting herself instead.

After splitting up with her partner a few years ago, she took a friend hostage with a plastic gun, then dialled 999, demanding psychiatric help. This resulted in a five-year sentence.

Holloway has at least three cases a day of self-harm among its 500 or so prisoners.

There were two suicides last year. In April, Julia Hope, 35, who was on remand for theft, was found hanged from the bars on the window of her cell. She had used a ligature made from sheets. A month later, Heather Wait, who was awaiting sentence after being convicted of burglary and criminal damage, was found hanged from a dormitory door. They were among 12 women prisoners across the UK to take their lives last year. A third woman suffered brain damage when her bid failed.

On her belt, Sue Chatten, Holloway's suicide prevention officer, carries a fish-shaped knife which has a special blade to cut off ligatures from the necks of women. She says self-harm has a huge impact on prison officers too. "I don't get upset about my work but I've been in situations where women have tied ligatures and you think 'what if I had not got there in time?' We are not condoning it [self-harm] - you have to manage it. We are trying to preserve life."

Two-thirds of women arrive at Holloway needing detox from drugs and alcohol. Without their daily fix, they often resort to self-injury for trivial upsets, such as running out of tobacco. Deliberate self-injury by women trebled between 2002 and 2003 to more than 7,400 desperate cases. This is partly as a result of the steady increase in the number of women jailed. Even so, female inmates, who account for only 6 per cent of the prison population, carry out nearly half of all suicide and self-harm attempts in British jails.

Last week, an inquest opened into the death of 18-year-old Sarah Campbell, who died in January 2003 at Styal prison in Cheshire even though she was on "suicide watch". Prison reformers say her death raises concerns about the treatment of women prisoners at risk of suicide and self-harm, especially those with drug and mental health problems.

Holloway has also introduced 15 free helplines for women at risk, activity boxes including relaxation tapes and puzzles to distract self-harmers, and nurses to sit outside the cells of suicidal prisoners. Camouflage make-up is provided by the Red Cross so that women can cover up their self-inflicted scars.

A prettily decorated special care suite grants distressed women the privacy they need. Here one prisoner can confide in another, trained by the Samaritans. Magda, an articulate woman in her thirties, who looks more like a chat show host than a criminal, especially helps mothers separated from their children.

"They are very sad, troubled women who do things out of desperation," she says. "There are a hell of a lot of emotional issues for them - substance abuse, rape. Very few women are here because of greed. Being locked behind a door is lonely. They think officers are there to trap them and don't trust anyone."

Some women signal distress by walking around with belts, scarves or fabric strips around their necks. Dr Louisa Snow, the prison service's self-harm and suicide prevention consultant, recalls one prisoner coming to see her who sat ripping strips off her T-shirt and tying them around her throat.

"Most of these people's background experiences are shocking," explains Dr Snow. "They have lost their motherhood, their identity. Self-injury is a way of achieving their needs. What we do is give people alternatives."

A balance also needs to be struck between preserving the dignity of individuals and protecting them from harm. Sheets on the healthcare wing cannot be torn and the windows do not open but personal possessions are not banned from regular cells, and mugs, which could be smashed and used to cut, are allowed.

"When I came to prison, I thought it was only me that did it. There is help out there," says Rachel, whose spiral of despair began at 14. "It makes a difference to be able to talk to someone."

Some prisoners' names have been changed