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Prisons: Suicides

I have to declare an interest. I am chair of the Prison Service Audit Committee and a non-executive member of the Prison Service change programme board. One possible interpretation of the title of this debate is that there is a direct link between the rate of the suicides in prison and current levels of overcrowding. I am not sure that all the hard evidence necessarily points conclusively in that direction although one’s natural inclination is to feel that it must be one possible factor among many. In Austria there has been a rise in the prison suicide rate during a period when the prison population has decreased, and so far this year in this country there has been a welcome reduction in the number of self-inflicted deaths at a time when overcrowding has increased. However, overcrowding in our prisons certainly is an issue and it has adverse effects on life in prison. Prison numbers are at record levels as the courts continue to exercise their judgment over who should be in custody and, more significantly, for how long. Overcrowding and the associated increased weight of numbers produces its own pressures—leading to less time for inmates out of their cells, reduced access to work and other constructive activity and less effective operation of procedures relating to matters such as visits and reasonable access to showers and telephones. Prison staff are placed under greater pressure as a result of overcrowding and have less time to deal with issues or spot problems. More inmates also means that more staff resources have to be directed towards running areas such as reception for longer hours as the number of prisoners being moved in and out of a prison each day rises. Overcrowding creates the possibility of disorder. The riot at Strangeways in 1990 and the wave of copycat riots in other establishments is one example. The loss and destruction of half of Wymott Prison in 1993 is another, as was the last major riot, in 2002, at Lincoln Prison. The loss of prison places as a result of another riot now and the resultant need to move existing prisoners elsewhere at short notice would cause considerable operational problems in a Prison Service already holding record numbers and at or near its full overcrowded capacity. Accommodation being tight also increases the number of occasions on which prisoners have to be transferred to other establishments, some considerable distance from their homes and families and to which they do not wish to go, in order to maximise the use of the available accommodation. That is because, for reasons related to ability to contain pressures where they can be most effectively managed from both a safety and security point of view, overcrowding population pressures are concentrated mainly in the local prison estate rather than across the prison estate as a whole. Where such moves of prisoners have to take place it is less likely that staff will know prisoners or will have time to get to know them, which potentially reduces the flow of intelligence to prison staff. Such moves also increase the likelihood of intergang and group rivalries since prisoners in one area do not always appreciate an influx of prisoners from another area of the country. Feelings of tribalism can at times be quite strong and destructive of harmony. In local prisons high numbers of prisoners are locked up for about 22 hours a day with only limited time out to collect meals and have access to exercise. This year it is possible on current trends that the number of self-inflicted deaths will be down on the last three calendar years and close to the target reduction figure. However, November and December, with the run-up to Christmas, are normally very difficult months. The three-yearly annual average figure is some 10 per cent over the target figure. One question must be how suicide rates here compare with other countries. Unfortunately, it is difficult to draw comparisons of prisoner or offender suicide rates between different countries since there are differing definitions of what is regarded as a suicide and methods by which the rates in relation to the prison population as a whole are calculated. However, it is clear that suicide rates are higher in prison than in either the general population or the general male population. Studies also indicate that it is during the first day, week and month in custody that suicides are most likely, and that for this reason remand prisoners are among the most vulnerable. Few studies have considered suicide rates among offenders under community supervision, but the work that has been done suggests that the rates for male prisoners are not higher than rates among male offenders outside prison. In England and Wales the suicide rates in the two groups were found to be similar. A recent finding from England and Wales showed that the number of suicides by convicted prisoners in the year following release from prison was more than double the number in prison. Between April 1996 and March 2000, 354 convicted prisoners died by suicide in the year following release from prison—23 per cent of whom died in the first month after release and 12 per cent in the first week. This compares with a total of 167 convicted prisoners who killed themselves in prison during this period. In England and Wales trends in prison suicide rates have paralleled reported trends in community rates. There has been an increase in the consumption of drugs associated with suicide risk, especially cocaine and crack in England and Wales. A high percentage of prisoners have been on drugs immediately prior to being convicted. Significant numbers suffer from mental illness and mental disorder. The prison population is mainly young males from lower socio-economic groups where the incidence of suicides in the population as a whole is highest. The prison population is not a cross-section of society but comes heavily from those groups most prone to self-inflicted deaths. Any self-inflicted death in prison is a matter of real concern and regret. Those remanded or convicted are placed in the care of the Prison Service, and any self-inflicted death inevitably raises questions about the effectiveness of the care that was provided. However, some who are determined to take their own lives give little or no indication of that risk. Dr Shipman would appear to come into that category. The reports from the ombudsman who investigates self-inflicted deaths in prison recognise that in many cases the outcome could not realistically have been prevented. Even with prisoners who do give signs that self-inflicted death is a serious possibility, it is far from easy to prevent that outcome over an extended period of time where there is an apparent determination to pursue that course of action. While attention will naturally be concentrated on suicide attempts that succeed, as I understand it no estimates are available to show what must be the very considerable number of suicides that have been prevented or thwarted by the actions and diligence of the Prison Service and its staff—actions for which they do not always get the recognition they deserve as too many people whose condition is a serious medical one end up in prison because there appears to be no appropriate place to send them. I refer to people who hospitals do not want because of their behaviour and attitude that makes them difficult patients; people whose mental problems may not previously have been fully diagnosed because they have been masked by the drugs they have been taking, but which come to light in prison as the drug taking stops; people who I understand claim they are ““hearing voices”” telling them to do things, including taking the most drastic step of all, which puts them at the top end so far as risk and seriousness of their mental state are concerned. Overcrowding in prisons certainly creates operational problems but it is not the key issue so far as the incidence of prison suicides is concerned. The key issue here is the need to deal more effectively and appropriately with the serious mental and psychological problems of so many of those who seem to end up in prison as there is nowhere else to send them and for whom there has too often been no means of seeking to address their problems before the criminal offences resulting in imprisonment are committed.