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Women Prisoner Suicides
11 am
Sandra Gidley (Romsey) (LD): I welcome the chance to highlight the high rate of suicide among women prisoners. I first became aware of the subject when I chaired a women's Liberal Democrat meeting at conference and met a lady named Pauline Campbell, the mother of the late Sarah Campbell, who died in Styal prison on 18 January 2003. There is a certain irony in the fact that I have managed to secure this debate when the inquest into Sarah's death is being held. The more I looked into the matter, the more I realised that the high rate of suicide among women in prison is a symptom of all that is wrong with how the criminal justice system, and particularly the prison system, treats women.
The facts are simple. I am sure that the Minister is aware of them, but I will repeat them for the record. In 2003 the female prisoner population reached 4,595, but that hides the fact that more than 13,000 women were in prison that year. There were 14 female suicides in 2003 and 13 in 2004. The Home Office, for some reason, prefers to use the term "self-inflicted death". I am not sure why. I shall stick to the term "suicide".
Of course, men commit suicide as well, but while women make up just over 6 per cent. of the prison population, they account for 15 per cent. of the suicides. They also account for 45 per cent. of the incidents of self-harm in prison, which are connected to the subject of suicide. Inquest, which campaigns against deaths in custody, said that the high number of female prisoner deaths was "desperate, depressing and shameful".
It seems clear to me that different factors are having an impact on women and that the reasons for the difference in suicide rates must be investigated. It is pertinent to look at the differences between the male and female prison populations. The key difference is the type of crime committed. Women are much less likely to have committed a violent crime. Only 10 per cent. of women in prison have committed a violent crime. More than 40 per cent. of women are jailed for crimes of an acquisitive nature—theft, to the average person—and 11 per cent. are jailed for drug offences. It is thought that a high proportion of the theft offences are linked to the need to steal to fund a drug habit, but it is difficult to establish a precise figure.
The evidence shows that women in prison suffer from a number of mental health problems. Two thirds show symptoms of at least one neurotic disorder such as depression, anxiety or phobia. More than half suffer from personality disorder. That can be compared to the general population, in which less than a fifth of women suffer from those disorders. Half the women in prison are on prescribed medication such as anti-depressants or anti-psychotic medicine, and there is evidence that the use of such medication increases while in custody. As if that was not enough, studies have shown that many women in prison also have serious drug problems, and about 40 per cent. could be described as harmful or dependent users of drugs.
It is clear that we are dealing with some of the most vulnerable members of society, particularly when one bears it in mind that one in four female prisoners spent time in local authority care as a child. The problem is
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much wider than trying to pin blame on the Prison Service. Forty per cent. left school before the age of 16 and more than half say that they have suffered domestic violence. One in three have experienced sexual abuse.
Prior to 2003, a high proportion of female suicides were to be found among remand prisoners. According to Government figures, in 2003 there were no deaths of females on remand. However, figures from the Howard League for Penal Reform indicate one death of a remand prisoner, so I am not quite sure how the difference has arisen. Either way, that seems to be a reversal of the trend and suggests that special attention has been paid to remand prisoners, but there is no room for complacency. We also have to take into account the number of failed suicide attempts and incidents of self-harm.
The situation of women at Holloway prison was recently highlighted by The Guardian:
"Officers at Holloway prison are cutting down five women a day from nooses, the Guardian has learned, and recently saved one inmate six times in a single night."
The article goes on to describe those women as the lucky ones because they did not succeed. It also quotes Deborah Coles of Inquest:
"'We know that prisons cannot keep women safe: it is not just those who are dying, but the numbers who are self-harming and committing suicide every day.'"
Seventy per cent. of the female prisoners at Holloway are on remand. It is clear that any improvement in the death toll among female remand prisoners is a temporary blip, as the rate of attempted harm remains unacceptably high, but I hope not. I have been told that there are hopes that the situation will improve because there are plans to reduce the proportion of remand prisoners at Holloway. However, there might be a problem if more remand prisoners are dispersed around the country to units that perhaps are not quite so used to dealing with the specific problems of Holloway.
Jeremy Corbyn (Islington, North) (Lab): Holloway is part of my constituency and I made a lengthy visit to the prison last week to discuss the whole process. Obviously, there are tragedies in Holloway, as I am sure the hon. Lady would accept. Does she also accept that the tragedies that occur there are largely a result of sentencing policy rather than of the prison itself, that the prison has made enormous efforts to try to support the prisoners—for example by giving them access to the Samaritans helpline—and that the staff involved in these tragedies also suffer terrible traumas? I am convinced that Holloway is doing its best to care for the women there, but frankly many of them simply should not be in prison.
Sandra Gidley : The hon. Gentleman makes a good point. I was not going to mention this, but perhaps I should have said that often the staff feel that they are struggling with the system too. They want to help but often cannot because of resource problems or just the sheer volume of the problem. I shall return to the sentencing point, because that is also pertinent.
It is helpful to think about how female prisoners are treated from the moment they enter jail. In fact, the system starts failing women even before they enter prison. The first point to bear in mind is that many
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women do not expect to find themselves in jail, because of the nature of the crime that they committed. They might not have thought that they could be put in jail for a theft, for example. A report by Her Majesty's chief inspector of prisons in 2000 said that more than half of new prisoners appear not to have expected to be remanded in custody and may not have made preparations for it. Has the Minister given any thought to a system such as that which operates in the Netherlands? There, if a decision is made that a woman with children should be jailed, she is given a breathing space so that she can go home and make appropriate child care arrangements.
The "First Night in Custody" project conducted interviews with 1,400 women coming into Holloway for the first time. On analysing the data, the Revolving Doors Agency learned that 42 of the women—3 per cent.—had no idea who was looking after their children and that 19 children under 16 were looking after themselves. The former figure does not include those women who knew who was looking after their children but had not expected to be separated from them that evening.
Clearly, separation from their children is traumatic for any parent, but I believe that separation has more impact on women because they have generally spent more time with the children and have taken on the major responsibility for caring for them. I find it shocking that the Home Office does not seem to see any need to keep a record of how many children are affected. We have heard much about joined-up government, and that information should be collected even if it is only so that social services can check that all is well with what is probably a vulnerable family.
Answers to fairly recent parliamentary questions show that
"prior to going to prison, 60 per cent. of the female prisoners who were mothers had been looking after their children at home."—[Official Report, 5 January 2004; Vol. 416, c.16W.]
An earlier answer showed that 66 per cent. of the female prison population were mothers of children under 18 and that more than one third of the mothers had one or more children under five.
Clearly, the process is stressful, but the Prison Service seems to have ways of adding to the stress. In a debate in another place on women in prison, Baroness Gale pointed out that Holloway does not have a lock-out system. I think that that is well meaning on the part of Holloway, because it thinks that it should be able to receive prisoners at any time. However, many male prisons in the area do operate a lock-out, which means that after, say, 7 o'clock they will not receive prisoners, so men are usually dealt with first and women are frequently kept in the transport van for long periods. A new system of escorting prisoners was due to come into effect last summer, but I understand that the option of escorting female prisoners separately from male prisoners is deemed to be prohibitively expensive. Has the Minister assessed whether the new system has improved things for women?
Women arrive stressed from the impact of not expecting to be in jail and of the inefficient transport system, combined with concern for their children if they
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are mothers. Sadly, things do not get much better. The Prison Reform Trust report "Lacking Conviction: The rise of the women's remand population" goes into detail about what happens next:
"When women enter custody on remand they are often subject to dehumanising treatment. This is largely due to the sheer numbers of remanded women and the problems they present."
The report of Her Majesty's chief inspector of prisons on Styal prison goes into detail on how women are treated on arrival. I do not have time to read it all, but the following sample will give the flavour:
"Women who have been newly sentenced or newly remanded into custody are known to be at risk of self-harm. It was therefore of great concern to find that many of the women we found sitting on the floor had been shuttling back and forth from magistrates courts and police cells for between two and four days. We talked to several of these women who had been locked out for some days. One woman was several months pregnant and another was 19. One woman aged 35 was detoxifying and concerned about her medication. They all looked exhausted and confused."
The chief inspector suggested that there is a strong link between the treatment of those women—he used the word "humiliating"—and the strong evidence that the risks of self-harm and suicide attempts are highest during the early days of custody. A later report in June 2004 found that women arriving at Styal were still lacking support and 48 per cent. of women surveyed said that they had not received any help or support from Styal within the first 24 hours of arriving. I think that that is due to the pressures of the system rather than the hard-heartedness of the staff.
It is worth picking up on the woman who was detoxifying and concerned about her medication, because it is believed that a relatively high proportion of female prisoners have a drug dependency problem. In an ideal world, the system should be able to identify those people and start providing appropriate help and support as soon as possible, but we do not live in an ideal world and I was disappointed that in response to a written question last June the Minister told me that data on the matter are not collated centrally.
The chief inspector's report on Eastwood Park in 2001 said:
"The initial services offered to women who had recently arrived and were withdrawing from substance abuse were uncoordinated and not meeting their needs."
That is of particular concern because responsibility for health in prisons is being transferred to primary care trusts. If the Home Office does not have any understanding of the scale of the problem, although I cannot believe that it does not, it will be difficult to get the PCTs to deal with the problem adequately. That is particularly so when drug rehabilitation services generally are often very difficult to access.
Eastwood Park is in the constituency of my hon. Friend the Member for Northavon (Mr. Webb), who tells me that the local PCT has real concerns that it will not receive adequate funding to deal with some complex problems that it will inherit. Any information on how the system will work and how the funding formula will be calculated will be welcome.
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Even if a detox programme were able to commence, there is the added problem that women are often in jail for comparatively short periods. I do not complain about the length of the sentences, but unless services start quickly and there is some attempt to continue them when a woman leaves prison, any positive work will be negated when the woman returns home.
I mentioned the high rate of mental health problems in women's prisons. It is worth repeating that 37 per cent. say that they have attempted suicide at some time in their life. The many stories of women who have succeeded in taking their own lives highlights the fact that friends and family members have often raised concerns in the days and sometimes hours before a suicide. In January last year, the Minister was asked
"what proportion of the female prisoners who committed suicide had previously been identified as at risk through the use of the HM Prison Service form F2052SH in each of the past four years."—Official Report, House of Commons, 5 January 2004; Vol. 416, c. 17W.]
The answer was staggering: all the women had been on an open F2052SH at some point during their imprisonment. In 2003, 64 per cent. were on an open form at the time of their death. In 2004, that had reduced slightly to 50 per cent., but it is still a very large proportion.
That is a damning indictment of the prison system's ability to keep its prisoners safe. It calls into question the accuracy of the review process and means that we need to examine the circumstances of the suicides and to learn from the failures of the system.
I conclude by highlighting one further area of concern: family contact. There are a small number of women's prisons, so women are more likely to be held long distances from home. Half of all women prisoners are held more than 50 miles from their home town and a quarter are more than 100 miles away. A Home Office study found that only half the women who had lived with their children or been in contact prior to imprisonment had received a visit since going to prison.
I have not painted a pretty picture. Clearly, action must be taken, and I am aware that the Government have launched their suicide strategy. However, although that is welcome, far more fundamental changes must be made. The first change relates to the point raised by the hon. Member for Islington, North (Jeremy Corbyn). We need to ensure that we jail only those women who really need to be in jail, whether that be because of the seriousness of their offence or for the protection of the public. The judiciary seems to take the attitude that it is okay to send women with children to prison for short periods without taking into consideration the wider impact on the family. If there is a will to reduce the number of women in prison—many of whom are imprisoned for relatively minor offences—the Home Office must impress the importance of those considerations on the judiciary.
Many people have called for the establishment of a women's justice board, which would address the particular needs of women in prison, and I fully support that call. We also need to ensure that there is a clear strategy for identifying the needs of women prisoners as swiftly as possible. A service is needed that is capable of dealing with child care, housing, mental health and drug rehabilitation services.
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I began by mentioning Sarah Campbell. Action must be taken for her sake, for the sake of the 26 other women who committed suicide over the past two years and for the sake of all those who tried to do so and did not succeed. This problem is not a happy legacy for the Minister to take on, but I believe that he is concerned about it. I look forward to him telling me how some problems that I have highlighted will be tackled.
11.17 am
The Parliamentary Under-Secretary of State for the Home Department (Paul Goggins) : I congratulate the hon. Member for Romsey (Sandra Gidley) on raising this difficult issue. I am pleased that she has brought it to the attention of the House. I am also grateful for the contribution made to the debate by my hon. Friend the Member for Islington, North (Jeremy Corbyn). I warmly acknowledge that both he and the hon. Lady have a long-standing interest in this and related issues. As the hon. Lady made clear in her opening remarks, the debate is also timely. The inquest on Sarah Campbell is taking place, and that draws our attention to this important issue.
As the Under-Secretary with responsibility for correctional services and reducing re-offending, I have many issues to consider, but none is more important than this one. The need to reduce the number of prisoners—and perhaps women prisoners in particular—who seek to take their own lives is of the highest priority.
The hon. Member for Romsey asked why we use the term "self-inflicted deaths" rather than suicide. Suicide implies intent, and we cannot always be certain that someone intended to take their own life. That is why we use the more inclusive term "self-inflicted deaths". It is not an act of political correctness, but an attempt to define the issue accurately.
Tragically, last year there were 95 apparently self-inflicted deaths in our prisons, 13 of which were those of women prisoners. The figures were broadly the same as the previous year, when there were 94 deaths overall, 14 of which were those of women. As in the previous five years, in 2004 the rate at which women in prison took their own lives exceeded the rate at which men did so. That runs counter to the trend in society as a whole, where women are less likely to take their own lives than men. Clearly, there are some unique factors at work in this situation that predispose women in prison to be more likely to self-harm and to take their own lives. We need therefore to appreciate the differences between male and female prisoners.
The hon. Lady gave the House some figures that demonstrate the vulnerability of women prisoners. It is interesting to contrast some of those figures with the figures for men. For example, we know that there is a close association between sexual abuse and self-harm by women prisoners. We have conducted interviews with prisoners who have self-harmed that show that 41 per cent. had experienced sexual abuse, compared with 18 per cent. of men. Some 44 per cent. of women on remand have attempted suicide in their lives, which compares with 27 per cent. of men on remand. About two thirds of the women who arrive in custody require clinical detoxification, as compared with just less than half of men. Those differences demonstrate the increased vulnerability of many of the women in our prisons.
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All those factors have been identified as significantly increasing an individual's risk of suicide. Also, as mothers tend to be the primary carers of their children, concerns about child care arrangements, the fear of losing contact with children, the inability to plan for children as they grow up and the sheer pain of separation all add to the stress and distress that many women in prison experience.
We cannot underestimate the unique pressures that are involved in the day-to-day care and management of such a vulnerable female prison population. I am delighted that my hon. Friend the Member for Islington, North paid tribute to the staff at Holloway prison and, indeed, staff at all of our prisons, who deal with such vulnerable people day in, day out.
Jeremy Corbyn : Has the Minister visited Holloway prison recently? If he has not, would he be prepared to go and examine the custody records, the inappropriate sentencing policies, which are not the fault of the prisons—they are the victims—and the caring approach taken by the staff, who are desperate to improve the situation of the prisoners? Will he see whether there are lessons that can be applied more widely? After all, 10 per cent. of all women prisoners are in Holloway prison and, as the hon. Member for Romsey rightly said, they are often isolated, and receive few visits and little support from outside.
Paul Goggins : I visited Holloway prison some time ago, but if there is an opportunity to do so again in the near future, I will seize it. Perhaps my hon. Friend would like to join me on that visit. We can learn many lessons from Holloway, not least about how the first night of a prisoner's stay is dealt with in such a sensitive and supportive way. We have carried those lessons across to other prisons, which is one way in which Holloway has helped to inform practice.
We are talking about the contribution that staff make. I am sure that it would interest hon. Members to know that 127 resuscitations were carried out on women prisoners in 2003 and that a further 51 were carried out in the first nine months of 2004. We are talking about people being brought back from the point of death by highly dedicated staff, to whom I pay tribute.
The hon. Member for Romsey and my hon. Friend the Member for Islington, North both raised the important issue of sentencing. Over the past 10 years, the female prison population trebled. However, I am pleased to say that the female prison population today is 4,134, which is 173 fewer than on the same day last year and more than 500 fewer than the record level reached in May last year.
I hope that my hon. Friend is encouraged by the fact that sentencers are getting the clear message that short-term prison sentences for less serious, non-dangerous offenders are an ineffective way of dealing with offenders and that robust community sentences are a much more constructive alternative for women prisoners, as they are for male prisoners. Offenders are provided with the opportunity to address the causes of their offending behaviour and at the same time put something back into the community where they committed those offences. For such offenders, that is a much more constructive approach.
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In the longer term, I hope that the women's offending reduction programme, which I launched in March last year, will help to rebalance the system and bring a sustained reduction in the women's prison population, ensuring that custody is reserved for the most serious and dangerous offenders. To achieve that, our priority will be to improve community-based services and interventions, so that they are more appropriate and accessible for women offenders. We also need to ensure that women who are sent to prison are kept safe from harm. The Prison Service is developing a suicide prevention and self-harm management strategy for women prisoners. The strategy recognises that, given the vulnerabilities and needs of women in prison, there are some areas of suicide prevention that require a gender-specific approach. The strategy does not aim at providing favoured treatment for women prisoners, but it acknowledges that treating men and women prisoners as though they are the same would not represent the best care.
The strategy is building on interventions that are already improving the care offered to women in prison. It might be helpful if I give one or two examples. Holloway and Bullwood Hall offer crisis counselling for women who self-harm. East Sutton Park has what is called a vision team, led and run by the prisoners. They help to deal with issues such as housing, employment and family matters. The first night in custody project at Holloway, which I mentioned earlier, focuses on the needs of women at the extremely vulnerable stage of initial entry to prison.
Several women's prisons, including New Hall and Morton Hall, have introduced the insiders scheme. Insiders are peer supporters selected and trained by officers to welcome new prisoners into reception, to check whether they have any immediate concerns and to share basic information with them as newly arrived prisoners. In addition, women's prisons run Samaritan-supported listeners schemes to support the more vulnerable prisoners. Holloway also runs a domestic violence programme based on cognitive behaviour therapy, which provides participants with information on how to get help and advice.
Those examples show the excellent work being done in women's prisons. However, beyond that there are high-level strategies that are having a positive impact on the care offered to women in prison. They include a strategic plan for detoxification and maintenance programmes throughout the prison estate to ensure that
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there is continuity of treatment between prisons and, indeed, after release—the hon. Member for Romsey emphasised the importance of that—and that women can develop ways of coping with their drug problems without feeling the need to self-harm. The hon. Lady suggested that there was difficulty in getting information about the number of detoxification programmes that are running. There should not be any difficulty, and I shall write to her with the information.
The Department of Health is providing an extra £1 million to recruit additional psychiatric nurses to add to the mental health support provided in prisons. We are developing a training pack for all staff working with women in custody to help them to understand the factors underlying self-harm and offer them practical ways of helping women in custody to cope with stressful situations.
The hon. Lady asked whether we had considered the system operating in the Netherlands, under which women are allowed to go home prior to a period of imprisonment. We have not considered that in any detail, but we have introduced a new sentence of intermittent custody, which is, I think, particularly helpful for women prisoners who have child care responsibilities. They spend part of the week in prison and part of the week at home. We have run it for almost a year and it is proving very successful. Families are helped to stay together, which includes the possibility of staying in work, but people face the appropriate punishment if they have committed a crime serious enough to warrant imprisonment.
The hon. Lady mentioned the escort arrangements for women prisoners. New contracts have been operating since last summer. Some of those arrangements are not working as well as they should be. That matter is a high priority both for the chief executive of the National Offender Management Service and for me. We shall expect improvements and I shall write to the hon. Lady in due course to report on them.
We are learning lessons all the time. The F2052SH form that the hon. Lady referred to is being superseded by a new system, which will, I think, engage prisoners and the staff around them more in their care. I assure her and my hon. Friend the Member for Islington, North—and the whole House—that we are determined to make progress on the issue, and that I shall continue to give it the highest priority.
11.30 am
Sitting suspended until Two o'clock.
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