1. Memorandum submitted by the Home
Office
A. SUICIDE PREVENTION
Statistics
The number and rate of apparently self-inflicted
deaths (SIDs) in prisons, 1993-2004, is shown in the following
table:
Year | Number
of male
SIDs
| Male
SID rate (per 100,000 men) | Number
of female
SIDs
| Female
SID rate (per 100,000 women) |
Total
number of
SIDs | Overall SID rate (per 100,000 prisoners)
|
| 1993 | 46
| 107 | 1 | 64 |
47 | 105 |
| 1994 | 60 | 128
| 1 | 55 | 61 |
125 |
| 1995 | 57 | 116
| 2 | 01 | 59 |
116 |
| 1996 | 62 | 117
| 2 | 88 | 64 |
116 |
| 1997 | 65 | 111
| 3 | 112 | 68 |
111 |
| 1998 | 81 | 135
| 3 | 97 | 84 |
129 |
| 1999 | 86 | 140
| 5 | 154 | 91 |
140 |
| 2000 | 73 | 119
| 8 | 239 | 81 |
125 |
| 2001 | 67 | 107
| 6 | 160 | 73 |
110 |
| 2002 | 86 | 129
| 9 | 209 | 95 |
134 |
| 2003 | 80 | 117
| 14 | 316 | 94
| 129 |
| 2004 | 82 | 117
| 13 | 290 | 95
| 127 |
| |
| | | |
|
Note: The Prison Service employs the term "self-inflicted
death" rather than suicide. This includes all those deaths
where it appears the person may have acted specifically to take
his/her own life and not only those that receive a "suicide"
verdict at inquest.
In the face of rising population levels, suicide prevention
efforts are proceeding with unprecedented energy and commitment.
And with some success: this year (to 27 October), despite the
rise in population, self-inflicted deaths are 25% down compared
with 2004: 65 (three of which were women) against 87 (inc 13 women).
The overall rate of 113.7 self-inflicted deaths per 100,000
average prisoner population for the financial year 2004-05 only
narrowly missed the challenging target rate of 112.8 set alongside
the Government's target for reducing suicides in the community.
The three-year rate is a more reliable indicator of underlying
trend, and this also has been falling over the last year. At the
end of September this stood at 124.1 self-inflicted deaths per
100,000 of prison population compared to a peak of 135.6 (for
the three years ending September 2004).
Why are There Self-Inflicted Deaths in Custody?
Because a high proportion of the prison population displays
key risk factors known to increase the likelihood of an individual
harming themselves.
The prison population contains a very high proportion of
highly vulnerable individuals with family and relationship, educational,
housing and employment difficulties, not to mention the obvious
stresses associated with being placed in custody. Many are struggling
to cope with additional various combinations of problems that
further increase the likelihood of their self-harming; factors
that put them at risk whether in prison or not—and continue
to increase the likelihood of them harming themselves upon release.
For example ONS research (1998) found that:
— Previous self-harm and suicide attempts—44%
of women (cf 27% of men) on remand had attempted suicide in their
lifetimes.
— Previous abuse—22% of male remand prisoners
who had attempted suicide in the past year had suffered sexual
abuse in the past.
— Drugs problems—55% of those received into
prison were problematic drug users, with 80% reporting some history
of misuse.
— Alcohol problems—63% of sentenced males
and 39% of sentenced females were classed as hazardous drinkers
in the year before coming into prison.
— 76% of female remands and 50% of male remands were
found to suffer from a common mental illness (depression/anxiety).
— 95.5% of prisoners who had had suicidal thoughts in
the previous week were found to have a common mental illness.
— 15% of women prisoners (11% of male prisoners) were
found to suffer from psychosis.
Suicide Prevention Strategy
Achievements to date include:
— Since 2001, over 26 million pounds has been invested
in safer custody arrangements, primarily in six pilot prison sites,
enabling physical improvements to reception and induction areas,
health care and detoxification centres, as well as the provision
of safer cells, which have been found effective in preventing
impulsive suicide attempts. There has been a c35% fall in the
three-year rolling average self-inflicted death rate at the six
pilot sites.
— Suicide Prevention Coordinators (or their equivalents)
now operate in all prisons. Coordinators help to provide a focal
point for suicide prevention at individual establishments and
to increase the profile of the issue.
A broad, integrated and evidence-based prisoner suicide prevention
strategy is in place. This centres on reducing distress for all
prisoners, not only those identified as being at-risk of suicide
or self-harm. By embedding suicide prevention as a current through
every area of prison life—including detoxification, decency,
healthcare, purposeful activity, staff training, and the built
environment—every prisoner benefits, and fewer are likely
to turn to harming and killing themselves.
The prisoner suicide prevention strategy also, of course,
seeks to provide the best possible care to those who we do
know to be at particular risk of suicide and self-harm. The key
intervention currently being introduced across public and private
prisons alike is the new care-planning system for at-risk prisoners:
ACCT.
ACCT (Assessment, Care in Custody and Teamwork)
ACCT is the replacement for the F2052SH, the care-planning
system for at-risk prisoners that has been in use in prisons since
1994. Manchester University evaluated the F2052SH in 2002. This
research identified both the strengths and weaknesses of the old
system.
The identified deficits included:
— The inflexibility of the F2052SH, eg for managing
prisoners who regularly harmed themselves, rather than being actively
suicidal.
— The emphasis on watching rather than care.
— Action plans not being carried out.
— Not relevant to the needs of prisoners whilst
in the care of escorts.
— Likely to be inappropriately opened by escorts,
ie on purely historical data rather than current need.
— Poor communication between residential and healthcare
staff.
ACCT was developed in response. ACCT aims to improve the
quality of care by introducing flexible care-planning that is
prisoner-centred, supported by improved staff training in assessing
and understanding at-risk prisoners. Key benefits of ACCT are:
— A faster first response. The first case review
must take place within 24 hours of the concern being raised. An
Immediate Action Plan is devised to keep the prisoner safe before
this first Case Review.
— More information. The prisoner is interviewed
by trained ACCT Assessors before the first case review to find
out more about his/her problems and the degree of suicide risk.
— Improved information sharing. If the prisoner
agrees that information on their needs and situation may be passed
on to all relevant staff involved in their care, staff of all
disciplines can share more than the minimum information.
— Individual/ flexible care based on levels of risk
and the specific problems that lead a person to be at-risk.
— Awareness that risk can change. Triggers/warning
signs (that may prompt self-harm/suicide attempt) are displayed
on the inside front cover of the ACCT Plan.
— More accountable care. The care and management
plan (CAREMAP for short) sets out who will do what to address
the prisoner's needs and by when, and how the prisoner can be
encouraged to develop their own supportive resources.
— A Case Manager organises and attends Case Reviews
and is responsible for ensuring the CAREMAP is actioned.
— Specialist training for Case Managers and Assessors,
and training for all staff.
— A requirement for Conversations (not just observations)
to demonstrate concern and ascertain whether the CAREMAP is working.
ACCT bridges the crucial interrelationship between suicide
prevention and mental healthcare provision, for example by linking
with reception screening, mental health awareness training and
mental health in-reach. Significantly, the implementation is taking
place in close partnership with regional NIMHE (National Institute
for Mental Health in England).
Already there are early signs of improvements in prisons
that are early implementers of ACCT: since April 2005 there has
been a 5% drop in the rolling three year numbers of annual self-inflicted
deaths in the 30 establishments now using the new system, with
the 5 ACCT pilots seeing a 10% drop since starting in January
2004.
Safer Cells
Safer cells can complement (but not replace) a regime providing
care for at risk prisoners and can reduce risks associated with
impulsive acts.
Safer cells are designed not only to remove ligature points,
but also to create a more relaxing and normalising environment.
They have been found to be more durable, easy to maintain and
easy to search.
An independent evaluation of safer cells, carried out by
the Jill Dando Institute of Crime Science in 2003, included observations,
interviews and focus groups with prisoners and staff. The evaluation
revealed that cell ventilation in safer cells is an issue that
needs addressing. Nonetheless, the Institute concluded that the
safer cells programme has much to commend it, and recommended
that the programme continue. Three prisoners stated to evaluators
that being in a safer cell had prevented them from killing themselves.
The Institute felt that, if ventilation problems were solved,
the safer cell could become the universal standard cell. This,
along with giving the cell as "normal" an appearance
as possible, would reduce any stigma associated with being located
in a safer cell.
The Prison Service is already looking into alternative safer
ventilator designs to overcome the report's main adverse finding.
Learning lessons
The Government do not underestimate the contribution that
can be made to preventing deaths in prisons by learning from what
has gone wrong in the past.
Since 1 April 2004, the Prisons and Probation Ombudsman has
been investigating all deaths in custody. His high quality reports
are increasingly being analysed at a local and central level,
themes extracted, good practice disseminated across the estate
and "lessons learned" reflected in policy and practice.
The Joint Committee on Human Rights published a report on
Deaths in Custody in December 2004. The report highlighted the
importance of individual Government Departments sharing experiences
and learning of lessons across different custody settings so as
to prevent loss of life. A number of bodies are already in place
and helping to deliver on this point, including:
— The Department of Health led Suicide Prevention
Strategy Advisory Group.
— The Ministerial Roundtable on Suicide in prison,
chaired by Baroness Scotland.
— The National Custody Forum in the policing sphere.
— And a grouping currently chaired by the Independent
Police Complaints Commission, which seeks to coordinate and share
lessons following deaths in custody across sectors.
Links between agencies, including police, courts, escort
services, prisons and probation as well as providers of mental
and physical healthcare, and health and drugs programmes, are
becoming stronger with the development of NOMS, which, with its
closer links to the Department of Health and other parts of the
Home Office, is bringing all these interests together while simultaneously
putting offenders and their care centre stage.
The Joint Committee on Human Rights called for the establishment
of a cross-departmental task force on deaths in custody. The Government
carefully considered the recommendation made by JCHR in its report
into deaths in custody. It fully accepts the need to carry out
the functions JCHR recommended for the new task force but considers
that these can most effectively be carried out by building on
and developing structures already in place rather than create
an overarching new body. There is strong support for development
of a modest practically based learning forum prompted by the IPCC,
which would improve learning across sectors. The Government has
committed a (single post) secretariat to assist the Chair and
forge links with other groups.
Women
In each of the past six years, the rate of female self-inflicted
deaths has been higher than the rate for men (see table above).
This is because a greater proportion of women prisoners display
key risk factors that we know increase the likelihood of them
harming themselves:
— Interviews with prisoners who had self-harmed
indicated that 41% of the women had experienced sexual abuse (cf
18% of men)
— ONS research (1998) found that 44% of women (cf
27% of men) on remand had attempted suicide in their lifetimes;
also:
— 40% of women (cf 25% of men) on remand reported
dependence on heroin in the year before coming to prison;
— 40% of women (cf 20% of men) received help/ treatment
for a mental health problem in the year before coming to prison.
Women, who are very often primary carers of their children,
are more likely to experience anxieties associated with child
care arrangements, fear of losing contact with children, and the
pain of separation.
Reflecting their particular needs and vulnerabilities, the
general prisoner suicide prevention strategy contains within it
a specific strategy for women prisoners. This builds upon a number
of interventions including:
— Individual crisis counselling for women prisoners
who self-harm.
— Investment and planning to ensure progress on
the detoxification strategy in women's prisons.
— Introduction of a training pack for staff in women's
prisons.
— £1 million from DoH has been allocated to
women's prisons to be spent on the recruitment of psychiatric
nurses.
While it is too early to draw firm conclusions, there has
been a dramatic reduction in the number of apparently self-inflicted
deaths involving women prisoners in 2005 to date—three compared
with 13 at the same point last year (to 26 October).
Juveniles
NOMS, the Prison Service and the Youth Justice Board (YJB)
are working closely together to prevent the deaths of young people
held in their care. For example, the YJB has funded a dedicated
juvenile outreach team to specifically assist juvenile establishments
further develop and maintain their suicide and self-harm strategies.
Reflecting their particular needs and vulnerabilities, the
general prisoner suicide prevention strategy contains within it
a specific strategy for juvenile prisoners. This focuses on:
— Increasing activity within regimes.
— Improved first night/ reception facilities.
— Child protection training.
— Improvements to healthcare centres and mental
health provision.
— Support groups for those who self-harm.
— Promotion of peer support for juveniles through
Insider schemes.
The strategy dovetails with the Safeguards Development Programme
(an inclusive approach to suicide and self-harm prevention as
well as anti-bullying, anti-discrimination and child protection
measures), which has recently emerged as a three-year funded change
programme by the Prison Service and YJB. The main programme consists
of:
— Funding of Safeguards Managers at juvenile establishments
to champion the agenda and drive local policy.
— Employment of Local Authority Social Workers in
each juvenile establishment to assist with child protection and
looked-after children issues.
— A programme of minor works across establishments
to improve provision of safer and reduced risk accommodation and
other built environment improvements.
Lancet Report (September 2005)
Vol 366 of the Lancet carried an article about suicides
in male prisoners in England and Wales, 1978-2003. It highlighted
the fact that male prisoners are far more likely to take their
own lives than men in the community.
Comparisons of the suicide rate in custody with that in the
community can be misleading because they are not comparisons of
like with like. Custodial institutions are dealing with an increasing
number of very vulnerable people who display many of the characteristics
that increase their risk of suicide beyond that applying to the
population at large.
The Lancet report also drew attention to suicide rates
among younger prisoners.
The average annual numbers of self-inflicted deaths (based
on three year rolling averages) for:
— Young Offender (YO) females have fallen from a
peak average of four per year to two.
— YO Males have fallen from a peak average of 12
per year to seven.
— Juvenile males have fallen from a peak average
of three per year to two.
The numbers of self-inflicted deaths in these age specific
categories are relatively low and therefore subject to significant
random variation. Annual figures are a poor indication of underlying
trend and we strongly advise against giving any undue emphasis
to them. Even three years is a little short for these categories.
Peer Support
Across the estate, over 2,650 "Listeners" (Samaritan-trained
prisoner peer supporters) have been recruited. A complementary
(to Listeners) peer support scheme known as Insiders has been
introduced, whereby prisoner volunteers act as information providers
for new prisoners (often those in the most vulnerable stage of
imprisonment).
Prison Mental Health
The Government's approach to mental ill health in prisons
has three strands:
— To try to ensure, through court diversion schemes
and the development of wider sentencing options for courts, that
people with mental health problems are not sent to prison inappropriately:
— A Court Diversion and Healthcare project has been
commissioned that will develop and embed models of good practice
in Court Diversion work across the court system.
— The Department of Health has been developing other
mental health services to close gaps in community care and so
reduce the number of mentally disordered offenders who reach the
courts.
— To make significant improvements to the mental
health services available within prisons through the development
of new, NHS mental health in-reach services backed by significant
new investment:
— In-reach teams are now operating at 102 establishments
and should become available by April 2006 within all prison establishments
where the need for them has been identified.
— Mental health awareness training for prison officers
is being implemented as a long-term strategy to raise the effectiveness
of discipline staff in understanding, engaging and getting support
in the care and management of prisoners with mental problems.
— To ensure that prisoners assessed as too ill to
remain in prison can be transferred to a hospital setting under
the Mental Health Act.
Interventions for Self-Harm
— A number of intervention strategies have been
introduced into establishments for people who self-harm. These
include counselling, support groups, and specialised psychological
interventions.
— The Prison Service has set up a network of establishments
to develop interventions, facilitate evaluation and share good
practice.
— Comprehensive electronic guidance to staff on
managing people who self-harm has been issued (on CD-ROM and on
the Prison Service intranet); this was developed in close partnership
with the Department of Health and NIMHE and aims to be of use
to all those working with people who self-harm within a secure
environment—in healthcare, probation, court, police and
prison settings.
— An information leaflet about managing self-harm
written by a prisoner for prisoners includes information on how
to manage self-injury and how to get help within the prison context.
— Touch screen technology is being developed in
prisons to inform prisoners of where to obtain support and how
to support other prisoners.
Early Days/Remand Prisoners
About a fifth of all self-inflicted deaths take place within
a prisoner's first week in custody. Prisoners in early custody
are therefore subject to a number of assessments and policies
designed to enhance their safety:
— An interview with a Reception Healthcare Screener,
who looks for signs that a prisoner may self-harm. All prisoners
new to custody, or those whose status has changed (for example
by being convicted or sentenced), receive such an interview. This
was recently revised to improve its sensitivity.
— Many prisons have introduced Insiders, who are
peer supporters selected and trained by officers, to offer information
and support to new prisoners during Reception and first night
in custody.
— Some prisons have dedicated First Night Centres,
which offer a supportive environment for assessment and ensuring
that prisoners' immediate needs are identified and met.
Violence Reduction
In May 2004 the Prison Service launched its Violence Reduction
Strategy. The national strategy requires each establishment to
have in place a local violence reduction strategy appropriate
to needs. A whole prison approach is encouraged, with the aim
of reducing violence and fear of violence. A focus on personal
safety, supporting victims, and repairing the physical and emotional
harm caused by violence links closely with the suicide prevention
strategy.
There is a large amount of evidence to suggest that many
establishments have implemented thorough local strategies, which
were formulated with the close involvement of focus groups of
staff and prisoners.
B. PRISON POPULATION
Key Facts
— Prison population as at 28 October 2005—77,749
— Women's population as at 28 October 2005—4,605
— Useable operational capacity* as at 28 October
2005—78,275
— Certified Normal Accommodation** as at 28 October
2005—69,433
— All-time high population—77,774 on 21 October
2005
— All-time high women's population—4,672 on
4 May 2004
* useable operational capacity is the total number of
prisoners that establishments can hold taking into account control,
security and the proper operation of the planned regime.
** in-use certified normal accommodation (CNA) level.
This is the uncrowded capacity of the prison estate (after adjusting
for accommodation out of use).
Managing the prison population
The National Offender Management Service (NOMS) keeps under
review the demand on prison places and the capacity of prisons
to accommodate those prisoners sent to them by the courts. Although
the population recently reached an all time high, NOMS is managing
this and actively continues to investigate options for providing
further increases in capacity.
The current high population level means that priority is
given to ensuring that "local" prisons maintain the
necessary capacity to receive prisoners from court. NOMS seeks
to make maximum use of all available space within the prison estate
to ensure full and complete use of any spare capacity.
Population pressures are mainly to be found in the adult
male estate (most prisons in the Women's and Juvenile, ie aged
under 18, estates are currently operating below their uncrowded
capacity level of the establishment).
The population is carefully monitored to ensure that the
estate is operating as effectively and efficiently as possible.
This includes making the maximum use of the prison estate, which
may involve changes in the function of accommodation (ie from
a women's to men's prison) as well as the expansion of the estate.
Prison Capacity
Prison capacity has increased by at least 3,800 in the last
two years. This includes building additional places at existing
prisons and the return to use of accommodation, as well as the
construction of two new prisons.
Current plans are to increase the number of prison places
under a funded building programme and deliver 1,800 new places
to increase capacity to 79,100 by June 06 and to a total of 80,400
by 2007. These additional places will be created by expansion
at existing prisons.
Accommodation is being brought back into use following refurbishment
quicker than anticipated. This should provide around 470 places
by the end of October. The build up of capacity will take full
account of any operational safety issues.
The Government is keeping the need for any further increase
in capacity under review and will ensure that places are available
for those prisoners committed by the courts.
On some occasions prisons are listed as having populations
higher than their Operational Capacity. The reason for this is
most often attributed to the fact a prisoner or a number of prisoners
are absent on authorised absences (ie when a prisoner is recorded
as part of an establishments population but is being held outside
the establishment, for example in hospital or on release on temporary
licence).
Prison Overcrowding
Population pressures have resulted in greater numbers of
prisoners required to share cells in crowded conditions (for example,
two prisoners sharing a cell certified for use by one prisoner
in uncrowded conditions). Cell capacity may only be increased
when assessed to be of adequate size and condition for doing so.
Each cell used for the confinement of prisoners has sufficient
heating, lighting and ventilation and is of adequate size for
the number of prisoners to be held in it.
The increase of cell capacity and a prisons useable operational
capacity must be approved by Prison Service Operational Managers.
As at the end of September, there were 24% of prisoners sharing
accommodation in crowded conditions in the public sector and 25%
in the private sector. This is kept under review.
Prisoner Allocation
Once prisoners have been sentenced, or subsequently identified
as suitable for lower category conditions, they are moved to a
suitable establishment as part of their sentence plan, so that
they are not disadvantaged in their preparation for release and
resettlement.
The needs of individual prisoners in relation to offending
behaviour, closeness to home and maintaining family ties, which
should be identified during the planning process and taken into
account before allocation. Allocation should facilitate links
with the community and other agencies, aiding resettlement. Governors
are required, whenever possible, to avoid moving prisoners if
it disrupts their participation in an educational course or treatment
programme or their consideration for parole.
The average distance from home for male prisoners is 50 miles
and for women prisoners 58 miles (the women's estate is much smaller
and more widespread).
Police Cells
There are no prisoners being held in police cells under Operation
Safeguard
The routine use of police cells to hold prisoners last took
place in 2002. NOMS is doing everything it can to avoid the resumption
of Operation Safeguard.
As an exceptional measure, some prisoners are held overnight
only in police cells when it is considered that, in view of the
length and the timing of journey from court, it would not be in
the best interests of the prisoner to take them to a prison.
C. SENTENCING
Rebalancing sentencing and early release
— Sentencing has got tougher over the last decade:
since 1993, custody rates have increased from 6% to 16% in the
magistrates' courts and from 49% to 60% in the Crown Court; and
sentence lengths in the Crown Court have increased from around
20 months to just over 27 months.
— This is against a background of falling crime
since 1995.
— The Government believes that serious, violent
and seriously persistent offenders should go to prison, and for
a long time if necessary. That is why we have created the public
protection sentences in the Criminal Justice Act 2003.
— But most offenders can better and more effectively
be punished in the community. We have introduced a community order
with requirements that can be tailored to the offender and the
offending and punish severely whilst working to avoid reoffending.
This is not a soft option and can be tougher than prison.
— Short custodial sentences can offer little in
the way of rehabilitation. One in four short term prisoners who
had stable accommodation lose it, and almost half of those in
previous employment lose their jobs.
— The public can have confidence that community
sentences will be enforced effectively: probation service performance
on enforcement has risen from about 45% in 2001 to 90% this year.
— The independent Sentencing Guidelines Council
(SGC) has been tasked with developing guidelines that promote
consistent and effective sentencing. It has provided a helpful
guideline on the new sentencing provisions in the Criminal Justice
Act 2003, which is comprehensive and pragmatic and will help to
ensure effective targeting of resources.
— People should be remanded in custody only where
there is a danger to the public or a significant risk of absconding.
In the latter case the risk can be managed by making tagging a
condition of bail. The time spent on remand should be minimised.
— The Home Detention Curfew Scheme (HDC) was first
introduced in January 1999. It allows prisoners to be released,
depending on their sentence length, up to four and a half months
earlier than they would be otherwise.
— Prisoners released on HDC are subject to an electronically-monitored
curfew to their home, usually for 12 hours a day.
— This enables a managed transition to the community,
providing some structure for offenders as they leave prison and
reintegrate into society.
— Since its inception, over 15,000 prisoners have
been released on HDC.
— The scheme is highly successful: 85% of prisoners
have completed their period of HDC successfully. Only 3% reoffend
whilst on HDC; and only 9% of those released on HDC reoffended
within six months of release compared with 40% of those not given
HDC.
The recent rise in the prison population
— The rise in the population is caused partly by
the cumulative impact of sentencing decisions over many years
and partly by a recent increase in both the remand and sentenced
population. The rise in the remand population has been particularly
sharp and appears to have been caused by both an increase in the
numbers remanded and the length of remands.
— To tackle the remand population we have notified
the courts of the availability of tagging to support a curfew
condition of bail for adults defendants who might otherwise have
been remanded into custody. We are also promoting the use of bail
information in court and in prisons.
— The Criminal Justice Act 2003 provides a new,
robust community sentence, the community order, that can provide
an intensive package of requirements for those who might otherwise
receive a short custodial sentence.
Alternatives to custody
We are developing tough and effective alternatives to custody
so that we can rehabilitate more effectively those who have committed
crimes.
We are introducing a range of innovative new sentences; a
new suspended sentence called custody minus, reform of custodial
sentences through the introduction of custody plus and a new intermittent
custody sentence that denies liberty through a custodial sentence
served intermittently, for example at the weekend, but allows
the offender to continue to work and maintain family ties.
To secure better public protection, we are also introducing
a special sentencing scheme for dangerous sexual and violent offenders
convicted of certain "trigger offences", which will
ensure that these offenders are only released when they do not
pose a risk to the public.
D. POTENTIAL LINKS
BETWEEN PRISONER
SUICIDE AND
PRISON OVERCROWDING
— Managing high numbers of prisoners can lead to
an increase in transfers between prisons, itself a time of heightened
risk. More people being received into custody means that some
prisoners are located further from home, which, in turn, may mean
that their access to familial or social support is affected. More
prisoners being remanded to prison results in prisons processing
large and variable numbers of prisoners, often arriving late in
the day, which may reduce the time staff can spend with individual
prisoners on care and risk assessment. And overcrowding can result
in an increase in the length of time prisoners are locked in their
cells, rather than engaged in regime activities, association and
other purposeful activity. These factors together increase the
distress which we know from research by the University of Cambridge
is directly related to suicide rates.
— But this is not a straightforward matter. Overcrowding
alone does not explain why there are self-inflicted deaths in
prisons. Most importantly, a high proportion of prisoners arrive
in prison with known risk factors that we know increase the risk
of them harming themselves (see above).
— Morven Leese of the Institute of Psychiatry has
conducted research (yet to be peer reviewed) looking at the relative
importance of different establishment factors, including overcrowding,
in predicting rates of self-inflicted death across the estate.
Dr Leese has found that higher self-inflicted death rates were
associated with particularly high levels of overcrowding in individual
prisons, as were high rates of positive drug tests and lower levels
of purposeful activity and completed offender behaviour programmes.
— Another piece of evidence is that prisons with
the highest rates of "churn" (or turnover) tend to have
the highest rates of self-inflicted deaths. But these prisons
also tend to be Locals, which have the largest proportions
of prisoners displaying key risk factors.
— Cell-sharing is a known protective factor against
suicide. The doubling-up of an at-risk prisoner with a cellmate
can help to reduce feelings of loneliness and provide both with
someone to talk to. Cellmates can also inform staff if they are
particularly worried about their companion. (Although of course
it remains the ultimate responsibility of staff to keep prisoners
safe, not their cellmates.)
8 November 2005
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