Joint Committee On Human Rights Third Report

11 Conclusions

Concluding Remarks

367. It is clear that there are many and complex inter-related issues which lie behind deaths in custody. In large part however our analysis is chillingly simple.

368. Preventing deaths in custody is an immensely complex and challenging task. There is no doubt that some of the most vulnerable people in the country are to be found in our prisons, special hospitals and other places of detention. There is no doubt also, that distress caused by detention adds to these vulnerabilities.

369. Prevention of deaths in custody can best be achieved in a system which takes seriously at every level its obligation to protect the right to life under Article 2 ECHR, but which also sustains a culture which respects the dignity, privacy and autonomy of the people it detains and their rights under Article 8 and Article 3 ECHR. Emerging findings from research by the Cambridge Institute of Criminology,[393] into the impact of the prison service safer custody programme, suggest that there are significant associations between the quality of prison life, levels of prisoner distress and an establishment's rates of self-inflicted death. Aspects of the quality of prison life that are associated with prisoner distress include distress on entry, perceived safety, opportunities for personal development and perceived fairness.[394] This research shows that the positive obligation to protect people detained by the State is not only a matter of physical security, but of the culture of detaining institutions. It places a responsibility on the State's systems of detention to address the problems faced by the people they detain, whether imported or arising following detention.

370. We consider that although practical measures such as the provision of safer cells are valuable and should continue to be advanced, these measures in themselves will not resolve the problem of the continuing high rate of deaths in custody. At the level of the day to day operation of prisons and other places of detention, the culture of a prison or secure hospital, the extent to which people are treated with dignity, the quality of relationships between prisoners and staff, are all critically important. This is an aspect of suicide prevention which in the healthcare setting has been termed "relational security." It is also reflected in the standard against which the Chief Inspector of Prisons inspects, of a "healthy prison", which meets standards of decency, safety, and respect. This culture, as research appears to confirm, is fundamental to prisoner safety, and therefore to the protection of rights under Article 2.

371. These essential changes cannot be realised without commitment, both of policy and resources, at the level of central government. Adequately meeting the complex needs of many of the people held in detention is inevitably resource-intensive, requiring not only high levels of staffing, but also highly trained staff, and high and consistent levels of healthcare, mental healthcare and detoxification and drug addiction services. It is also extremely difficult to realise within an overburdened or overcrowded system, and it is incumbent on the Government to devise alternatives to custodial sentences, commanding public and judicial confidence, which can prevent the senseless incarceration of highly-vulnerable individuals, such as many of the young women we met at Holloway, imprisoned for very short periods for petty crime.

372. This misplaced over-reliance on the prison system is at the heart of the problem addressed in this report. Throughout our inquiry we have seen time and time again the links between mental illness, drug and alcohol dependencies, short sentences and potential for self-inflicted death. It must, therefore, be seen that the imprisonment of such vulnerable people is at the root of the problem itself. It is not only that this incarceration is senseless, but that it is in fact the first step on a path that can lead to the self-inflicted death of one person every four days, on average, in our custodial system. Until we change our approach to criminal justice for vulnerable people convicted of petty crime we cannot begin to meet our positive obligations under Article 2 and meet our duty of care to them.

373. A further issue which has been highlighted throughout our inquiry, and in particular in relation to police custody and Mental Health Act detention, is the lack of central co-ordination to enforce standards and train staff in areas relevant to deaths in custody. This has allowed examples of good practice to remain isolated, and essential guidelines which underpin human rights protection, to take insufficient effect in practice.

374. Neither has there been significant sharing of information and good practice between the police, prison service and NHS. The problem of deaths in custody has not been neglected by government or public bodies. Evidence to this inquiry has detailed a wealth of initiatives which have sought to research and address aspects of the problem. In this Report we have noted a number of examples of good practice which can assist in changing the culture of detention establishments to ensure better protection of detainees' rights and a reduction in the incidence of deaths in custody. However, these disparate initiatives have not been effective in tackling the scale of the problem.. They are very far from having reached the stage where they might be considered to have become firmly established in the institutional and cultural norms of our prisons, police stations, immigration removal centres and mental health units. Greater urgency in eliminating bad practice and spreading good practice throughout these institutions is badly needed. In numerous areas the issues surrounding deaths in custody are similar, regardless of whether they are being faced by our prisons, our hospitals, our police stations or our inquiry bodies. This applies to healthcare, physical and mental, risk assessment and management, dealing with violent behaviour, training staff, and devising satisfactory procedures for inquests.

Final Recommendations

375. Our principal conclusion is therefore that there is a need for a central forum to address the significant national problem of deaths in custody. One existing model for such work is the cross-government group on the management of violence, which is working towards the production of joint guidance on the use of restraint and other responses to violence, applicable across prison, police, and mental health act detention. We consider, however, that a permanent body, with a remit to address all aspects of deaths in custody, is required.

376. We recommend that the Home Office and the Department of Health, as the main responsible departments, should establish a cross-departmental expert task-force on deaths in custody. This should be an active, interventionist body, not a talking-shop, with its membership drawn from people with practical working experience of the problems associated with deaths in custody. The task-force should also have at its disposal human rights expertise. Broadly, the functions and powers of such a body should be—

Led by Dr Alison Liebling Back

394   HC Deb., 10 February 2004, col. 1437W Back

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Prepared 14 December 2004