Prison Suicide: Problems and Potentials for Action

1. PRISON SUICIDE: PROBLEMS AND POTENTIALS FOR ACTION Dr Philippa Tomczak Criminology Research Fellow, The University of Sheffield @philippatomczak

2. In January 2017: government figures illustrated that prison suicides/SID in England and Wales had reached a record high. The rate of suicide in our prisons has doubled since 2012. • Represents the extreme end of a continuum of near deaths, injuries and suffering. Other signs of our prison crisis have also been well documented: increased violence; use of new psychoactive substances; and a series of riots. • Moral, organisational and economic problem (generally).

3. Costs • The cost of the 95 prison suicides which occurred between 2014 and 2015 has been estimated at £300 million – to the public purse • Dealing with suicides consumes an enormous amount of prison staff time, and takes them away from their usual duties. The involvement of prison staff in the police, ombudsman and coroner investigations which follow each prison suicide regularly drags on over months/years – stressful • Anecdotal evidence indicates that staff can become burnt out/brutalised by repeated exposure to self harm and suicide • Attempts can also leave people injured, perhaps requiring life long treatment and support. For example, Mr JL - remanded in custody at Feltham YOI in 2002. Found hanging from bars of cell window a month later. Successfully resuscitated, but left with serious brain damage through deprivation of oxygen and rendered incompetent to conduct own affairs 

4. Karen Revell’s son Greg died on his second night on remand in HMP Glen Parva in 2014, an institution which our Chief Inspector of Prisons deemed ‘unsafe’ He was 18 Crick Centre blog – why prison suicides matter Human cost

5. Human cost Hennie Fenlon was 15 when her dad Robert died in HMP Woodhill in 2016 Robert was one of the 18 men who have taken their own lives at HMP Woodhill since May 2013 High Court permitted a claim tackling the suicide rate at HMP Woodhill/ Joseph Travers currently on trial for gross negligence manslaughter (unsuccessful)

6. A conundrum? Recent multiplication of prison inspection, monitoring and regulation mechanisms - 2008 establishment of the Independent Advisory Panel and Ministerial Council on Deaths in Custody - 2004 expansion of the Prisons and Probation Ombudsman to investigate prison deaths - 2003 formation of Prison Independent Monitoring Boards - 2002-3 Attorney General's review CPS's handling of death in custody cases - Reports ad nauseum - Enduring lobbying activities of voluntary organisations

7. There is a 'complex regulatory space' in relation to prisons (Seddon, 2010) – public regulation of public and private providers; NGO/voluntary organisations; IMBs; Ombudsman, Coroners, academics? (networked escalation) • I adopt an expansive definition of regulation: as all attempts at steering the flow of events and behaviour (Braithwaite et al, 2007) “Looking at the prison system, its fundamental nature as a closed institution with coercive powers over its inmates certainly changes the regulatory challenge that it presents” (Seddon, 2010: 267).

8. Theoretical framework(S)..... (Ayres and Braithwaite, 1992; Braithwaite et al, 2007)

9. Plethora of 'systemic' responses to individual suicides - Death in custody reported to the Coroner, PPO and Police - Internal reviews? → Casework of Special Crime and Counter Terrorism Division (Part of CPS, lawyers advise and prosecute on deaths in custody and corporate manslaughter, advise Police/HSE/IPCC) → Inquest (Coroner) → PPO investigation and recommendations

10. - Hypothetical murder/manslaughter charges at corporate and individual level - Corporate Manslaughter and Corporate Homicide Act 2007- s. 2(1)(d) a custody provider could be found guilty of corporate manslaughter if the way in which its activities were managed or organised resulted in a death and amounted to a gross breach of a relevant duty of care to the deceased - Not been invoked for a prison suicide. 'Causation'... WHO? Can't find health and safety prosecutions either. 'Insufficient evidence' - WHY NO/FEW HEALTH AND SAFETY PROSECUTIONS? - Prison officers

11. HMP Woodhill 18 men taken their own lives at HMP Woodhill since May 2013 Taskforce/ Action Plan • High Court permitted a claim tackling the suicide rate at HMP Woodhill/(unsuccessful) • Seems to have settled however Joseph Travers awaiting trial for gross negligence manslaughter? Hanging, Ryan Harvey Category A male prison, located in Milton Keynes, England. Woodhill Prison is operated by Her Majesty's Prison Service.

12. PPO annual report 2016- 2017 • “One of the systemic failures is the apparent inability of prisons under pressure to learn lessons or to sustain improvement based on that learning. There is plenty of learning available, not least the copious amounts generated by my office.…In short, it is not lack of knowledge, but a lack of effective action that is at issue.” -> this knowledge has come at a price • “Investigations rarely identify a fundamental lack of care or compassion among those who support the suicidal – although this year did see the criminal prosecution of at least one member of prison staff for dereliction of duty in this regard. However, too frequently, I do find failures of management, weak procedures, poor information sharing, a lack of joined up working, gaps in training and poor emergency responses. Only by systematically addressing these failings will we stem the rising toll of despair in prisons”

13. “Court staff have advised that they will routinely complete what’s known as a suicide and self harm warning form, if any risk has been identified during the time in court custody. And they don’t think that they get taken any notice of, when they arrive in prison.” “Reception [...] I think you have to have a real skill set to be able to work in Reception and just the sum of the, like, just deep frustration that you feel when you read someone’s huge numbers of risks and it is staggering the conclusions that people can draw. Like open neck wounds from self harm the day before and 'they seemed fine'. It’s just crazy and I think Reception, a lot needs to happen in Reception. [...] even where someone has been identified as a risk of suicide and self harm they are often put on hourly obs until assessment and like no kind of real weight is given to those really serious risk factors that they arrive with”.

14. Mental (ill) health “Nobody's looking at why people are in prison in the first place. It isn't the coroner or PPO's fault but it is nobody's remit. Nobody's saying should this person have been in prison in the first place? We put a lot of people in prison and there's nobody looking at whether that is reasonable. Nobody is drawing it all together to say – systemically we have a problem”. “You know what we never did, you call it going upstream, we never looked at whether those people should be in prison in the first place”.

15. JCHR Mental Health and Deaths in Prison (2017) Transcript of evidence: Frances Crook “How we came to this situation, it is not inadvertent, it is a decision. Decisions have been made by successive governments about what happens in prisons and they have not been held accountable. I welcome the move towards holding governors accountable, but politicians should be held accountable too. If you decide to cut staff, there are consequences; people die as a consequence. If you decide to close prisons and not cut the number of prisoners but cram everybody into fetid cells that they are sharing with a toilet and cockroaches, their mental health will deteriorate and people will die as a consequence. Those are decisions that are made by politicians. It is not inadvertent. Over the years, deliberate policies have come into force, in contradiction to all the expert opinion that has been put out there by voluntary organisations, psychiatrists, doctors and Members of your own Houses, and that is why we are in this situation. That is why people are dying”.

16. Polygon, not pyramid.... Inspect, increase standards, publish reports – PSOs/PSIs, HMIP, IMBs, Voluntary Sector, PPO investigations and reports, ad hoc reviews e.g. the Harris Review, Inquest verdicts and PFD/Rule 43 reports

17. Polygon not pyramid (for suicide at least)?“walk softly whilst carrying a very big stick”Responsibility not clear

18. Potentials?

19. Samaritans prison listener schemes also illustrate how things could be otherwise…? • Only been running since 1991/2002 but now have become part of the machinery – this itself is a lesson

20. A good news story? • Kevin “Lets be modest and conservative here, every week, it saves a life, somewhere in the country, by virtue of a peer being available to somebody who is in acute distress. • It has much broader impact in terms of things like prisoners having something to aspire to which is to say become a listener, prisoners having a sense that they have a positive role to play in their tiny community of the prison, staff learning that prisoners can be depended on to help each other out... In a high security prison I had the Head of Security say can you imagine making it through a night now without the listeners. […] The listeners response, which is peer support through times of distress, has become an institutional part of the way prisons deal with self inflicted death and that’s… an immeasurable improvement and much, much better way of working at this problem than before. So yeah, there are areas where there’s a lot of hope about how things can be improved despite what I was saying earlier about the bad news, as it were”

21. Kevin: “that same process as Samaritans listeners which is to say go from being good practice in one or two places, to just the way prisons work. For instance reception, if reception gave as much attention in the first week to the needs the person left outside, as they do to what they need inside, there would be a measurable difference in death in custody because people have these anxieties and they are not being picked up by reception staff”

22. @philippatomczak http://www.crickcentre.org/blog/prison-suicides/