Friday, 10 February 2017

Death of PSR Linked to Prison Suicides

The Centre for Crime and Justice Studies publishes a regular bulletin and it always serves as a good pointer to what's going on:-

In its structure, planning, delivery and financing, probation across England and Wales continues to face major problems. We are developing ideas for a project looking at what has gone wrong, and how it can be put right. If you have some experience or thoughts to share, or you would like to support this initiative, please get in touch.​

Richard Garside, Director

In the news

In an article for the OpenDemocracy website, our Senior Policy Associate, Rebecca Roberts, argues that the £1.3bn for new prisons would be more wisely invested in community and welfare provision. Our Deputy Director, Will McMahon, was a co-signatory on a letter inThe Guardian calling for a moratorium on new prison builds. We helped Building magazine with a piece on the dodgy economics of the prison-building programme.

Ex-services veterans under probation supervision

We partnered with the Probation Institute and the Forces in Mind Trust on a profile of the landscape of services for former service personnel with a criminal conviction. Our Research Director Roger Grimshaw summarises our findings.

Colonialism and criminal justice

In May we will be holding an event on the relationship between Britain's colonial empire and the development of criminal justice in the United Kingdom. Book your place here.


Pieces on our site this month include:
David Scott on the sickness haunting our prison system
Roger Grimshaw on why monitoring places of detention matters
Mike Guilfoyle on the perils of partnership working

And finally...

Dr Mark Sanford-Wood, lead for the General Practitioners Council on prison medical services, questions whether prisoners with mental health problems are in the right system.

'We are seeing increasing numbers coming through reception direct from court where the crime they are accused of appears to be the result of mental illness, rather than anything else', he told GP magazine.


I think it's worth re-publishing the article from GP magazine, especially in view of the recent policy statement from the Sentencing Council regarding the need to avoid court adjournments for Pre Sentence Reports at all costs. Well here we have the evidence for what the cost is:- 
In the last year, the GP said, ‘the courts appear to be sending us increasing numbers of people who are already quite significantly mentally ill.
We we are seeing increasing numbers coming through reception direct from court where the crime they are accused of appears to be the result of mental illness, rather than anything else. There does seem to be an increasing number of people who clinically, you would question whether they are in the right system.’
Of course this should also serve to highlight the fact that in addition to the PSR being virtually abandoned as a vital professional assessment process, it's now virtually impossible to obtain a Psychiatric or Psychology report prior to sentence.  


Rise in seriously mentally ill prisoners linked to record suicide rate, fears GP

Increased numbers of seriously ill people being jailed rather than sent to hospital could be contributing to soaring suicide rates, a senior GP working in the prison medical service has warned. GPC lead on prison medical services Dr Mark Sanford-Wood said he believed the numbers of people who are already significantly mentally ill being sent to prison was on the rise and was putting additional pressure on the system.

The HMP Exeter GP told GPonline that prison doctors were having to care for more patients with serious mental health problems because it had become more difficult to access specialist psychiatric support services. Dr Sanford-Wood’s comments came as the Ministry of Justice last week revealed there had been a 32% increase in suicides in prisons in England and Wales, with a record 119 people taking their own lives last year. Rates of self harm and violence against prisoners and staff also increased.

The government has agreed to fund an extra 2,500 prison officers to ease staff shortages in England and Wales after the Prison Officers Association warned of ‘bloodbaths’ because of declining staff levels and rising prisoner numbers.

The Prison Ombudsman last week criticised the criminal justice system after a man with serious mental health problems killed himself in HMP Chelmsford despite having been recommended by a psychiatrist for transfer to a secure hospital. The ombudsman said Dean Saunders should have been in a hospital and had been ‘let down’ by prison and health services. The prison had ‘insufficient’ psychiatric cover to meet the population’s needs, it said.

Dr Sanford-Wood, speaking before the latest suicide figures were published, said the increase in self-inflicted deaths was caused partly by resource pressures in prisons. ‘When you have a system under so much resource strain, strain on finances, strain on staffing, then inevitably it is going to make things more difficult, and you may get more suicides,' he said.

In the last year, the GP said, ‘the courts appear to be sending us increasing numbers of people who are already quite significantly mentally ill’.

‘We we are seeing increasing numbers coming through reception direct from court where the crime they are accused of appears to be the result of mental illness, rather than anything else. There does seem to be an increasing number of people who clinically, you would question whether they are in the right system.’

If more patients who should be treated in secure psychiatric settings are being sent to jail, Dr Sanford-Wood said, ‘inevitably, the prison system is going to be more challenged in providing them the care they need’. The Devon GP leader said that increasing difficulty in accessing specialist psychiatric support services in hospitals also meant prison GPs were having to care for more patients with more serious mental health conditions.

‘Most GPs would recognise the amount of availability and support of specialist psychiatric services in hospitals can be quite patchy. That may be a funding issue, or it may be shortages in the psychiatric workforce,' he said.

‘There has been an increase in the number of psychiatric cases we are having to deal with ourselves. More challenging access to specialist psychiatric input for cases. GPs, in my experience, are now picking up more complex cases that previously probably would have seen a consultant psychiatrist.’

He added: ‘I'm not not saying those cases are being unsafely dealt with, but there is certainly a more challenging environment. Because the people we are dealing with are inevitably more unwell.’

The doctors’ leader was speaking on the eve of last Friday’s BMA conference for prison GPs to exchange ideas and experience of the fragmented service.


  1. Very true; a very important message but one that will continue to be ignored because its 'too costly' in financial terms. Our mental health services are on their knees and can't cope. If someone commits a criminal offence its so much easier to let them be absorbed into the criminal justice system "because they're bad, not mad."

  2. Difficult not to think of 'alternative facts'. Here we have doctors worried about the mentally-ill being denied pre-court assessments and yet the sentencing council asserts that 'ideally' reports should be done on the day of sentencing.

    The old ideal was to sentence on the merits of the individual case, which included the characteristics and motivation of the defendant. This ideal was not time specific and so time was allowed to investigate the circumstances of the defendant, especially where there were initial assessments of, or histories of mental health issues. Not anymore. The drive to reduce court budgets means those without resources, will be processed without regard to individual need. People are decanted into the prisons and placed at increased risk of poor healthcare, self-harm and suicide. And these practices are endorsed by the sentencing council, just as they were endorsed by the probation service – pre-TR as well – when management championed expedited reports that were forever getting shorter and faster, while quality never got a look in.

    1. Absolutely right 17.56. Increasingly when I think of all the things that are going wrong and when I see no managers putting up a fight or any objection, when I see them doing the opposite, going along with the nonsense, promoting it, selling it , entering into the narrative , making it the new norm, then I know that me, myself, I am the last Tuzla thin protective layer between the crushing inhumanity of an increasingly evil system and the service user. I find ways of not going along with what is being demanded, I speak against the narrative in word and in deed, pushing it as far as I can, being open about it to try and encourage my colleagues. We have to or we are no better than the system we work in. Nazi getmany would never have gotten as far as it did without the willing compliance of its bureaucrats and the minions of its bureaucracy, us. We have a responsibility. Do not be afraid. Say it as it is at work now.

    2. Agreed, otherwise we become like the DWP who now commit abuses against those they are supposed to be helping.

  3. Cumbria Constabulary have added their voice:

    "In December [2016] the force dealt with 377 incidents relating to mental health, a total way above the five-year average of 220.

    In 2016 as a whole, officers also typically handled between 250 to 350 incidents a month – again above this average.

    By comparison, in December 2012 there were 185 incidents.

    As people are encouraged more and more to talk about their problems, Mr Pannone believes an increased number of people are prepared to look for help, which is why further incidents are being reported to the force.

    Martin Plummer, chairman of the force union, Cumbria Police Federation, said it was good to see the public confiding in the police.

    But he added that police reforms and reforms in other emergency services had a knock-on effect on the type of incidents police were dealing with.

    “It really is a vicious circle,” he said. “Unless there are reviews of the resources allocation, then this is only going to get worse.”

    Mr Plummer thinks a review of emergency services is vital to look at what needs to be done to help a process he said is “very quickly going down hill.”

    “We are having to do the very best that we can,” he said.

    “Sometimes that means transportation in police vehicles and places of safety within custody suites. That cannot be right.”

    Though officers are trained in relation to mental health, they are not trained in the same way as mental health professionals and sometimes those with the appropriate training aren’t available.

    Mr Plummer said these situations can be distressing and a further problem for people with mental health issues. It also means that a backlog is created as calls come in on jobs they are trained to deal with."