Wednesday, 31 January 2018

Prison and Suicide

One of the consequences with a blog that's in its ninth year and tries to focus on one fairly narrow subject area is that pretty much everything's already been said. With increasing frequency I find that when considering the next topic to fill the daily post, a brief search throws up extensive evidence of us having been there before, and often several times. Take suicide for instance and particularly those that increasingly are occuring in prison.

This line of thought was triggered by Andy Green and his recent Guest Blog piece describing the Safer Lives project, working with men awaiting sentence mostly for internet pornography offences and as a group, their noticeable propensity for depression and suicide. It got me pondering on my own practice experiences, historical involvement with the Samaritans and the struggle during the 1980's to get the prison authorities to accept their involvement. 

I've always had a lot of time for this organisation and was an active volunteer for many years early on in my probation career. Indeed the setting-up of the hugely successful Listener scheme in 1991 was largely due to the sustained efforts of another Probation Officer, Kathy Biggar who was National Vice Chair at the time. Here is Erwin Jones of the Guardian writing in 2006:-

A Samaritans scheme for prisoners has helped save numerous lives over the last 14 years, writes Erwin James

The other week I attended the annual Perrie Lectures at Prison Service Headquarters, Newbold Revel, near Rugby. I'd been invited to present a talk about my experiences with prison staff. This theme of this year's lectures, named after humanitarian prison governor Bill Perrie, was Prison Staff: Turnkeys or Role Models. Very timely I thought.

Each year an annual Perrie Award is presented to an individual who has performed "work of note" in our prison system. This year the award went to Kathy Biggar, former vice chair of the Samaritans and now Suicide Prevention Officer at the Department of High Security Prisons, in recognition of her heroic efforts and success in establishing the Listener scheme into prisons of all security categories throughout the country.

To my great honour, at the end of my talk I was asked to present the award to Ms Biggar, and I have to say that the moment was one of the most special in my post-prison life. The Listener scheme, whereby Samaritan trained prisoners provide a patient and compassionate ear for fellow prisoners in distress, is one of the most innovative inventions ever introduced to the UK prison system. It began in Swansea prison in 1992, following the death of a 15-year-old boy called Philip Knight who hanged himself in his cell.

The governor of Swansea at the time was Jim Heyes. Mr Heyes, a man of foresight who had been deeply affected by the death of the youngster, welcomed the Samaritans into his prison and worked closely with Ms Biggar to establish the Listeners as an integral part of his prison regime. Between them they created "a living organism", as one governor described the scheme that has spread through the prison estate like a healing liniment on a festering wound. Mr Heyes' support for the scheme was perhaps the first step in official acknowledgement that prison life is difficult, and that for some, it is insufferable.


I started off by saying we've often been here before and in September 2016 I wrote:-  

Prison Suicides
The Samaritans is a highly-respected charity and in my experience hardly ever puts its head above the parapet and gets involved in politics of any kind. The fact that they have gone public regarding the suicide rate in prisons shows just how bad things have become. This from their press release:- 

Action is needed to tackle rise in prison suicides, says Samaritans
Samaritans is calling on the Government to recruit and retain more prison staff in the face of sharp rises in the rates of self-harm and suicide in jails. In the past year to June 2016, the self-inflicted death rate in prisons has risen by 20 per cent, self-harm is up by 27 per cent and numbers of prison staff have fallen by 25 per cent over the last six years.


Here's Frances Crook of the Howard League on the general topic of prison reform writing for the WriteYou website:-

We need penal reform before it's too late
When the newly appointed Secretary of State for Justice and Lord (note, not Lady) Chancellor appeared before the Justice Select Committee last week she indicated that legislation on penal reform would come, but just not yet.

Michael Gove spent a year consulting on his plans for reform. David Cameron made a seminal speech setting out new principles focused on redemption and compassion. This was all very wonderful and it did help to change the public, and media, discourse. But, over that year, prisons deteriorated and community supervision that had been privatised by Chris Grayling slowly decomposed.

Things are so bad in prisons that someone takes their own life every four days. There is a record number of unexplained deaths, probably caused by a toxic cocktail of drugs. People are locked up in cells the size of a public toilet, and have to defecate in front of their cell mate, with little or no ventilation in the cell. They spend most of the day in this cell, lying on a filthy bunk in dirty clothes.


By February 2017 in a blog post entitled 'Death of PSR Linked to Prison Suicides'  I highlighted the concerns of the medical profession:-

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.


I was particularly struck by two of the comments that resulted:-

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.

Absolutely right  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 Germany 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.

We all know what the issues are and the cost both personal and to society. There's a mountain of evidence and reports from extremely well-respected professional groups, organisations and academics, but nothing seems to happen and the prison suicide rate is still increasing. This Guardian article is from May last year, but could have been written last week:-

Government response to UK's soaring prison suicide rate has been pitiful
Record levels of self-harm and suicide in our jails reveal a collapse in mental health support for vulnerable prisoners. Last year there were 40,161 recorded instances of prisoners harming themselves, almost 8,000 more than 2015. That is almost 800 a week. Suicides reached 119, the highest since records began in 1978. That means a prisoner kills themselves every three days. Labour’s Luciana Berger has described it as “the death penalty by the back door”.

As well as coroners’ inquests and the findings of prison inspectors there have been at least 10 major reports investigating deaths in custody since 1991, including six in the last six years. Since 2010, according to Full Fact, the number of frontline prison officers has been cut from 19,900 to 14,700 full-time equivalents, as the prison population continues to climb.

This week, parliament’s joint committee on human rights – with members drawn from both the Lords and Commons – rushed out a report on mental health and death in prisons before parliament was dissolved. They have been trying to understand why the deaths have continued despite the endless investigations and government promises to do something. It identifies a series of mutually reinforcing failures behind the mounting toll.

Unforgivably, training for prison officers has been scaled back, leaving many ill equipped to identify and address mental health problems. There are huge variations in mental health support between prisons, with some unable to provide vital services. People who are acutely mentally unwell are given short prison sentences instead of community alternatives where they can be cared for more effectively. Fear among mentally ill prisoners of their prospects on release, such as the chances of getting a job, somewhere to live and continued support, actually increases the risk of self-harm and suicide towards the end of a sentence. Meanwhile, psychoactive substances such as spice blight prisoner mental health.

The government response is pitiful. It has promised to recruit 2,500 prison officers, far too few for the task and no substitute for the thousands of experienced officers who have been lost. A review of suicides in custody by Lord Harris found that relationships between prisoners and staff were key to managing suicide risk, with experienced officers using “jailcraft” to identify and manage vulnerable prisoners. The action promised on drones flying in drugs and phones is a glorified publicity stunt that will have a negligible impact.

Research by the Howard League for Penal Reform reveals that suicides are not an unfortunate deviation, but the inevitable outcome of a system that is responding to ever-growing prisoner numbers and too few staff by pursuing a punitive regime that creates precisely the conditions in which poor mental health, self-harm and suicide flourish.

The government has allowed prisons to become dirty, frightening and dangerous. Since 1990 the number of prisoners has almost doubled to around 85,000. Prisoners are routinely locked up virtually the entire day. There is excessive use of solitary confinement and other punishments. Prisons even fail to look after prisoners on the day they arrive, with shortcomings ranging from not telling staff about arrivals to locking someone up for their first night in the segregation block because there happened to be a spare bed.

The revised Incentives and Earned Privileges (pdf) scheme introduced by the Ministry of Justice in 2013 tends to put prisoners with a history of mental health problems on the lowest level of privileges, making it even more difficult for them to cope. The Howard League says this regime undermines precisely the factors that can reduce the risk of suicide, such as involvement in activities, contact with family and spending time with other people.

Prison mental health services are not just having to meet the needs of vulnerable and ill people; they are having to cope with mental illness created and exacerbated by appalling conditions which amount to an abuse of prisoners’ human rights.


  1. "
    Prison mental health services are not just having to meet the needs of vulnerable and ill people; they are having to cope with mental illness created and exacerbated by appalling conditions which amount to an abuse of prisoners’ human rights."


    1. There is a widespread perception that mental ill health is on the rise in the West, in tandem with a prolonged decline in collective well-being. The idea that there are social and economic causes behind this perceived decline is increasingly convincing, amid what has been termed the zombie economics and grinding austerity, which have followed the global financial crash.

      In particular, there is growing concern that the conditions and effects of neoliberalism – the enervating whirl of relentless privatisation, spiralling inequality, withdrawal of basic state support and benefits, ever-increasing and pointless work demands, fake news, unemployment and precarious work – is partly to blame. Perhaps most wearying are the invasive yet distant commands from media, state institutions, advertisements, friends or employers to self-maximise, persevere, grab your slice of the diminishing pie, “because you are worth it” – although you must constantly prove it, every day.

      In our work and leisure we are urged to feign permanent enthusiasm amid radically lowered expectations. Neoliberal newspeak hollows out the terminology of achievement, mandating boasts about personal “excellence” and “dedication” as actual possibilities for achievement diminish and work becomes stripped of meaning. At my institution, the cleaners’ uniforms are emblazoned with inscriptions announcing that they deliver their work with “passion, professionalism and pride” – as if it were reasonable to demand “passion” from a cleaner on minimum wage whose workload has doubled since 2012.

    2. Neoliberal states divest themselves of the costs of care by individualising and privatising care duties. People displaying troubling symptoms are divided into the “dangerous”, against whom punitive or authoritarian containment methods may be used, and those left to cope with what resources they or their families have left.

      The 1970s-80s saw the closure of the last asylums in the UK and the welcome end of long-term institutionalisation for thousands written off as “mad” and without rights to liberty. As the state also made significant savings through the transfer of patients back into “the community”, the situation appeared win-win. But half a century after “care in the community” became the norm for most chronically ill patients, effective community treatment is stymied by slashed budgets, low staffing levels and morale. Systematically defunded NHS psychiatric services struggle to fulfil the legal burdens placed on them to provide basic care.

      Increasingly, it is the police who handle “front-line” mental health crises in the UK. Prisons “warehouse” the mentally distressed. Meanwhile in US prisons “mental health” wards house suicidal or otherwise mentally or emotionally unstable prisoners, who are placed in special “suicide-proof” garments and cells, sometimes in prolonged isolation. Any pretence of care will ultimately recede in favour of protection against litigation in the prison context. “Suicide smocks” are now placed on patients who appear suicidal or psychotic on admission or during incarceration in many US states, and are worn even in court.

      What ways, then, are there to resist these worrying trends? Black humour is one way to deal with systems which command “positivity” while simultaneously informing you at every stage that you are already a “loser”. But collectivity of various kinds will be our best protector. As psychologist Paul Verhaeghe predicts, the age of the “utterly unrelieved individual” has (probably) reached its limit. What lies beyond the limit, particularly for those already broken or caught in the punitive grip of incarcerative “care”, is less clear.

    3. Only this week we have had a landmark example of blatant discrimination towards those with mental health issues: the PIP assessments, A government defeated in the courts for discriminating against the mentally ill. The government talks compassion and acts with cynicism.

      There is good evidence – as set out in a book, The Spirit Level - that those societies with high economic inequalities have more citizens with mental health issues.

      And the statistical evidence of declining prison staff numbers alongside increasing incidence of self-harm amongst prisoners shows what happens when prison regimes unravel . It is shameful that so many people in prison feel unsafe – either from other prisoners or prison staff. Feeling at constant risk of being abused and bullied, never mind coping with underlying vulnerabilities, pushes individuals towards brinks of one sort or another. No wonder recidivism is high: prisons manufacture it.

  2. Prison officers have never had decent mental health training. I remember talking to one (25 yrs experience on the job) about what sort of training was available to them in this area and they responded that HMPS offered a three day voluntary training session. That was it. Just three hours and not compulsory to attend and that was supposed to equip officers to deal with really complex mental health needs. Things will presumably only have gotten worse post Grayling and they probably don't even offer that pitiful amount of training any more

    1. There's a number of good articles to be found in this months edition of inside time, the prisoners newspaper.
      This seems relevant to today's post.

    2. More harmful than helpful

      It baffles me to see that beyond the immediate and often necessary need for ‘public protection’, there continues to be some kind of institutional denial of the fact that not only is the current prison system not fit for use, it is actually more harmful than helpful.

      The record number of people in prison is shocking, 90,000, but also the terrible levels of prison violence, high staff turnover, massive levels of reoffending and chronic overcrowding provides the empirical evidence that supports the compelling anecdotal evidence that is in no short supply in these tragic and desperate institutions. The truth is that prison staff, prisoners, and society as a whole are all victims of this shameful, government-backed atrocity.

      My own simple explanation of the primary cause of crime is that it is a poor attempt to meet some kind of functional need, such as the need for safety, warmth, food, status, belonging, etc. It is where social and personal values conflict and where society must always be seen to win. Prisons do such a bad job because they teach us prisoners, innocent or not, to meet our needs in ultimately unhealthy and unhelpful ways that are worse than the ones we used before prison.

      Each day we are faced with dilemmas requiring us to make judgements that are necessary for survival, much like animals living in the wild. It is a crazy-making kind of reality where hierarchy and status, trust or mistrust, aggression or non-violent communications, and co-operation or selfishness are the paths we must choose wisely or face the tragic consequences of a poorly-played hand. There is little time for the reflective stillness, necessary for personal transformation when ‘Big K’ and his boys are sniffing around your cell knowing that you are packing 6 packs of spicy noodles somewhere in there from your weekly canteen. At the same time, you notice that the screws seem to have strategically disappeared to ‘catch up on admin’…which is, apparently, nothing to do with them being outnumbered, weary and desperate to go home and be with the people who love and appreciate them.

      ” Each day we are faced with dilemmas requiring us to make judgements that are necessary for survival, much like animals living in the wild. “

      Predictably, the fact that our prisons are so poorly funded, means that the resultant scarcity of resources leads to the kind of ‘famine mentality’ that Charles Darwin observed to trigger and instinctive ‘win or lose’ drive. This is always going to be messy when applied to some of the most dangerous men and women in society. Here at ‘HMP No-Hope’, both prisoners and staff alike need to develop a psychologically necessary desensitisation in order to numb the reality we are forced to face that can never be allowed out in the land of the free.

      To call our current prison system a ‘false economy’ would be a crass understatement. Until the government invest sufficient resources into the prison system to make it safe enough to support personal change, most prisoners will continue to develop and hold onto the kind of schemas and ‘character-armouring’ necessary to survive jail and for this to be polished and primed ready for their release into what is a very different and comparatively vulnerable kind of world. Is it any mystery that apart from the lucky few, so many return?

      Safety will always provide the foundation for any process of rehabilitation and change, and are clearly observable measure of this in any socially beneficial system is the level of co-operation seen between those involved. Where resources are sufficient and fairly distributed, greater co-operation leads to better outcomes for everyone, such as with successful prisoner rehabilitation and prison staff retention, and the unquestionable link between the two.

      The alternative to this, such as with the current model of ‘containment rather than cure’ we now see, makes a bad situation much worse and results in what the 17th century philosopher Thomas Hobbes referred to as ‘Solitary, poor, nasty, brutish and short’. Does that sound familiar?

  3. Jurors have criticised “appalling systematic failures” at a prison as they cleared an officer over the death of a suicidal inmate.

    Joseph Travers, 55, was accused of breaching his duty of care by failing to remove a noose from Ryan Harvey’s cell and to prevent his death.

    He was the night orderly manager at HMP Woodhill near Milton Keynes when the 23-year-old hanged himself on May 3 2015.

    In an unusual move, jurors also included a written statement saying: “We would like to record our view that the case has thrown up a number of appalling systematic failures to provide frontline staff with sufficient information as to the inmate’s background.”

    1. A senior prison officer observed prisoner with noose around his neck - and he's acquitted of gross negligence/manslaughter. How exactly does Woodhill prison define a cry for help?

  4. Prisoner stabbed to death at Wormwood Scrubs.

  5. Maybe if prisoners from a variety of prisons took a "class action" (plenty of good lawyers around who will work on a "no win, no fee" basis) against the Government for failure to look after their basic human rights and failure to protect them from harm whilst under their care it may focus Government's mind. If 90,000 prisoners are all asking for compensation of, say, £100,000 each then the Government must realise it will be cheaper to act without delay to improve the fabric and facilities of prisons and to introduce proper training and decent meals to assist in prisoner rehabilitation. Even the Tories can calculate the possible cost of a class action on this scale. Worth a try?
    If, for legal reasons, prisoners are not able to sue the Government then maybe the Labour party or charities could sue on behalf of the prisoners.

  6. I noticed a comment from a twitter Follower to me thus - which I was unsure how best to reply - other current practioners may respond more helpfully than I could.

    "Maybe one of your priorities could be reducing self inflicted deaths of those under probation supervision"