Monday, 8 December 2014

Suicide in Prison: Behind the “Blip”

During his lamentable performance in front of the Parliamentary Select Committee on Justice last week, perhaps the most damning comment made by Secretary of State for ‘Justice’ Chris Grayling was his description of the 69 percent rise in suicides by serving prisoners as “a blip”. It was, even by his standards, a callous throwaway line that has inevitably caused deep offence among the families of the dead – some of whom I knew personally. For me this is an undeniably personal issue.

Does this face look bothered?
Generally speaking, when a group of human beings has been so demonised and depersonalised to the extent that their deaths can be dismissed so lightly by a leading politician, you know instinctively that something is really rotten in our political system. In such circumstances, where families are still living with the traumatic impact of sudden and often violent bereavement, it would have cost nothing for Mr Grayling to have expressed some modicum of regret or sympathy, what the late Peter Ustinov once described as “adding a dash of pity”. But not a bit of it. 

The hard cold fact that between January 2013 and the beginning of October 2014 a total of 134 men and women, many of them young and most of them vulnerable, have ended their lives within the confines of a tiny concrete prison cell is no more than an inconvenient statistic to Mr Grayling. He obviously sees the rising figures, but not the horror and tragedy that lies behind them, or the legacy of loss and grief that their families are living with on a daily basis. 

Since this marked rise in self-inflicted deaths in our jails has neatly coincided with Mr Grayling’s period in office as both Justice Secretary and Lord High Chancellor of England and Wales, it might have been worth him getting some numerate minion within his vast empire to do some number-crunching at least to try to make sense of this issue ahead of giving evidence to the Justice Committee. Much of the groundwork work has already been done in the reports issued by Nigel Newcomen, the Prisons and Probation Ombudsman for England and Wales (see here).

For example, are more people being sent to prison because they have mental health conditions at a time when there aren’t suitable hospital places available? Are more vulnerable people being remanded in custody ahead of trials by risk-adverse magistrates and judges? But no. ‘Crisis’ Chris had nothing remotely meaningful to say on this matter beyond the trite comment that the suicide figures for young men generally have been rising in recent decades.

Out of sight... out of mind
It seems that in Grayling World prisoners are considered to be such worthless scum (whether convicted or not) that their deaths scarcely merit any analysis or investigation. Collectively, the dead represent a statistical “blip”. We are now told that the Ministry of Justice (MOJ) has commissioned an ‘independent’ probe of deaths in custody of those aged 18 to 24. It remains to be seen what conclusions are reached, but it will be very interesting to see whether it is completed or published before the forthcoming general election.

In October, The Guardian did a very timely and important analysis of the reality behind the stark figures for prison suicides (see here) on Mr Grayling’s watch. The feature began the process of re-humanising the dead. It gave some of them names and faces, while allowing a few of the grieving families to share their stories of loss and pain. Their photos, many of them informal and smiling family snapshots, are both poignant and haunting. It was one of those occasions when the British quality press does what it should be doing: informing the general public about a matter of national concern.

The article looked beyond the headline figures and started the process of deconstructing them. Using official statistics and data, the authors highlighted the fact that an average of more than six prisoners have killed themselves each month since January 2013. Of the 125 who died between then and the end of August 2014, 121 of them were male, while four were women. By the beginning of October, a further nine inmates had taken their own lives.

The individual stories relate an all-too familiar pattern of poor mental health, disrupted childhoods, personality disorders and personal crises. Many of those who have died were vulnerable young men with multiple problems. Was prison really the most appropriate place to hold them, particularly at a time when staff resources are at an all-time low, many jails are severely overcrowded and mental health provision is so scarce that – as HM Inspectorate of Prisons has found – in some establishments the only way to get any attention is to self-harm?

Going into prison: a one-way journey?
What should also be very disturbing is the number of prisoners who have felt impelled to commit suicide, but who are serving relatively short sentences for very minor offences, sometimes acts of petty theft or even for attempting to harm themselves (rather than anyone else). At times, it really makes you wonder in what fantasy world some of our magistrates and judges live.

Moreover, 26 percent of those who have committed suicide since January 2013 were being held on remand, untried and unconvicted of any offence. The pressures of being remanded, including the uncertainty about their future and the prospects of losing jobs, homes and even families, is a recognised risk factor in self-harm and suicide among prisoners. Is this rise due to a lack of trained staff able to monitor vulnerable prisoners – or is it more down to a failure to even recognise these warning signs?

At HMP Elmley, a Cat-B/C local prison on the Isle of Sheppey in Kent, there have been nine deaths so far during 2014. Of these, four were suicides, while a further four were due to natural causes and the circumstances of the ninth have yet to be determined. Three of these deaths occurred over a three-week period.

HMP Elmley: deteriorating rapidly
In November, Elmley (which is part of the so-called ‘Sheppey Cluster’ that includes HMP Standford Hill and HMP Swaleside) received a shocker of a report from HM Chief Inspector of Prisons, Nick Hardwick (see here). At the time of his inspection the establishment held 1,252 men. The normal certified accommodation figure is 985. Nearly 23 percent were unconvicted remands, while a third were still unsentenced. 

The report also warned that staff shortages meant there was a “very restricted and unpredictable regime”. In particular, work, education and exercise were being cancelled frequently as a result of staffing problems. Around 15 percent of prisoners were regularly locked in their cells for 23 hours per day. At the same time, assaults and other violence had rocketed by 60 percent during the year. Against this background, it’s perhaps not surprising that incidents of suicide, self-harm and violence have risen.

As the HMIP report also noted, the situation was “deteriorating quickly” and the trend for violent incidents was going upwards: 

More than half of prisoners told us they had felt unsafe at some time and a quarter told us they had felt unsafe at the time of the inspection. The first night centre was an unstable and frightening environment with a toxic mix of new prisoners and others who had been in trouble elsewhere in the prison. Inspectors witnessed vulnerable prisoners being abused without staff intervention.

Perhaps predictably, the easy availability of drugs was a major concern:

Forty per cent of prisoners told us it was easy to get drugs, the MDT programme was flawed and there were indications that the use of new psychoactive substances such as ‘Spice’, which were not easily detectable, was common. One in 10 prisoners told us they had developed a drug problem in the prison.
Spice: in common use

As is often the case where you find drugs so freely in use in prison you will also find violence, bullying, intimidation and debt, as well as pressure to smuggle contraband into the establishment, both applied to inmates and their families back in the community. Because the newer synthetic substances aren’t identified during routine mandatory testing, the risks of taking them and getting caught are much lower.

What is particularly shocking, however, is the rapid descent into violence, fear and chaos since the previous HMIP inspection report back in March 2012 when the prison was stated to be “well run” and “reasonably safe”, even though the establishment was at that time already 300 prisoners over its normal capacity. Why have things gone so wrong so quickly?

Reading the latest report, it seems clear that the key problems are operational and primarily down to inadequate staffing when the prison remains well over its certified capacity. Responsibility for this dangerous situation has to be laid firmly at the door of the MOJ and its political leadership.

This is all pretty damning and yet the MPs on the Justice Committee and the general public are calmly assured that there is no crisis of any kind in our prisons. Of course, there are “challenges” (the weasel word preferred by politicians and bureaucrats who don’t like to acknowledge that there are problems), but there is no impending disaster on the horizon. I’m not sure whether it is the complacency or the casual denial of reality that shocks most. Perhaps it’s a combination of both, with more than a dash of arrogance, nastiness and contempt thrown in for good measure.


  1. whilst you are correct to highlight the impact of a suicide in custody on the family, please also recognise the impact on prison officers and medical staff involved, they have feelings also and are battling in the front line,
    from my experience prison staff work very hard where they are aware of someones intention to end their life to ensure this does not happen, but it's much harder to prevent a suicide where you have no early warning,

    1. I entirely agree. I have had the misfortune to be on a prison wing (as an inmate) when a young man was found hanging in his cell. It had a profound effect on the whole wing. Staff were clearly shaken by the incident, quite understandably, although they presented a brave face as best they could to the inmates.

      For us, we were banged up for the morning whilst the incident was dealt with and not given any information of what or to whom had happened.

      Sadly, the young father died.

      We all felt a huge feeling of loss, for me personally I knew of the guy but had never spoken to him. I felt guilty that maybe a few words of friendship would have made a difference - something that still haunts me years later. Many warning signs were missed in his case by management and maybe the dire outcome could have been avoided.

      Amazingly the inmates on the wing donated over £70 which was split between funeral flowers and a donation to The Samaritans. This from 160 guys earning less than £10 a week each.

      It is true that prison suicides have a massive effect on prison staff, inmates and ultimately the deceased's family.

      To a minister it's just a "blip". Worrying.

    2. Thanks to both for your comments. Maybe I can respond to both together. Your points about the impact of prisoners' suicides on staff - uniformed and civilian - are very valid.

      In fact, in my first blog post on the impact of suicides in custody I did flag up this issue: "In these two cases, the dead prisoners' cell-mates kept asking themselves whether there had been any warning signs that they had missed. Perhaps part of this trauma is 'survivor's guilt' which is sometimes present as an element of post traumatic stress disorder (PTSD). It is possible that similar feelings can be experienced by prison staff or healthcare personnel who dealt with the deceased, but I've never had the chance to discuss this with them."

      On the other hand, I've witnessed some pretty awful safer custody practices inside, including prisoners on the ACCT book being put on Basic - one of whom then hanged himself. That case was a tragedy waiting to happen, and sadly it did. He was 21 and the father of a little girl.

      While many tragedies are directly attributable to staff shortages on wings, the wider question is whether prison is the appropriate place for inmates with often severe mental health problems. I've also seen situations where mental health team access is only available after a prisoner has self-harmed and this is now being flagged up more frequently by HM Inspectorate in reports.

  2. I suspect it would be illuminating if the statistics for self-inflicted deaths also included the number of prisoners who come close to ending their lives, either because a suicide attempt doesn't result in death or because someone (staff or other prisoners) is able to save them.

    1. Thanks for your contribution. You are quite right. In fact there are published figures for self-harm, although as far as I recall these incidents are not disaggregated by seriousness or how close to death the person was. What is clear is that cases of self-harm are also rising significantly, a point that was highlighted in the most recent annual report issued by the Prisons and Probation Ombudsman.

  3. I ain't being funny but anyone who's lost their freedom home etc is going to b feeling low even suicidal. So prisons aren't cut out to deal with this. It's so wrong people dying inside. The punishment is loss of liberty. Not your life. We in uk are meant to b advanced civilised nation. Wrong. We r going back to the bad old days of Hitler I'm afraid. Just look at people losing benefits cos they mentally ill. This government is all about the rich simple as that n we the common people allow them to bend us over n take it up the ring piece. Vas

    1. Thanks for your comments, Vas. I think that many prisoners do contemplate suicide - but often the planning phase is as far as most people ever get (fortunately). I've never really been suicidal, but I know I did this myself on a few occasions and never moved into a new cell without identifying all the possible ligature points. In a way, it can be strangely comforting - knowing that you still have sufficient control over your own life to end it at a time of your own choosing.

      Sadly, for a rising number of prisoners - especially those in total despair or crisis - the planning of suicide goes much further and they carry it out, or attempt to do so. Others act on impulse, perhaps without really considering all the options or consequences. Most prisoners who do kill themselves are vulnerable and many have mental health issues, whether diagnosed or not. However, you are right when you observe that often prisons aren't equipped or staffed to deal with such people or their problems.

  4. We are a nation of fighters. Small island race n all that. Y for gods sake are we not standing together on the prison system n this damp government. We have lost our guts I feel. I'm so angry like I said before prisoners ain't got solidarity like those lads in strange ways back in the day. They got things changed cos they stuck together n fought the vast Ards. Vas

    1. I take your points, but for the 95 percent of the population who never see the inside of a prison, the reality only hits them when they, or a person they know or care about, ends up inside. I think that there is a lot of nostalgia for the 'old days' when prisoners stuck together, but to be honest, I also think that even back then the situation was much more complicated. Lifers and IPPs who get involved in prison protests now risk the prospect of dying in prison, so they tend to prefer a quiet life and hope for parole.

  5. That guy who led the prisoners in strangeways riots got 10 yes added to his sentence. N he said he would do it again if he had to. I take my hat off to him. So unless we plan n go to maps or protest. Or get involved then we ought to shut up cos talk is cheap u get me. Vas.

    1. I think that there are ways of making a difference and improving the situation in our prisons, but reform takes time and also requires a political commitment. At present, that just doesn't seem to exist, perhaps because so many people are struggling economically outside at the moment.

      The overwhelming majority of prisoners are from poor backgrounds and have had disrupted education and/or difficult family backgrounds. Add to that a history of drug or alcohol dependency in many cases, as well as mental health problems and it's easy to see why protesting isn't really an option for people who are so severely marginalised and vulnerable.

  6. I guess cons with very challenging behaviour are not sent to prison hospitals due to financial reasons. It costs £300,000 per year to care for a patient at Broadmoor.

  7. We need more people to start campaigning and not stop til conditions n regimes improve vas