Acts of Despair… Suicide in Prison

The latest annual report issued by the Prisons and Probation Ombudsman (PPO) makes very grim reading. Even the title – A Rising Toll of Despair – fails to prepare the reader for the dismal and unremitting catalogue of tragedy, casual negligence, inhumanity and institutional failure that afflicts our failing prison system. You can find the whole document here.

Allow me to take you on a brief tour of the highlights of this particular catalogue of horrors. The headline figure, of course, is the substantial rise in the number suicides in custody during the period 2013 to 2014. A total of 90 prisoners took their own lives, up from 55 in the previous year. That represents an increase of 64 percent year on year. I’m not a statistician, but I’d say that rise was ‘statistically significant’ by any measure of the term.

Within these grim statistics, there was an increase in suicide among adult male prisoners, particularly among 25 to 30-year-olds (24 percent of the total), who accounted for 22 deaths, up from 14 in 2012-2013. The report also draws attention to an increase in suicide among prisoners newly sent to prison. 

In his introduction to the report, Nigel Newcomen, the Prisons and Probation Ombudsman observes that: “Self-inflicted deaths among prisoners are tragic indicators of the level of personal distress and mental ill health in prisons. Some may even evidence broader institutional stresses and failures.” He adds that the rise in the number of suicides was “a troubling reflection of the state of our prisons”.

A grim place to die alone

Mr Newcomen, a man I genuinely believe means well but who has little real power or authority, also highlights what he describes as “a rising toll of despair among some prisoners”. While he acknowledges that his office cannot offer a “definitive explanation for this increase [in suicides]”, it is also clear that he is highly critical of the institutional failures that underlie too many of these personal tragedies and acts of desperation. 

As he rightly points out: “… there have been too many instances of prisons failing to adequately identify the risk of suicide posed by prisoners, despite clear warning signs being present. Even where risk of suicide was identified, monitoring arrangements and case reviews were too often inadequate.”

One of the specific issues flagged up in the PPO report is concern as to whether the Prison Service can actually cope with the rising levels of mental illness among prisoners. Readers of my previous blog posts on this subject will be aware that my own view – based on my experience in prisons – is that current shortages of staff, serious overcrowding in many establishments and the mismanagement of very limited mental healthcare resources all have a part to play in the institutional failure to reduce levels of suicide and self-harm in our prisons.

Too few prison staff?

The contentious issue of inadequate staffing levels – always a highly political point – is raised by Mr Newcomen. As he points out: “It has been suggested that prison staff are now so stretched, and the degree of need among some prisoners so high, that they may no longer be able to provide adequate care and support for some vulnerable prisoners.” 

However, he goes on to observe: “The evidence for this remains anecdotal and every day prison staff do save many prisoners from themselves – an achievement which goes largely unreported and without which the tragic number of suicides would be even higher. Nevertheless, the prison system is undeniably facing enormous challenges.”

Personally, I’d agree that prison staff and support services are over stretched and are often unable to cope. I have also seen for myself the casual, even callous manner in which some prison officers deal with cons in crisis, dismissing them as weak or attention seeking cry babies. Moreover, the monitoring of inmates who are considered to be at risk of self-harm or suicide can be extremely lax or overly complacent. 

Prisons are supposed to use the Assessment, Care in Custody and Teamwork (ACCT) system to assess, monitor and share information about such people when they are placed on what is often called the “ACCT book”. However, when this is used more as a ‘tick box’ exercise, the outcomes can be tragic. As the PPO annual report acknowledges: “While we believe that the ACCT process can be an excellent tool to help keep prisoners safe, if it is not implemented correctly, it can provide false assurance for both staff and prisoners.”

The reality for many prisoners

From a personal perspective, however, I could point to other issues playing a part in the rising suicide rate, such as the toxic ‘legacy’ cases left over by the catastrophic (and now discontinued) Indeterminate Sentence for Public Protection (IPP) where thousands of prisoners have been left in a soul- and mind-destroying limbo, often with no realistic prospect of release even when they are years over the minimum tariff handed down in court. 

I have often reflected that had I received an IPP, I’d have very probably joined the ever-lengthening list of suicides myself. A determinate sentence – even a very long one – at least has an eventual end point. You can dream and plan of what you’ll do with the rest of your life after release. 

With an IPP sentence, you have nothing to hang on to, even if hope dies last. I’ve known innumerable cons serving these sentences and the stress of it mentally destroys them. In my own opinion, some are probably far less mentally stable, and more angry and bitter now than when they were sentenced. That doesn’t bode well for future public protection if these men do ever get released. 

Of course, there is a wide range of other root causes of self-harm and suicide in UK prisons. These include relationship breakdowns (very common inside, as well as out in the community); overwhelming guilt over terrible crimes committed; the death of close family members and mental illness, particularly depression. Older prisoners may also conclude that spending what is left of their lives in a concrete cell really isn’t worth the effort, especially if they are in poor health or severe pain. While individual screws and other staff may be supportive and good listeners, the Prison Service as a whole is not well equipped to deal with these personal tragedies and crises. 

Good intentions: not always enough

Even when inmates can find a kindly member of staff ready to listen, such as wing officers or chaplains, their hands are often tied by the endless red tape and regulations that can even prevent them facilitating access to a telephone so a distressed prisoner can make a compassionate call to a loved one dying in hospital or a sick child. I’ve sat with sobbing inmates who are terrified that their relative will die while they are imprisoned miles away, utterly helpless and unable to be there to say goodbye. 

The recent tightening up of the rules for Release on Temporary Licence (ROTL) is likely to block some cons from being able to visit close family members on their death beds in hospitals or from attending funerals. This will doubtless be made worse by the current shortage of staff to serve as escorts for such compassionate leave outside the prison walls.  

And I think that there are other factors to consider. The changes to the rules for the Incentives and Earned Privileges (IEP) system introduced on 1 November 2013 in PSI 30/2013 may well be playing a role in making the experience of imprisonment much more difficult to endure. Placing more and more cons on the highly punitive Basic regime, particularly those who are steadfastly maintaining innocence, is never going to improve mental health. 

Almost anyone, no matter how strong, will eventually deteriorate mentally and physically if held in what amounts to solitary confinement for up to 23 hours a day with no rented TV and next to no personal property or opportunity to telephone family or even take a shower. It would be instructive to know just how many of the prisoners who have committed suicide, or attempted to do so, were on the Basic regime at the time of their deaths or a serious attempt to self-harm.

Wilde: first hand experience

Beyond those pressures, I would also add the general, all consuming weariness of prison life, particularly for those cons serving very long sentences. As Oscar Wilde so accurately observed in his Ballad of Reading Gaol: 

All that we know who lie in gaol

  Is that the wall is strong;

And that each day is like a year,

  A year whose days are long.

Sometimes the prospect of those long days and even longer years proves to be too much for some prisoners to bear and even death seems to offer a merciful release. While I never considered myself to be particularly suicidal, I have to make a confession: I never moved into a new cell in a B-cat or C-cat nick without checking on all the available ligature points. I always knew in my heart of hearts that if things ever got too much to bear, by making use of either the TV coaxial cable or my belt, I could exit on my own terms. 

Ligature points

As I’ve written in earlier blog posts, three of my friends in prison – one of them just 21 years of age – did opt for that course of action in their misery and sadness and I still think of them almost every day. Perhaps you could call it survivor’s guilt.

However there is one man who is probably incapable of feeling any compassion or guilt whatsoever. Our Secretary of State for Justice, Chris Grayling, is a man in total denial. His public statements bear all the hallmarks of a classic prison psychology report: “he refuses to acknowledge or accept responsibility for the consequences of his actions” and “he lacks empathy with his victims”. He had better hope he never ends up in the nick! Prison psychologists would have a field day.

No matter how strongly Mr Grayling maintains his innocence, we all know the truth. He and Mike Spurr of the National Offender Management Service (NOMS) have blood on their hands. All the forensic evidence in the reports by HM Inspectorate of Prisons and the Prison and Probation Ombudsman doesn’t lie.