This September, marking World Suicide Prevention Day, 150 prisoners across 60 prisons in England and Wales tell government how to reduce unprecedented levels of suicide and self-harm.
No one wants anyone to suffer the pain of suicide in prison and the terrible impact such a bleak death has on family, friends, fellow prisoners and prison staff. Everyone wants to turn back the rising tide of self-harm in our jails. And yet last year 113 men and 12 women took their own lives in custody in England and Wales and there were well over 40,000 incidents of self-harm - the worst figures ever recorded.
Preventing self-harm and suicide in prison
In February this year the Independent Advisory Panel on Deaths in Custody (IAP), which I chair, and the national newspaper for people in prison, Inside Time, began a unique collaboration to help keep people in prison safe. Supported by the Samaritans, the IAP called on Inside Time readers and Prison Radio listeners to say how best to prevent suicide and self-harm. By July we had heard from over 150 prisoners across 60 prisons. Prisoners are experts by experience - they see and hear and know things about life behind bars that others don't. What is striking, though not surprising, is how sensible and deliverable their ideas are to prevent deaths in custody.
More prisoners wrote about the importance of good, professional relations with staff than anything else. Many wrote about the damaging impact of staff cuts, exhaustion, low morale, no time to talk and more lock-up, as well as the loss of experienced staff - people like the 'one particular officer who can tell just by talking to me how my mood is. He notices if I'm down, if I don't eat, if I don't socialise.'
There were some inspiring accounts of where a life had been saved by the compassion and humanity of an officer. At the same time, the IAP was very concerned about examples of disrespect, of officers laughing at prisoners or even goading them in one or two instances to harm themselves. The messages prisoners have for the Ministry of Justice and the Prison Service are clear:
• recruit and retain enough good, decent people,
• train, support and supervise staff to meet standards set,
• establish and maintain safe staffing levels for each prison.
Mental health need
According to Ministry of Justice figures, 46% of women in prison and 21% of men have attempted suicide at some point in their lives compared to 6% of the general population. Almost half of all the letters and phone messages were about mental health. "Jail is not a mental hospital. Well it shouldn't be. But it is at present." Alongside calls for prompt assessment and diversion into treatment, solutions offered included counselling, peer support, medication, increased exercise and activity. People wanted to ensure that the ACCT process (Assessment, Care in Custody, and Teamwork to monitor those at risk of suicide) is more than just a box-ticking, back-covering exercise. These thoughts were echoed in recommendations to respond to basic needs for fresh air, decent food, a night's sleep and more time out of cell.
Prisoners stressed the importance of family contact in preventing suicide and self-harm. Proposed improvements included being located closer to home, in-cell telephones and internet access. Nepacs, a prisoners' family charity, called for an emergency contact line for family and friends and asked that they are not dismissed "as worriers, worse still, nuisances." Launched this week, Lord Farmer's review of the importance of strengthening family ties to reduce reoffending, and government acceptance of his recommendations, should mark a sea change here.
Beyond loss of liberty
People are sent to prison to lose their liberty not to lose all hope, their dignity or, at worst, their lives. A quarter of prisoners wrote about the enduring pressure and hopelessness of still serving an IPP sentence (Imprisonment for Public Protection the indeterminate sentence abolished in 2012) - especially for those 3,000 or so people who are years beyond their original tariffs. "This is nothing but torture of the highest order."
Many prisoners are living in fear of the impact of drugs such as "the epidemic called Spice" (NPS: new psychoactive substance) in prison, including the debts and violence that go with it. They believe that too often 'the dealers have the upper hand.'
Ministers are being asked in the strongest terms - both to get to grips with this unjust lingering sentence and with unsafe and unhealthy prison environments
Self-inflicted deaths in prison are avoidable, not inevitable. The government has a duty to hold people safely in custody and to take active steps to protect life. Prisoners' views and solutions in this Keeping Safe report reflect evidence from, and recommendations made time and again by, amongst others, the Prisons and Probation Ombudsman, HM Chief Inspector of Prisons, the Chief Coroner and the National Audit Office.
In many instances, making the changes suggested by people in prison does not require legislation - but, rather, operational adjustments and attitudinal shifts. Having been relegated in recent years, safer custody is back as a top priority for Ministers and remains so for managers. There is an overarching need for consistency and accountability. How much better to be wise before the event and keep people safe rather than to have to promise yet again to learn lessons from another tragic death in custody.