Suicide and Self-harm in Prison (England)

Part of PRAYERS - [Mr Christopher Chope in the Chair] – in Westminster Hall at 11:00 am on 1 March 2017.

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Photo of Luciana Berger Luciana Berger Labour/Co-operative, Liverpool, Wavertree 11:00, 1 March 2017

I thank the hon. Gentleman for his intervention and for his commitment to the issue of mental health. Deaths in prison should be treated no differently from those in any other setting. Issues such as ligature points are contended with very differently in inpatient settings and in prisons. We could point to many things that should be treated in the same way as in any other element of life outside prison.

The number of self-harm incidents has also reached a record high of 37,784, which is up nearly 7,000 on the previous year.

One group that has been uniquely failed by the prison system is transgendered prisoners. There have been four deaths by suicide of transgendered people while in prison over a mere matter of months. That is from an estimated prison population of just 85.

We know that the prevalence of mental health conditions is much higher among the prison population. Prisoners are over three times more likely to suffer from depression, 12 times more likely to suffer from a personality disorder and 16 times more likely to suffer from psychosis.

For prisoners who need to be treated in a mental health inpatient unit, departmental guidance states that transfers under the Mental Health Act 1983 should take place within 14 days. I was appalled to learn from the answer to my written parliamentary question that in 2015-16, 1,141 prisoners—three in four—waited longer than that two-week window. Such ubiquitous failure would never be tolerated in the outside world.

With regard to data on mental health in prisons, it feels like a minefield trying to get hold of figures that give a true representation of the scale of the problems. I cannot help but feel that the Minister and his Department are trying to pull the wool over our eyes. When I resubmitted my question to get the most up-to-date figures, I was told that, in the space of just a few months, the data are now

“not held in the requested format”,

despite the wording of my question being identical. I hope the Minister will tell me why the collection of the data has changed.

When I finished drafting my speech shortly before we began this morning, the Department’s answers to four of my named-day questions were long overdue. The answers would have played a key part in my contribution, but, regretfully, I cannot hold the Government to account fully for them today. Just one example is a question I asked about what proportion of people who died by suicide in prisons were not on the assessment, care in custody and teamwork pathway for people who have been identified as being at risk. In 2015, only 35 of 89 people who died by suicide were on the ACCT pathway, suggesting that too many vulnerable inmates are not being identified early enough. I asked the question again on 31 January—over a month ago—and the Minister’s Department has still not come back to me with that vital information.

Prison should offer a unique opportunity to provide mental health treatment in a secure environment, but the Government are betraying the vulnerable people our criminal justice system is supposed to protect. I met representatives of the Prison Officers Association who told me that, despite having worked in the Prison Service for decades, they had never received any mental health training. A recent Royal College of Psychiatrists forensic faculty survey found that service cuts mean most prison psychiatrists do not feel able to deliver a basic level of care. It is clear that the mental health services in our prisons are buckling. On a recent visit to a local prison, I saw at first hand the lack of care and services available to inmates. A recent consultation by the Centre for Mental Health found that a decrease in prison staff meant inmates often missed psychiatric appointments because there was no one available to escort them, and consequently they could not get the treatment they needed.

This is the stark reality that has been created by decimating staffing levels in prisons. There are 7,000 fewer prison officers than when the coalition Government came to power in 2010. The impacts of such drastic cuts are not trivial. Our prison services are out of control. Assaults in prisons rose by a third in the 12 months to September 2016 and are the highest on record. There was a wave of prison riots in the final weeks of last year, including at Birmingham, Bedford, Swaleside and Lewes. The inconvenient truth for the Minister is that, as things stand, he cannot guarantee the security of anyone who sets foot in our prisons.

Her Majesty’s inspectorate of prisons has found that an increasing number of prisoners report feeling unsafe in prison. Yesterday, we heard the conclusions drawn from an unannounced inspection of HMP Featherstone. We heard that some prisoners felt so unsafe in the prison that they resorted to self-isolation, asking to be locked up for nearly 24 hours a day. In some instances, this had lasted for months.

Nationally, there has been a significant increase in the ratio of prisoners to prison staff. It is not only prisoners who do not feel safe, but hard-working staff who brave the frontline every day, aware that there might simply not be anyone there to back them up if an incident becomes unmanageable.

A couple of weeks ago, BBC’s “Panorama” aired an undercover investigation that was filmed inside HMP Northumberland. I am sure anyone who watched it was, like me, appalled to see the truth about prison life laid bare: pervasive violence; widespread drug use; security systems not fit for purpose—put simply, chaos.

During this debate, it is important to remember that part of the reason this dire situation has arisen is that far too many people have been inappropriately put in prison, when they should be receiving mental health treatment in a secure inpatient unit. There is a need to address how the courts treat people with mental health problems, particularly in respect of community sentences and the inclusion of mental health treatment requirements within those.

I have been raising questions about suicide and self-harm in our prisons for many years, but I was compelled to request this debate because of one particular case, the tragic case of Dean Saunders. He was just 25 years old when he died by his own hand at Chelmsford prison in Essex last year. I had the privilege of meeting Dean’s parents, Mark and Donna, to hear about this tragic case in their own words. Dean was suffering from severe mental illness and had harmed himself and his brother and father as they tried to help him during a paranoid episode. He was charged with attempted murder and sent to prison. His family were told that there he would be safe.

The inquest jury unanimously concluded that Care UK, the private company that ran healthcare at the prison, treated “financial considerations” as a significant reason behind the decision to downgrade him from constant watch to half-hourly observations, despite several warnings that he might harm himself. It said that there were “multiple failings”, including a “complacent” approach to Dean’s mental health. The jury found an assessment of his mental health needs was “not adequately conducted” and concluded that the cause of death was “contributed to by neglect”.

The system failed because of financial cuts in the prison budget, and Mr Saunders paid for it with his life. Despite that damning verdict, Care UK continues to provide healthcare, including mental health services, to more than 22,000 prisoners in many prisons across the UK.

I note that the Justice Secretary has met Mr Saunders’ family, and I welcome that, but Mr Saunders presented a high risk of suicide—he should never have been in a prison in the first place. He needed specialist treatment in a secure mental health facility to protect him, but none was made available.