Suicides in Prison: Ten Years On

When I read this, 1 could hear the words of so many officers, telling me 'we lock up 300 bodies on this wing', or I was reminded of the 'body book' signed at reception when the police handed over a prisoner. A first ever Thematic Inspection had been carried out on 'Suicide in Prison' in 1984. This had been inspired by three hangings within 12 months at HMP Swansea, and a 'lack of care' verdict brought by an inquest jury following the suicide of a young prisoner at Ashford Remand Centre. In Scotland, a series of suicides at Glenochil young offenders complex resulted in a detailed report on the then current suicide prevention procedures (SHHD 1985). Dr Derek Chiswick, a forensic psychiatrist and main author of the report concluded: 'this is not a psychiatric problem, it's a management problem'. It was in this context of growing concern, increasing numbers, an especially rapid increase in the numbers of young prisoners taking their own lives, and some revisiting of suicide prevention procedures that I began the research I conducted for my PhD degree. I had been working in young offenders' institutions a Detention Centre and two Youth Custody Centres, interviewing staff and prisoners as part of a Home Office funded study of throughcare. I had been struck by the prevalence of self-injury, the helpless and sometimes angry reaction of staff, and the use of strip cells for those considered at risk. Some prisoners thought attempting suicide was a prison disciplinary offence. It had been a criminal offence until 1967. Those considered at risk carried a large red 'F' on their files this stood for 'felo-de-se': the murder of oneself. The late 1980s and early 1990s, witnessed dramatically increasing suicide rates in prison, particularly amongst the young. What was often overlooked was the dramatic increase in suicide amongst young males in the community: those in lower socio-economic groups were particularly at risk. Large groups amongst the prisoner population share those characteristics associated with increased suicide risk in the community: adverse life events, negative interpersonal relationships, social and economic disadvantage, alcohol and drug addiction, contact with criminal justice agencies, poor educational and employment history, low self-esteem, poor problemsolving ability, impulsivity, and low motivational drive. Whilst the media blamed overcrowding and prison conditions, the prison population was also carefully selected to be at risk. Prisons like Risley, Brixton, and Leeds suffered from apparent epidemics. Was this a problem of conditions, demographics, imitation, psychiatric disorder, manipulation, lack of care, prison culture, inactivity, or management? I reviewed the literature. The first UK study I could find appeared in the third report of the Commissioners of Prisons in 1880. It was commissioned by Dr Gover, the first Medical Inspector to be appointed by the newly established Board of Prison Commissioners, in response to a growing concern over the high numbers of suicides in English prisons at the time. 81 suicides were considered. They occurred mostly in the first week of custody; 42 per cent were first time prisoners; a third were on remand; prison staffs lack of knowledge of individual prisoners was relevant: those establishments least able to assign a motive to the suicides were those with the highest numbers. This study was followed by another, and the question was always raised whether suicides were related to the special environment of the prison, or the special characteristics of prisoners (see Smalley 1911; Goring 1913; Topp 1979). These largely medical and psychiatric studies, based on small samples, continued sporadically until Dooley's more systematic 1990 study of suicides in English and Welsh prisons between 1972 and 1987 (Dooley 1990a; 1990b ). All of these studies followed the same pattern: despite the fact that a rather low proportion of completed prison suicides were found to have a history of psychiatric treatment (around 30 per cent, compared to 90 per cent in community studies),