Official figures show that the numbers of deaths, self-harm incidents and assaults in prisons in England and Wales have increased to new record levels. Photo credit: Press Association/Peter Macdiarmid. All rights reserved.
Perhaps one of the most disturbing features of imprisonment today is the high number of self-inflicted deaths (SIDs). At 120 SIDs per 100,000 people prisoners are nearly 10 times more likely to take their own lives than those living in the wider community. A recent government report, published on 26 January, states that there were 119 self-inflicted deaths in prisons in 2016 (and this number may still rise as 28 prisoner deaths are still awaiting classification), equating to one prisoner taking their own life every three days in prisons in England and Wales. 354 people in total died in prison in England and Wales in 2016 (on average of nearly one person a day). Deaths in prison are up by 38% and there has been a 32% increase in SIDS from 2015. This year (up until 20 January) there were already 15 deaths in prison. All of this points to the fact that prisons are places of terrible harm and death.
There were 119 self-inflicted deaths in prisons in 2016, equating to one prisoner taking their own life every three days.
A history of death in prison
Whilst current explanations of the high number of SIDs have been restricted to prisoner mental health problems and reduced numbers of staffing, deaths in prison cannot be limited solely to prisoner vulnerabilities and regressive policy changes over the last six years. The figures indicate that self-inflicted deaths in prison have risen substantially over the last four decades. There were major inclines in recorded deaths in 1987, 1994, 1998, 2004 and in 2016 where we have reached a record high. Deaths of prisoners have been ever-present throughout the history of imprisonment, indicating how deeply entrenched death is in the everyday workings of prisons, particularly since they were reformed in the early nineteenth century.
Recent concerns have also focussed on the clustering of SIDS. From 2015-2016 there were six SID’s at HMP Woodhill, a high security male prison in Milton Keynes, Buckinghamshire. This was not an aberration - cluster deaths have plagued prisons for years. For example, from 1987 to 1989 11 SIDs were recorded at Risley Remand Centre. From August 1991 to March 1992 four young offenders, including a 15 year old, took their own lives at Feltham YOI. Six women incarcerated in the same prison wing hanged themselves in a three-year period from 2002 to 2005 at HMP Durham. While from August 2002 to September 2003 six women took their lives at HMP Styal.
While many people in prison have mental health problems, those who commit suicide are less likely to have a psychiatric history than those on the outside who take their own lives.
Suicide risk is generally connected to people with serious mental health problems. The suicidal prisoner is considered to suffer from fear, depression, despondency and hopelessness and a general inability to adapt to prison life. The rationale is that they simply do not have the personal resources to cope with the deprivations of imprisonment.
The facts show that identifying suicide risk purely on the basis of mental health has its limits. While many people in prison have mental health problems, those who commit suicide are less likely to have a psychiatric history than those on the outside who take their own lives. Recent history indicates that there has been a systemic failure by the Prison Service to identify those at the greatest risk. Independent research has shown that only around one in four prisoners who successfully end their lives have been identified under prison service suicide prevention policies in the past . Under the current Assessment, Care in Custody and Teamwork (ACCT) policy things have not fared much better: in 2015 only 35 of the 89 prisoners who took their own lives that year had been identified by the ACCT.
There is a prevalence of suicidal thoughts among prisoners, with a number of recent studies identifying exceptionally high levels of suicidal ideation: 46% of male remand prisoners have thoughts of suicide in their lifetime, and 40% of male prisoners and 55% of female prisoners experience suicidal thoughts in their lifetime, compared with 14% of men and 4% of women living in the wider community. Dividing prisoners between ‘copers’ and ‘non-copers’ provides a false assumption over who may be suicide prone. Most prisoners only just about cope.
Life in prison is a humiliating and unsafe experience perpetuating fear and loathing on a daily basis.
The pains of imprisonment
There is an alternative explanation of SID’s that has not been fully explored in the media or in contemporary policy, but which appears to fit much better with historical and contemporary evidence. Deaths in prison should not be considered as aberrations or malfunctions of either the prisoners themselves or of the system; rather, they are located in the daily processes of imprisonment itself. The real pains of imprisonment are not to be found in living conditions, relationships with staff or levels of crowding, but in the denial of personal autonomy and the lack of an effective vocabulary to express the hardship of watching life waste away. Life in prison is a humiliating and unsafe experience perpetuating fear and loathing on a daily basis.
Adaptations to imprisonment are not a permanent state of affairs but open to erosion, meaning that even small changes in the prison world may reignite underlying difficulties a person has in coping with life inside. Coping mechanisms for everyone, irrespective of the numbers of prison officers or the extent of prisoner mental health problems, are tenuous. Coping and non-coping with prison life are matters of degree that fluctuate over time and all prisoners are vulnerable to suicidal ideation.
A suicide attempt may then be a frantic and desperate attempt to solve problems of living. If the response to their situation is hopeless and there is an explicit or implicit expectation that the individual will take their life, this negative communication may erode any sense of hope and facilitate a suicide attempt. SIDs then should be conceived as a social problem where those who take their own lives are responding to given temporal, spatial and emotional contexts of the prison place.
This failure is not down to individual incompetency but rather to how thoughts of death are systematically generated through the daily grind of the prisoner experience.
We will not find a solution to the current problems of SID’s by updating failed policies of the past that focus on risk. Indeed, the large number of different policies and procedures over the last 50 years indicate just how badly the Prison Service is failing to protect people in prison. This failure is not down to individual incompetency but rather to how thoughts of death are systematically generated through the daily grind of the prisoner experience. In 2007 the World Health Organisation noted not only how difficult it is to identify suicidal ideation among prisoners but also that ‘suicide risk profiles’ may be unhelpful as many of those who die conform to ‘normal’ prisoner profiles.
To address the humanitarian disaster confronting prisons in England and Wales today there should be immediate interventions directed at helping all prisoners develop new meanings and alternative coping strategies that can help them take their lives forward. The nurturing of hope is absolutely central for human wellbeing, but hope will always be in short supply in an environment deliberately intended to inflict pain and suffering. The deprivations structured into the everyday workings of the prison mean that such institutions are potentially life-threatening environments for all prisoners irrespective of their backgrounds or mental health. Ultimately we need to shift attention away from the problems of individual prisoners to an acknowledgement of the deep-rooted problems that lie at the heart of penal regimes. The only truly effective policy that can prevent self-inflicted deaths of prisoners is one that acknowledges the inherent harms of the prison place and is committed to the radical reduction in the number of people sent to prison in the first instance.
 Alison Leibling ‘Prison suicides and prevention’ in Jewkes, Y. (ed) (2007) Handbook of Prisons ,page 426.