07:14, July 25 81 0 theguardian.com

2017-07-25 07:14:03
Mary O'Hara: Lesson from America  
 Tackling suicide in prisons requires more cash and care

Less than a month after Jamie Wallace gave evidence in court about the dire state of mental health care in the Alabama prison where he was incarcerated, and two days after being taken off suicide watch, he was found dead, alone and unsupervised in his cell after taking his own life. Even by the harsh standards of US prisons, Wallace’s death was disturbing.

Here was a mentally vulnerable 24-year-old who had stood up and spoken in public in a bid to get the help he needed. By giving evidence as part of a three-phase lawsuit brought by the Southern Poverty Law Centre, Wallace highlighted a problem that is too often ignored: any prison system that fails to meet the needs of inmates with mental health problems is indefensibly cruel.

With rates of suicide and self-harm in prisons on the rise in both the US and the UK, isn’t it time to pay attention, and demand action?

Last month, in the case for which Wallace had given evidence, the judge ruled that poor mental health provision within Alabama’s prison system was “systemically” putting inmates’ health and lives at risk. The damning ruling excoriated authorities, citing skyrocketing suicide rates, persistent overcrowding, staff shortages and failure to provide even basic treatment for mentally ill prisoners. Mental health provision was, the judge said, “horrendously inadequate”, and the court ordered the state to take action.

Alabama is notorious for overcrowding and it has seen its inmate suicide rate double in the past two years. But while it may be among the most concerning, it is far from alone. Across the US, prisoner suicide rates rose sharply in state prisons between 2013 and 2014. During this period, deaths by suicide rose by 30% and in 2014 accounted for 7% of all state prisoner deaths – the highest proportion since 2001.

The US prison system, with its reputation for punitive approaches and mass incarceration could be dismissed as a global outlier, but if anything it should be seen as a flaming red flag.

Deaths by suicide in prisons are rapidly increasing in the UK too, where budget cuts and overcrowding are a growing concern. In 2016 the number of people who killed themselves in prison in England and Wales reached a record high when 120 inmates took their own lives, a leap of 32% and double the rate in 2012. Twice as many female prisoners (12) died by suicide in 2016 than in 2015.

Asresearch from the Howard League for Penal Reform and The Centre for Mental Health has repeatedly shown, too often an alarming cocktail of issues including high use of isolation, lower staff-to-inmate ratios and deteriorating conditions in prisons generally create fertile ground for suicidal actions by inmates. In a recent joint analysis, Preventing Prison Suicide, the organisations point out that the trend towards rising numbers of suicides corresponds directly to drastic cuts to prison budgets and staff, and to a swelling prison population and overcrowding.

In addition, it referred to the detrimental impact of prisoners “spending up to 23 hours locked in their cells,” and the fact that “violence has increased and safety has deteriorated” as budgets have been slashed. It reported that “a more punitive daily regime was introduced in prisons at the same time as the number of deaths by suicide began to rise.”

And last week, the chief inspector of prisons warned of a “staggering” decline in safety in youth jails, something that undoubtedly puts younger inmates at risk, while a recent National Audit Office report concluded that prisons have “struggled to cope” with surges in self-harm (up by 73% between 2012 and 2016) and suicides. The report also stressed that the government doesn’t know how many inmates have a mental illness, nor how much is being spent on their care. Without the most basic understanding of the challenges, how can appropriate responses be devised, never mind implemented?

The government has faced severe criticism for its response to the crisis.While ministers have acknowledged the issue needs to be addressed, including a belated announcement to recruit more prison officers, much of what has been proposed has been “tinkering”, says Andrew Neilson, director of campaigns at the Howard League.

He’s right. As the death of Wallace and the growing numbers of lives lost in Britain so tragically show, a chronically underfunded, overcrowded, overly punitive system is never the solution.

Mary O’Hara is an award-winning columnist and journalist and author of Austerity Bites