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The Royal College of Psychiatrists Improving the lives of people with mental illness

Multi-agency working needed to tackle ‘worryingly high’ prison deaths

Embargoed until 04 June 2009

Mental health care must improve to halt the staggering number of suicides occurring in prisons, new research has revealed. 

In 2008, there were 91 suicides per 100,000 per year in England and Wales in the prison population, compared with 8.5 per 100,000 in the general population. Now a new three year study has found that a large proportion of those entering prison are already ‘vulnerable’ with self harm, alcohol misuse and psychiatric issues.

The National Case-Control Study of Self-inflicted Death in Prisons in England and Wales collected data based on 220 prisoner records and feedback from prison and healthcare staff.

Men accounted for 95 per cent of the deaths, the research conducted by Professor Jenny Shaw, at Northwest Forensic Academic Network and The University of Manchester and colleagues found. Professor Shaw presented the research findings today at the Annual Meeting of the Royal College of Psychiatrists in Liverpool.

Hanging was chosen as the method of death by 90%. Alarmingly, over a third (35% ) of deaths happened within the first month in prison and departed prisoners were three times more likely to have had no  visits during the prison term.

They were also six times more likely to have a history of self-harm and twice as likely to have a history of alcohol misuse problems.

The findings have prompted calls for multi-agency working between prison officers, doctors and mental health professionals. According to Professor Shaw ‘imported vulnerability’ where prisoners enter the system with psychiatric diagnosis, self harm history, alcohol misuse problems and mental health contact is ‘very common’ in the general prison population.

“To reduce the risk we need to improve the general mental health care of all prisoners,” Professor Shaw said. “We need to include the kinds of methods we have in the community but adapted for prisons. Because of the nature of the place you have to adjust what you do and address the fact they are locked up for most of the day and are in a custodial regime. We need models that work for the socially excluded people at a primary care level, including prison officers in training.”

Professor Shaw also urged better exchange of information between the prison service and outside agencies and called for an improvement in the assessment and monitoring procedures for those at risk. Extra care should also be provided at time of key risk, Professor Shaw said.

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Annual Meeting of the Royal College of Psychiatrists, BT Convention Centre, Liverpool, 2 -5 June 2009


Note to editors:

The report, headed by Jenny Shaw, was compiled by the Research & Collaborative Team: Naomi Humber, University of Manchester; Professor Louis Appleby, University of Manchester; Dr Mary Piper, offender health, Department of Health; Jenny Rees, Safer Custody and Offender Policy, Ministry of Justice


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