Chapter 7: Analyse strategies and recommendationsThis chapter will analyse strategies and provide recommendations based on; suicide, mental health and private/public prisons. Recognising, the need to reduce suicide-related behaviour is of increasing importance and is regularly stated as a priority for the Prison Service (National Offender Management Service, 2016). Therefore, this chapter will discuss the actions that should be taken to tackle the problem and discuss recommendations. The World Health Organization estimates that one suicide attempt occurs approximately every three seconds, and one completed suicide occurs approximately every minute.
This means that more people die by suicide than by armed conflict. Consequently, reducing suicide has become an important international health goal (WHO, 2007). This is a problem for both, outside and inside the prison system, and previous research suggests that the problem is heightened within the prison system. The World Health Organisation (2007) discusses the development of suicide profiles, to help towards reducing inmate suicide. The first profile includes pre-trial inmates who commit suicide in custody, stating they are generally male, young (20-25 years) and first time offenders.
Suggesting, they normally commit suicide within the first few hours, due to many factors including: sudden isolation, shock of imprisonment, insecurity about the future. And the whole impact regarding pains of imprisonment, showing how drastically prison can have an impact on someone’s well-being. To reduce the risk of first time offenders committing suicide the staff should pay attention to the individuals on their arrival, especially more vulnerable inmates that already suffer from a mental health problem. They could find out if an individual suffers from a mental health problem by asking questions and examining their behaviour towards the system. However, a limitation to this method is to examine the difference between a mental health issue which relates to suicide, including: depression, anxiety, which are more of the common problems that lead to suicidal thoughts. Compared to an individual angry at the system and showing behavioural problems that doesn’t associate with mental health. Nevertheless, prisoners who enter custody should be watched with a careful eye and monitored throughout their process through prison, and individuals who show signs of suffering from mental health should be monitored more so. Furthermore, The World Health Organization (2007) also mentions how suicides tend to occur by hanging, when the victims are being held in isolation or segregation cells. And during times when staffing is at the lowest, such as nights or weekends. There are also a lot of suicides when prisoners are alone. These are situational factors that could be changed by the prison once aware of vulnerable inmates and should avoid having them alone when they suffer from suicidal thoughts or mental health problems. Additionally, psychosocial factors have an impact on an individual. Including poor social and family support, also prior suicidal behaviour (especially within the last one or two years). And a history or psychiatric illness and emotional problems are common among inmates. Moreover, suicidal inmates often face bullying and inmate-to-inmate conflicts, which can relate to masculinity theory of if the prisoners do not fit in and are seen to be vulnerable or week they can have a worse experience than the average prisoner. And on top of that, could develop or increase their mental health problem causing them to feel worthless. Furthermore, suicide comes to be viewed as the only way out of a desperate and hopeless situation. Therefore, individuals who speak their feelings about feeling worthless and admit to suicidal intent or plans should be considered at high risk of suicide and referred to the most appropriate place for them, which could be a hospital. In the wake of recent increase in prisoner suicide, research commissioned by the Harris Review on the views and experiences of prison staff suggests that identifying and managing vulnerable prisoners requires the building of staff-prisoner relationships, knowing the prisoners and understanding what makes them tick’. However, prison staff say that this has been adversely affected by the need to deliver budgetary savings (University of Cambridge, 2015). The University of Cambridge (2015) identified that the staff used their own knowledge and experience to deal with vulnerable prisoners to manage at high risk. Due, to the lack of time and budget, and a reliance on blanket risk management procedures. Failing in training staff on how to correctly deal with these types of prisoners to reduce the likelihood of them committing suicide. Therefore, staff training is important to provide efficient monitoring and know how to manage high risk offenders that suffer from mental health. Such staff could prioritise prisoner care by using their initiative, for example, creating jobs for the prisoners which could include cleaning or painting. This could allow them to not be on their own in their cell, also providing them with games to play which can distract them from negative thoughts and help build relationships within the prison, by improving their social bonds. Towl (2002) mentions that policy and practice are characterised by understandable anxiety over suicide as a symptom of underlying yet intractable problems. This anxiety is fuelled by media and political interest. There is a constant pressure for the organisation such as the criminal justice system to be seen to be doing something to tackle the problem’. A common criticism of suicide prevention strategies, both current and former, is that they fail their implantation. This is a regular observation from internal reviews, as well as external reviews such as HMCIP’s establishment inspections and those conducted by organisations such as the Howard League (1999). To Summarise, the development of an effective suicide-prevention programme in prison requires a carefully held degree of balance of care, control, and the creation of safe environment. Each of these elements must work together to ensure there is a balance maintained without endue emphasis on any single factor. The relationship between these elements is complex, perhaps as complex as suicide. Historically, the research has been primarily concerned with identifying correlates of suicide. Such models are, it may be argued, essential in guiding future research into suicide and suicide prevention in prions. The National Institute for Health and Care Excellence (2018) responds to mental health problems relating to adults in contact with the police, that may suffer from mental health problems. By providing recommendations to try reduce the risk of suicide for individuals that suffer from mental health. One recommendation is to educate the police on how to respond to these problems in a way that reduces the risk of anxiety, self-harm or aggression. Explaining, how it’s important for police officers to recognise features of mental health problems and to know to how respond. Therefore, training should be provided for the police officers and have regular updates. Because of this, police officers may be able to calm people down to minimise anxiety, also to help adults who show signs of aggression which can minimise the need for restrictive interventions such as restraint. Furthermore, a comprehensive mental health assessment, which includes relevant information about the person, for example previous suicide attempts. This means they can be referred to the appropriate services to receive the care and support they need. The importance of this assessment is for the police and mental health services to work together to ensure adults with suspected mental health problems are referred for mental health assessments. Additionally, sharing a person’s mental health care plan with other relevant services, for example, police, prison, probation services and social services, will help to ensure that they receive the treatment and support they need. Pratt (2015) conducted a cognitive-behavioural suicide prevention (CBSP) therapy investigation, on suicide behaviour in men within the prison system. The study compared inmates that received the therapy, with men who didn’t. The results showed more than half of the participants in the CBSP group achieved a clinically significant recovery by the end of the therapy. Therefore, this therapy may offer significant promise in the prevention of prison suicide. Although, this research is lacking in evidence on a larger scale to help the global problem of suicide, due to not enough research on a longer time frame and a larger scale of participants. However, further study into this therapy could provide a sense of hope. In relation to private and public prisons, Liebling (2011) discusses prisoners’ experiences of respect in public and private sector prisons. Comparing different types of respect’, for example individuals communicate respect through their character’ or the way in which they express themselves, through body language and eye contact. Sennett (2003) argues that respect is and expressive practice’, which is separate from the inequalities that are embedded in society. Furthermore, from Liebling’s (2011) study, results suggested that prisoners in the public sector often complained about how staff spoke to them disrespectfully because of their low regard for them. Additionally, within the private sector prisoners also mentioned similar complaints around staff. Although, not towards the lack of moral status that officers gave them, but to staff naivety and inexperience. Furthermore, the study highlighted that within the private sector staff lacked confidence and experience. Compared to public prisons, where it was a form of over-confidence among staff about their power and moral status (Crewe, 2011). Therefore, these results show lack of training for the officers, due to some being over-confident and others lacking confidence. Suggests, officers will respect’ prisoners in a manor they feel is acceptable, although this manor might not always be the correct way in dealing with diverse inmates. Linking this, to the Harris review of prisoner and staff relationship being a factor towards possibly helping mental health and suicide. Overall, strategies and recommendations have been discussed throughout this chapter, which will hopefully allow reduction in suicides within the prison system. But most importantly, try to help towards solving the global problem, one recommendation at a time.