Tomczak Philippa
prisonHEALTH Research Group, School of Sociology and Social Policy, University of Nottingham, Nottingham, England.
Front Psychiatry. 2022 Apr 1;13:862365. doi: 10.3389/fpsyt.2022.862365. eCollection 2022.
Prison suicide/self-inflicted death is an international public health crisis, harming stakeholders including bereaved families, prisoners, prison staff and death investigators. England and Wales' record prison suicide numbers in 2016 cost at least £400 million. Death rates are an indicator of prison safety, and unsafe prisons mean unsafe societies. I present four case studies of people with very severe mental illness who were remanded to prison from police and/or court custody and went on to take their own lives in prison. I use publicly available data from Ombudsman and Coronial death investigations in England and Wales, highlighting that these accessible sources could be more widely mobilized to reduce the substantial harms and costs of prisoner deaths. Case studies include three men (Lewis Francis, Jason Basalat and Dean Saunders) and one woman (Sarah Reed) who took their own lives between January 2016 and April 2017. All four people were clearly very mentally unwell at the time of their alleged offense and remand to prison. I develop the concept of "risky remands" to highlight that people with very severe mental illness being remanded to prison is a particularly problematic practice. I highlight the implications of people with very severe mental illness transitioning into prison in the first place, arguing that being remanded to prison is not an acceptable or safe pathway into healthcare. I illustrate that police custody suites and courts may lack awareness of mechanisms and/ or the practical ability to transfer ill detainees charged with a serious crime to mental health facilities for assessment and/ or treatment. My analysis amplifies and extends recent Criminal Justice Joint Inspection findings that it is unacceptable to use prisons as a "place of safety," and that the Department of Health and Social Care, NHS England and the Welsh Government must increase the supply of medium and high secure beds. Moreover, Ombudsman investigations did not engage with the remand transition, effectively legitimizing this risky practice for very ill people. As such, my analysis also counters the apparent "problem of implementation" in prison oversight, instead questioning what reviewers recommend, based on which evidence.
监狱自杀/自伤死亡是一场国际公共卫生危机，会对包括遗属、囚犯、监狱工作人员和死因调查人员在内的利益相关者造成伤害。2016年，英格兰和威尔士创纪录的监狱自杀人数造成了至少4亿英镑的损失。死亡率是监狱安全的一个指标，不安全的监狱意味着不安全的社会。我介绍了四个患有非常严重精神疾病的人的案例研究，他们从警方和/或法庭羁押被还押至监狱，并最终在狱中自杀。我使用了英格兰和威尔士监察员及死因裁判官公开的死亡调查数据，强调这些可获取的资源可以得到更广泛的利用，以减少囚犯死亡造成的重大危害和成本。案例研究包括三名男性（刘易斯·弗朗西斯、贾森·巴萨拉特和迪恩·桑德斯）和一名女性（莎拉·里德），他们在2016年1月至2017年4月期间自杀。这四人在被指控犯罪并被还押至监狱时，显然都患有严重的精神疾病。我提出了“有风险的还押”这一概念，以强调将患有非常严重精神疾病的人还押至监狱是一种特别成问题的做法。我首先强调了患有非常严重精神疾病的人进入监狱的影响，认为被还押至监狱并非进入医疗保健的可接受或安全途径。我举例说明，警方拘留所和法庭可能缺乏将被控严重罪行的患病被拘留者转至精神卫生设施进行评估和/或治疗的机制意识和/或实际能力。我的分析放大并扩展了刑事司法联合检查最近的调查结果，即把监狱用作“安全场所”是不可接受的，卫生和社会保健部、英格兰国民保健制度和威尔士政府必须增加中等和高度安全床位的供应。此外，监察员的调查没有涉及还押过渡问题，实际上使这种对重病患者有风险的做法合法化。因此，我的分析也反驳了监狱监督中明显的“实施问题”，而是质疑审查人员根据哪些证据提出了哪些建议。
