I call on the Deputies who tabled questions to the Minister for Justice, Equality and Law Reform in the order in which they submitted their questions to my office.
Private Notice Questions. - Prison Suicides.
(Mayo) asked the Minister for Justice, Equality and Law Reform the circumstances in which a 25 year old prisoner was found hanged in his cell in Mountjoy prison, the second prison suicide in a week; and if he will make a statement on the matter.
asked the Minister for Justice, Equality and Law Reform the investigation, if any, being held into the death today of a prisoner in Mountjoy jail, apparently as a result of suicide; the steps, if any, planned to prevent further suicides, in view of the fact that this is the second suicide in the jail within a week; and if he will make a statement on the matter.
I propose to take all questions together.
I first extend my sincere sympathy to the family of the deceased. The death of a young member of a family is particularly tragic and the grief can only be heightened by the fact that his death occurred in prison. The family have asked that personal details be not released and that they be allowed to grieve in private and I intend to respect their request.
In common with the recent death in custody in Wheatfield, the deceased hanged himself in his cell using a bed sheet. He was accommodated in a double cell and his cell mate raised the alarm. Attempts were made to resuscitate him. He was taken by ambulance to hospital where he was pronounced dead. There was no prior indication of the risk of self harm and he was not under special observation. He had been examined by the prison medical officer on the day following his committal and further treatment or appointments were not required.
As the House is aware this is the third death in custody to have taken place over the past four weeks. Every such death is a tragedy for the family, relatives and friends of the deceased and also for the prison service. As I have explained to the House before, there are procedures in place to prevent suicides in each prison. However, the possibility of suicides in custody cannot be completely prevented without the total denial of personal privacy to prisoners at all times.
All deaths in custody are investigated by the Garda and are the subject of an inquiry in the form of a coroner's inquest. The preventative measures in place to deter suicides are under continuous review. The suicide awareness group in each prison examines closely the circumstances of each death in custody. The purpose of their examinations is to identify, where possible, measures which might be taken in the future to contribute to the prevention of tragic deaths of this nature. This is an important mechanism for absorbing the lessons to be learned in each case.
Some offenders present a special risk of self-harm and there are procedures in place to identify and monitor them. These offenders are usually placed under special observation when locked in their cells. In spite of our best efforts, we cannot escape the fact that where an offender is determined to take his or her life the scope for prevention is limited. Unfortunately, suicide is not a completely preventable act in a free society or in a prison system which accords any respect to the personal dignity and privacy of prisoners.
The Department of Justice, Equality and Law Reform published the report of the National Steering Group on Deaths in Prisons last May. The group, which was established under the chairmanship of a senior prison governor, comprised representatives of various disciplines involved in the care of prisoners. They had been assigned the task of reviewing and overseeing the implementation of the recommendations of the advisory group on prison deaths published in 1991. The group reported that there are sound policies in place and a high level of awareness among prison staff in regard to suicide awareness. It also reported that many deaths are possibly averted by the alertness and vigilance of staff.
Following the publication of its report, I invited the group to continue to meet on a regular basis to provide a forum for collating the reports of the local suicide awareness groups within the institutions and disseminate significant findings and lessons learned through the prison system. It was also invited to organise an annual forum for the suicide awareness groups in each institution. The first such forum took place recently.
The occurrence of the three recent tragic deaths in our prisons within a short time is a matter of concern. While the circumstances of each death are being reviewed individually by the prisons concerned, I have asked the director general of the Prison Service to have the circumstances of all three deaths reviewed collectively to determine whether there were any common features which can be identified in the interest of putting in place whatever additional measures may be required to build on the already comprehensive suicide prevention measures being taken at each prison. The director general assures me that, to this end, he will convene an immediate meeting of the National Steering Group on Deaths in Prisons to undertake this task and report as a matter of urgency. He is fully committed to ensuring that all possible measures are in place to prevent deaths in our prisons and has my full support in this most important work.
(Mayo): I also offer my sincere sympathy to the family of the deceased young man following their tragic loss. Given that there has been five prison suicides since the beginning of the year – three occurred in the past month while two occurred in the past week – does the Minister agree that it is a clear indication that the prison medical, psychological and psychiatric services are simply not up to par? Does he realise that the young man who hanged himself at Wheatfield Prison last week had already attempted suicide on two previous occasions and, according to his mother when she appeared on RTE recently, had not been offered any counselling? Apart from the medical report which essentially deals with the physical well-being of a prisoner when he enters prison, was there any psychiatric assessment of this prisoner? If not, why not?
Each prisoner presenting himself at a prison is examined by a prison doctor and that procedure was not departed from in this instance. The deceased was examined by a doctor in the prison as per usual. It was not deemed necessary for him to receive psychiatric treatment and, therefore, he did not receive any. There were not any indications from the information available to me that he was disturbed to the extent that he might attempt to take his own life, which, tragically, he subsequently did.
I convey my sympathy to the family of the young man. He resided in my constituency and came from a good and caring family. It is understood that he was serving a short sentence and I respect the fact that personal details should not be discussed. I accept that prisoners are examined by medical officers when they enter prison. However, are previous records sought relating to prisoners in order to ascertain whether they might be expected to make an attempt on their lives or to ascertain whether they have psychiatric problems or suffer from depression?
The proposals to redesign cells, particularly in older prisons, were put forward to counteract any suicide attempts. Have those measures been put in place? While I accept that in this case the prisoner was not in a cell on his own – and that is an important factor in this regard – proposals were made by the National Steering Group on Deaths in Prisons. Were they implemented?
The prisoner in question was examined by a doctor and the doctor deemed him to be fit and well. On that basis, it was not considered necessary for him to obtain or receive psychiatric treatment. The deceased would have been asked certain questions by the doctor in regard to his medical record and if anything had come to light the doctor would have taken whatever action he deemed necessary.
An elaborate strategy is in place to prevent suicides in prisons but unless there is to be a total denial of personal privacy to all prisoners at all times the possibility of suicide in custody simply cannot be precluded, no more, indeed, than it can be in the wider community and, unfortunately, that is the position. Offenders who are identified as being at risk are given special attention by prison staff with the specific objective of preventing self-injury. The procedures for identifying and providing for offenders at risk are kept under continuous review and all measures which can reasonably be taken to help in a specific case are taken immediately. Where a person is determined to take his or her own life, frequently there is not a prior warning of any such intent and there are limits, unfortunately, to what the prison authorities can reasonably do.
A special suicide prevention circular has issued to all prisons. It emphasises the importance of suicide prevention policy, sets out clear procedures to be followed in all institutions and identifies the responsibilities of all staff in regard to suicide prevention policy. It deals in a clear and specific manner with immediate on the spot responses to particular types of self-injury, for instance, hanging or cutting of the throat. Special training has been provided for prison staff who are medical orderlies, in the first aid techniques in treating such self-injuries and in resuscitation techniques generally. Particular emphasis is placed on identification of suicide risk cases by the circular on prison management . Prisoners who are identified as a suicide risk, for whatever reason, are put on a special observation list which is notified to, and regularly reviewed by the prison medical officer, who is the GP attached to the prison, the prison governor and the relevant chief officer in the prison.
Prisoners such as these are checked in their cells every 15 to 20 minutes after they are locked up for the night and a special element of the training package for prison officers deals with special observation issues. As a last resort, where a prisoner is regarded as being in extreme danger of committing suicide he or she is confined to a special cell known colloquially as a "padded" cell where the scope for self-injury is extremely limited. No inmate would be held longer than overnight in such a cell without the involvement in his or her case of the prison medical officer and it would be highly unusual for a person to spend more than 48 hours in such a cell. The use of special cells is an extreme measure and is only invoked as a last resort but it can and does act as an effective short-term expedient to contain a prisoner who is intent on seriously injuring himself or herself. Deputy O'Sullivan also asked what was the position on the recommendations of the national steering group on deaths in prisons. It found that of the 57 recommendations in the 1991 report, 34 were fully implemented and 15 were partially implemented. The Director of Prison Service, Mr. Aylward, is currently pursuing the remainder as a matter of urgency.
(Mayo): How can the Minister credibly tell the House that prisoners who are deemed to be prone to suicide attempts are subject to special measures and special observation when the young man, who was found hanged last week, had attempted suicide – according to his mother – on two separate occasions and had not been given any counselling? Will he accept that in suicide cases there are invariably tell-tale signs that should be picked up if the services exist? In this case there would have been some indication, if the necessary psychiatric and psychological services had been in place. This young man came from Limerick and was sentenced to three months in Mountjoy jail. Why was consideration not given to accommodating him in a prison much nearer home, for example, Limerick prison?
Every possible step is taken by the prison authorities to try to minimise the risk of suicides. It can be fairly said that the vast majority of suicide attempts in prisons are prevented as a result of the measures in place. This matter is taken seriously by the prison authorities and the medical staff in every grade. Clearly, it is not possible, without denying an individual's total privacy or without denying the individual even a limited amount of freedom, for one to be absolutely certain an individual will not take his or her life. The best that can be done is being done to the best of the ability of the prison authorities; of that I am certain. However, if there are improvements which can be made, those improvements will certainly be made. The Director General of the Prison Service, for example, has instructed the national group to look at the recent three suicides collectively to see if there are some common threads which can be picked out and upon which we can build greater preventive measures. It is a particularly difficult area and Deputy Higgins will appreciate that.
With regard to the young man who received a short prison sentence the family do not want me to go into details. Clearly the sentencing of the young man concerned was a matter for the courts. They made their decision. On no account should it go out from this House that this is a problem which is swept under the carpet by the prison authorities. Everything that can be done is done to try to ensure people do not take their own lives while in custody.
Young men will often put on, what I might call, a macho front. Despite the fact that they may be examined by a medical officer on arriving at the prison, they may not display suicidal or depressive tendencies whereas that would possibly be indicated in medical records. Medical records should be sought in respect of prisoners immediately they enter prison because they may not display such signs in a medical examination. The report from the group indicated that on average only about a minute is spent by prisoners, in many prisons, with the medical officers. There may not be sufficient time to speak to a prisoner.
Where there is a suicide, do fellow prisoners receive counselling? Obviously a suicide has a serious effect on other prisoners, particularly the cell mate in this case.
The prisoner is seen within a period of 24 hours of his arrival in prison by the doctor. Obviously an examination takes place. In this instance the doctor deemed the young man to be fit and well. In regard to the records of the young man concerned, my information is that the doctor would have questioned him and if he was concerned about his mental health he would certainly have referred him for help to a psychiatrist and or a psychologist. That did not happen in this case for the reason I have outlined, that is that the doctor deemed the young man fit and well. As it subsequently transpired, unfortunately, the young man took his own life. Clearly that is a matter of considerable regret for me as Minister and for the prison authorities. I have outlined that it is not possible – everybody, I think, understands this – to ensure an individual will not take his or her life in custody no more than it can be ensured outside. All one can do is minimise the risk of it happening. In so far as that can be done it is done.
I too extend my sympathy to the family of the bereaved, the prison staff and the other prisoners in the prison. A suicide is an extremely traumatic event for anybody. What changes have taken place in the past two years given that the national task force on suicide, which reported less than two years ago, expressed extreme concern about the level of organisation of mental health services provided in the prison system? It stated that there is a need to augment significantly the existing provision of what could be considered the caring services in the prison environment, for example, the medical services, which include psychiatric and psychological services. Will the Minister outline what action has been taken in view of that strong recommendation by the national task force, bearing in mind that prisoners are five times more likely to be suicidal than the general population?
The National Steering Group on Deaths in Prisons found that of the 57 recommendations in the original 1991 report, 34 were fully implemented and 15 were partially implemented on an on-going basis.
That was eight years ago.
That would include recent years. Eight longer-term recommendations were not fully implemented. The Director General of the Prison Service is pursuing their implementation as a matter of urgency. The steering group identified a number of priority issues, including the establishment of a high support facility in each of the closed institutions for prisoners exhibiting suicidal tendencies and the establishment of an assessment centre, such as that which will exist in the new remand prison in Clover Hill. The group recommended the co-ordination of information from the local suicide awareness groups within each institution and intergovernmental agencies as well as the appointment of a pharmacist to oversee the control and dispensing of drugs in prisons, in addition to employing qualified nurses. In December 1998, I established a group to examine and report on the future needs, structure and organisation of the psychology service, about which I have concerns. Its report is being reviewed. The service is recruiting extra staff. I do not want to pre-empt publication of the report but it is my intention to improve the service. Currently a service is provided for prisoners by professionally qualified staff based in the Department who service the prisons on a call out and regular appointment basis. On taking office it was clear that the future needs, structure and organisation of the service needed to be examined. It was in that context that I sought the report of the group which is being reviewed and will be published in the near future. In the meantime, I will continue to recruit the additional staff required.
(Mayo): Does the Minister realise the committal sheet to which Deputy O'Sullivan referred is only one page, that it contains a set of basic questions and that no medical report is required? Will he ensure this inadequate admissions procedure is rectified immediately? The man concerned was serving a three month sentence for a relatively minor offence. Does the Minister acknowledge that we have a crazy prison philosophy given that over half of those in prison are serving sentences of three months or less? Rather than send to prison persons who should never be there, the Department's tackling crime document, the Whitaker report, the sociological and criminological profile of Mountjoy Prison – the document obtained by the criminologist, Paul O'Mahony – and my alternatives to prison all push in the direction of sensible enlightened penal policies where prisoners would be enabled to repay their debts to society by way of community service orders.
When a prisoner is committed to prison he or she is met by prison staff at reception and asked, as Deputy Higgins said, to complete a committal sheet seeking the usual statistical information – the person's name, address, age and so on. The offender is allowed to telephone his or her next of kin and asked to hand over personal belongings. Every offender admitted to prison is then seen and examined by a doctor who makes a professional judgment to the best of his or her ability. That is what happened in this case. Neither I nor the prison authorities can make this assessment. Each and every prisoner is dealt with in a humane and sensitive way. It is a different argument whether a person should be sentenced to prison, that is the preserve and constitutional obligation of the courts. It is not a matter for me or the prison authorities. That is the way things are. In normal circumstances each individual is seen and assisted in so far as possible by a probation and welfare officer before being admitted to prison. We are trying to improve on the current position. I outlined in reply to Deputy Neville what I am trying to do in the psychology service. I will make whatever other improvements are required. The usual investigations will be conducted in this case by the Garda Síochána, the coroner and the Director General of the Prison Service. The national steering group has been asked to examine the three most recent cases collectively. While everything humanly possible will be and is being done to prevent prisoners taking their lives in custody, it is virtually impossible for any Minister to assure the House that it will not happen again. That is the tragic situation. I extend my deepest sympathy to the family of the young man concerned and the families of the other two persons who died in custody in recent weeks. It a traumatic time for the families concerned. All we can do is our level best to try to ensure the risk of it happening again is minimised to the greatest extent possible.
Written Answers follow Adjournment Debate.