Tuesday, May 11, 2004

How detox and self-help brought suicide jail back from the brink

UK: Six suicides in 12 months made Styal prison notorious and the Prisons Ombudsman criticised the prison and its staff for serious failures. But things are changing.

The Observer was allowed rare access to Styal and found it striving to change, with a scheme to help newly arrived drug users, and inmates, [prisoners], trained by the Samaritans to help women in despair. Report by Jane Mulkerrins.

At first sight, Styal prison is unrecognisable as the grim institution described in a report last January by the Prisons Ombudsman, Stephen Shaw. In the Cheshire countryside near Wilmslow, the official blue sign at the entrance to the drive spells out its purpose.

Yet instead of the vast Victorian corridors one might expect, most inmates, [prisoners], share individual two-storey red-brick houses in the complex, built as an orphanage. The houses have sitting-rooms with comfortable chairs, stereos, TV sets and pot plants, and are reached along small paths separated by grass.

Each inmate, [prisoner], has her own keys to her room, though the front doors of the houses are locked by staff at night. From a distance, it all seems very progressive.

Yet Styal has another side: beyond the neat houses on the other side of an ugly 20 metre-high fence is Waite wing, home to 160 of the most vulnerable women. Shaw called it 'isolating and forbidding'.

It was here that five of the six women who killed themselves at Styal in the year before last August died. All five were in their first month of custody, and four were in their first week.

Julie Walsh, 39, a mother of two, overdosed on drugs stolen from a medical trolley. Hayley Williams, 41, Jolene Willis, 24, Anna Baker, 31, and Nissa Ann Smith, 20, all hanged themselves with home-made 'ligs', nooses fashioned from material and fastened to furniture.

Sarah Campbell, 18, died of an overdose within 24 hours of starting a three-year sentence for the manslaughter of a man who collapsed after she hassled him for money in the street.

Five of the inquests have yet to take place, but Shaw's report identified drugs, mental health issues, administration of medicines and communications failures between staff as factors in the deaths. Four staff members, one a nurse, face disciplinary action.

The governor, Steve Hall, admits there are major problems, but vows: 'We are trying to address them.'

The number of women in prison in England and Wales has risen by 173 per cent in 10 years to more than 4,400. Between 1990 and 1995, seven women inmates, [prisoners], killed themselves, an average of 1.2 a year. In 2002, that increased to nine and last year it was 14. Women prisoners are three times more likely to commit suicide than their male counterparts.

More than 100 female inmates, [prisoners], were resuscitated after a suicide bid last year. There were a further 5,142 reported incidents of serious self-harm or attempted suicide not involving resuscitation.

Despite being only six per cent of the prison population, women account for half of all self-harm - one reason for the high pressure on staff in women's prisons where it is not unusual for 15 per cent of inmates, [prisoners], to be on the F2052 procedures for monitoring those deemed at risk.

Six deaths at Styal in a year was extreme, but there have been no suicides since last August mainly, say inmates, [prisoners], because women who use drugs in the outside world are now given methadone.

Styal is the second largest women's prison in England and Wales, housing 440 prisoners of all categories, from those on remand to murderers. Eighty per cent arrive with a drug problem. Most are heroin addicts but many are taking a combination of drugs, including amphetamines, cocaine and crack.

Until last September, newcomers had to go 'cold turkey', given only painkillers to ease the cramps, insomnia, vomiting, shaking and sweating of withdrawal - a system compared to giving an aspirin to an amputee.

Prisoner Sarah McKeever found this tough. 'I couldn't cope with the pain, so I stole my cellmate's painkillers and took 86 paracetamol tablets. All I wanted to do was end it,' she said.

McKeever has been in and out of prison three times since 1999 and been homeless after each release. This time she stole a purse to get money for accommodation. Although painfully thin, she is bright-eyed and chatty. 'Last time I came in,' she says, 'I had a straight rattle [cold turkey] and got really depressed. You've just been locked up and taken away from your family. Coming straight off heroin as well is just too hard - you can't cope and you just want to die.'

Methadone eases the pain of withdrawal. Daily doses are reduced over 15 days. The programme had been planned at Styal for three years, but money for it became available only six months ago. In March, three-quarters of the 230 new inmates, [prisoners], were on the drug.

'It's a different place here now,' says Sarah. 'Last time, there were three suicides in the nine months I was here. It was very edgy. Everyone wondered who would kill themselves next.'

Niall Clifford, who oversees women's prisons, said: 'Women have confidence in the detox programme, so they are not terrified of the process like they were before. That has made for a far calmer atmosphere.'

Waite wing itself is changing. The fence between it and the rest of the prison is coming down and what one inmate, [prisoner], saw as a battleship-grey, 'concentration camp' look has been transformed into a cheerfully painted environment with communal areas and cell furniture with fewer points for ligatures.

Suicide attempts may never be completely eliminated, however. 'Women will cut themselves with the tops from margarine tubs and bits of Biros, if that's all they can find,' said deputy governor Susan Howard.

Governor Hall believes this is why women's prisons should work to a different charter from the one that regulates men's jails. 'We are probably closer to being a hospital than a prison in many ways,' he said.

Statistics back this up. A Prison Reform Trust report showed that two-thirds of women prisoners suffer from a mental disorder, and 40 per cent have attempted suicide at some time.

'Detox is just a start and it only treats the symptoms of a much deeper problem,' says Hall. 'Drug use often masks serious mental health issues and depression. For many women coming off drugs, it is the first time they have had to face up to the realities of their lives. Once we treat the drug dependency, we often uncover sexual and physical abuse, issues with men and families, reasons for criminal activities and so on.

'Women would come in, detox over two weeks, then settle into a period of self-harm where they would think, "What have I done? Where are my kids?" Hall says. 'There is a sense of hopelessness they have avoided up to that point through drug use.'

In The Observer last month, Cherie Booth QC argued for reducing the number of women in prison. 'Everyone has a choice not to commit crime,' she wrote. 'But that choice is harder when, after years of being the victim of domestic violence or sexual abuse, you have lost all respect for yourself and others. It is harder still when you are addicted to drugs, or have stopped caring whether you live or die.'

Hall believes women feel the effects of prison more deeply than men. 'Men offend at a rate 16 times that of women, but the intensity of what women need is much higher,' he says.

'The expressions on their faces when they queue up to collect their methadone are very different from that of men. There is a different look in their eyes - more desperate.' Huge quantities of tranquillisers are dispensed in women's jails. In Styal fewer than 10 per cent of the inmates, [prisoners], are free of medication.

Dr Louisa Snow, a prison suicide prevention adviser, said: 'Women tend to be primary carers for their children, so the impact of leaving them behind is enormous. There are only 19 women's prisons, so they are usually much further from their families and have fewer visits.'

Hall believes women inmates, [prisoners], differ from men in positive ways too. 'You can harness peer support and responsibility more naturally - it is a natural thing for them to share emotions,' he said.

Peer support is evident in Styal's Listeners scheme, where a group of inmates, [prisoners], trained by the Samaritans is on call around the clock to listen to women who need support. Styal is also pushing art, sport, dance and education courses.

The Government too has a new approach. Prisons Minister Paul Goggins launched a Women's Offending Reduction Programme last month to tackle mental health and drugs problems.

Most Styal inmates, [prisoners], feel that on release they are replanted in environments that caused them problems before, with little or no support. In some cases, they feel even worse off. 'It's ridiculous that I stole a purse to get by last time I was released. This prison has really improved, but there is still no one to help keep us straight when we get out,' says McKeever.

My Sarah was smart and talented - Why did she die in jail?

LONDON: Sarah Campbell was just 18 when she killed herself [? committed suicide,] one of seven women to die in jail this year. Our correspondent asks why so many women kill themselves in prison [? commit suicide in prison.]

Posted 11 May 04 The Observer

ED: Actually some men are biologically women in that they are more women than men, that means men suffer the same if not similar problems and some are also primary carers for children and suffer from detox problems. The real answer is that we are all people and to solve any problem holistically one must go to the root and the root is a human being and not a women or a man. Therefore there is really not much difference with the way people suffer, prisoners' suffer, and prisons are barbaric in relation to punishment especially in the 21 century and they should be abolished.


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My Sarah was smart and talented - Why did she die in jail?
LONDON: Sarah Campbell was just 18 when she killed herself [? committed suicide,] one of seven women to die in jail this year. Our correspondent asks why so many women kill themselves in prison [? commit suicide in prison.]