Comment: People in New Zealand prisons are more likely to commit suicide and self-harm than those in the general population. Things need to change.
This important, but uncomfortable, subject is the focus of a recently released Prison Inspectorate report examining the period from 2016 to 2021. The report records 29 suspected prison suicides over this time. On average, that’s a rate 2.26 times higher than the rate of suicides in the general population.
During the same period, 158 people were involved in self-harm incidents in prison, where—if it weren’t for custodial staff intervention—the likely outcome would have been death (only self-harm incidents involving threat to life were examined in the report).
These statistics have been attributed to people in prison having a disproportionate number of risk factors for suicide and self-harm, including mental health or substance use disorders, previous suicidal or self-harm behaviours, chronic pain, and histories of trauma. People convicted of violent and sexual offences were also more likely to die by suicide.
Some groups are disproportionally represented in these unhappy statistics:
- people on remand accounted for 76 percent of suspected suicides and 74 percent of self-harm incidents. These prisoners make up 43 percent of the current prison population.
- 51 percent of prisoners in self-harm incidents were under 30, a group that comprises 24 percent of prisoners.
- 38 percent of self-harm incidents involved Pākehā prisoners, in a rare instance where Pākehā (who comprise 30 percent of prisoners) are disproportionally represented in negative prison statistics.
The built environment of prisons doesn’t help. The predominantly cold grey concrete, steel, artificial light, and incessant noise of shouting and banging doors can be triggering for the many prisoners with mental health disorders and past trauma, including childhood abuse. Social isolation experienced by people in solitary confinement can also be a contributing factor.
But it’s not just the severity of prison interiors. Prison receptions, where prisoners are initially assessed for their mental health needs, are frequently noisy and lack privacy. The Inspectorate report noted at least one nurse said they “would call in sick if rostered in the receiving office due to the pressures of the environment and their fears that they may miss something of clinical significance”.
Added pressure to process high volumes of people in a short time can lead to heartless situations—as in one prison where “staff sometimes asked prisoners the Reception Risk Assessment questions at the same time as they were conducting the strip search”.
Change is needed to better equip prisons to identify and support vulnerable prisoners. This includes staff training, more timely access to healthcare for prisoners, and addressing ongoing staff shortages. In 2021, 30 mental health staff positions in prisons were unfilled, while in 2022 19 remained vacant.
Other systemic failures are using prisons for people with serious mental illnesses, and gaps in data management and communication preventing identification of vulnerable prisoners.
Significantly, 55 percent of suspected suicides in the period from 2016 to 2021 were concentrated in the 15 months after the first COVID-19 lockdown in March 2020. When the lockdown began, new prisoners experienced a 14-day quarantine isolation and prison regimes became more restrictive. This might suggest COVID caused a numerical blip, but that assumption could be erroneous. Remember, the report records 158 prisoners also self-harmed only narrowly escaping death. It is this number that might better represent the scale of work needed to address suicidal harm in prisons.
It is certainly an issue that Ara Poutama/Department of Corrections has increasingly given more attention. The Department’s 2022 Suicide Prevention and Postvention Action Plan is one key initiative but, like many of the proactive or positive strategies and services implemented to address self-harm, formal evaluation regarding its effectiveness is yet to occur. A revised mental health profile of New Zealand prisoners could helpfully inform such evaluations, given continued reliance on research based on data that is now nearly a decade old.
This latest report productively adds to our understanding of the coincidences and tensions between mental health and prisons. So too does Erik Monasterio’s recent New Zealand Medical Journal editorial decrying the use of prisons to house people with the some of the greatest mental health needs in New Zealand.
Monasterio’s analysis is consistent with the Inspectorate’s identification of a shortage of forensic in-patient beds. This situation can result in judges sending remand prisoners better managed by forensic mental health units to prison simply because there are no other places for them.
All this points to the cultural significance of New Zealand’s “first-ever mental health prison” at Waikeria, now scheduled to open in 2025. This is a direct response to a clear need, but it continues an unhealthy vortex that inextricably implicates prisons in providing for New Zealand’s mental health needs, avoiding the critical question of: “Why are we incarcerating our most seriously ill people when it’s the worst possible place for them?”
This article was originally published on Newsroom.
Christine McCarthy is a senior lecturer in the Wellington School of Architecture at Te Herenga Waka—Victoria University of Wellington. She is a former president of the Wellington Howard League for Penal Reform.