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Date: April 29, 2024 Mon
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Results for deaths in custody (u.k.)
10 results foundAuthor: Hannan, Maria Title: Deaths In or Following Police Custody: An Examination of the Cases 1998/99 - 2008/09 Summary: Deaths in or following police custody are a controversial area of policing, and they represent some of the most high profile cases handled by the IPCC. They impact on trust and confidence in the police, particularly in Black and minority ethnic communities. The number of deaths in or following police custody is relatively small, but each death represents a tragedy. Despite the high profile nature of this area relatively little research has been conducted into it, or were carried out some time ago. Forces have a statutory duty to refer all deaths following police contact, including those that occur in or following police custody, to the IPCC. The IPCC reports on these deaths as part of our annual statistics into deaths during or following police contact. This study examines deaths in or following custody over an extensive period in order to identify trends, and, most importantly, the lessons that can be learnt for policy and practice to prevent future tragedies. The research used completed investigations to gather data on all 333 deaths which occurred between 1998/99 and 2008/09. The study looks at trends in the incidents, and examines a range of themes – the use of restraint, mental health and suicide, alcohol and drugs, risk assessment and medical provision, and investigation and investigations outcomes. The final report makes a series of recommendations for police forces and the health service which aim to improve policy and practice in this area. Details: London: Independent Police Complaints Commission, 2010. 93p. Source: Internet Resource: IPCC Research Series Paper:17: Accessed March 23, 2011 at: http://www.ipcc.gov.uk/Pages/deathscustodystudy.aspx Year: 2010 Country: United Kingdom URL: http://www.ipcc.gov.uk/Pages/deathscustodystudy.aspx Shelf Number: 121103 Keywords: Deaths in Custody (U.K.)Police MisconductPolice Use of ForceRisk Assessment |
Author: Prisons and Probation Ombudsman for England and Wales Title: Learning from PPO Investigations: Violence Reduction, Bullying and Safety Summary: This report is focused on themes of violence, bullying and safety in custody. It has been produced as a result of the finding that 20 per cent of the PPO’s fatal incident investigations into self-inflicted deaths in custody have found evidence that the deceased was subject to bullying or intimidation by other prisoners in the three months prior to their death. This finding is placed within the wider context of violence in prisons, by exploring official statistics and considering prisoners’ own perceptions of safety. The national approach and local responses to violence in custody are then considered. Looking specifically at 42 self-inflicted death investigations, the PPO found that staff responses to allegations of bullying, assaults and other related incidents could have been better in 17 cases. The study found slightly higher proportions of self-harm history, mental health needs and suicide prevention measures at the time of death in cases where evidence of bullying or intimidation was found compared to cases where it was not. Whilst issues around bullying or intimidation by other prisoners were encountered more often in Young Offender Institutions (YOIs) and women’s prisons, learning could be found across all functional types. Seven fatal incident investigations are summarised as case studies, with learning highlighted. The cases covered address specific themes including: • Dynamic security and collating security information about safety concerns • Implementation of local violence reduction strategies • Locating vulnerable prisoners • Approaching the subject of intimate relationships formed between prisoners • Abusive shouting through cell windows • Defining and investigating bullying • The learning identified is categorised into three groups: the importance of recording and sharing information, improving understanding of violence reduction and the importance of protecting prisoners at specific risk of victimisation. Details: London: Prisons and Probation Ombudsman, 2011. 28p. Source: Internet Resource: Accessed October 18, 2011 at: http://iapdeathsincustody.independent.gov.uk/wp-content/uploads/2011/10/PPO-Report-on-Violence-Reduction-Bullying-and-Safety-October-2011.pdf Year: 2011 Country: United Kingdom URL: http://iapdeathsincustody.independent.gov.uk/wp-content/uploads/2011/10/PPO-Report-on-Violence-Reduction-Bullying-and-Safety-October-2011.pdf Shelf Number: 123044 Keywords: Deaths in Custody (U.K.)Prison ViolencePrisoners |
Author: Great Britain. Prisons and Probation Ombudsman Title: Learning from PPO investigations: Natural cause deaths in prison custody 2007-2010 Summary: This report presents analysis of data collected from 402 PPO [Prison and Probation Ombudsman] investigations into deaths in custody from natural causes conducted between 1 January 2007 and 31 December 2010. Details: London: Prisons and Probation Ombudsman, 2012. 19p. Source: Internet Resource: Accessed August 28, 2012 at http://www.ppo.gov.uk/docs/learning_from_ppo_investigations-natural_cause_deaths_in_prison_custody.pdf Year: 2012 Country: United Kingdom URL: http://www.ppo.gov.uk/docs/learning_from_ppo_investigations-natural_cause_deaths_in_prison_custody.pdf Shelf Number: 126157 Keywords: Deaths in Custody (U.K.)PrisonersPrisons |
Author: Coles, Deborah Title: Learning from Death in Custody Inquests: A New Framework for Action and Accountability Summary: For thirty years INQUEST has monitored inquests into deaths in custody. One of the striking features of this work has been our repeated experience of attending inquest after inquest where the same issues are identified as possibly contributing to the death. A number of factors explain this including: the narrow and restricted remit of the inquest; the prevention of discussion or reference to previous similar deaths; and the lack of an effective mechanism to ensure action is taken on the basis of inquest findings. This feature of our work has contributed to the development of our critical analysis of the investigation of deaths in custody and also to our work to improve the current system. This report aims to be part of that process. While the coronial service can and does make a vital contribution to the prevention of deaths and the conditions of safe custody, that input is at risk of being critically undermined by the failure (1) to recognise the value of properly-collected data; and (2) to monitor compliance with and/or actions based on the findings and reports that emerge from inquests. The essential argument of this report can be expressed in compressed form: the more effective use of narrative verdicts and Coroners Rule 43 reports1 is overwhelmingly likely to assist in the saving of lives. This matter is not simply a technical question, nor one of mere procedure, but rather a matter of foremost importance that goes to the heart of the United Kingdom’s treaty obligations as a signatory to the European Convention on Human Rights (ECHR) to foster, maintain and scrutinise its article 2 ECHR duties in mediating the relationship between the state and the citizen. The critical evaluation and onward dissemination of the combined findings of the inquest – both the verdict and rule 43 report – constitute a powerful tool for harm prevention embedded within the inquest system. This report identifies and explains why this tool has proved largely ineffectual historically. In short, this is because the existing system is flawed. The lessons to be learned from the contents of these verdicts and reports are far too frequently lost: they are analysed poorly or ignored; misunderstood or misconstrued; dissipated or dismissed. Consequently, there is an overwhelming case for the creation of a new mechanism. The indispensable constituent parts of this fresh structure are that there should be a central oversight body tasked with the duty to collate, analyse critically and report publicly on the accumulated learning from coronial narrative verdicts and rule 43 reports. Further, there must be public accountability, accessibility and transparency. The conclusions of this report are based on a critical review of the evolution of the law and practice relating to narrative verdicts and the use by coroners of rule 43 powers in inquests into deaths in prison and in police custody or following police contact and a unique analysis of a sample of narrative verdicts and coroners’ rule 43 reports arising from such inquests. The report presents the data in a range of formats to demonstrate and illustrate the detail included in narrative verdicts and rule 43 reports. The report also documents recent developments and changes in law and practice. Whilst this report does not include the outcomes of inquests into deaths in mental health detention, we think the conclusions and recommendations are equally applicable to these deaths and would be usefully read by those involved in relevant regulation and inspection bodies including the Care Quality Commission. Most deaths in state detention or involving state agents take place within a system of dependency and control. There is a body of statutory and common law authority that recognises the special role of an inquest when someone dies in situations where they are dependent upon or subject to the control of the state. In addition the Human Rights Act 1998 (HRA) obliges the coroner to consider whether the deceased died as a result of the state violating her or his right to life (article 2) and whether the state subjected the deceased to inhuman or degrading treatment (article 3). Deaths in custody represent the extreme end of a continuum of near deaths and injuries and a proactive post-inquest strategy in response to verdicts and reports can not only avert deaths but also risks to custodial health and safety generally. In the past, narrative verdicts and/or rule 43 reports produced by inquests have informed changes to custodial policies and practices. However, such positive developments have been piecemeal and often in spite of rather than because of the current system. This report argues that this vital learning – the accumulated knowledge we as a community have gleaned collectively when contact between the citizen and the state has ended in disaster, death or tragedy – must be put on a more secure footing. We have before us an unmatched opportunity to make changes for the better in this intensely sensitive and important area. We urge that the opportunity is not squandered. Details: London: INQUEST, 2012. 40p. Source: Internet Resource: Accessed October 3, 2012 at: Year: 2012 Country: United Kingdom URL: Shelf Number: 126546 Keywords: Deaths in Custody (U.K.)Human RightsPrisonersPrisons |
Author: Edmundson, Anna Title: Fatally Flawed: Has the State Learned Lessons from the Deaths of Children and Young People in Prison? Summary: The inquests and investigations into the deaths of children and young people in prison between 2003 and 2010 reveal that they were often very vulnerable and that none received the level of support and protection they needed. In many of the cases, the fact that they were in prison in the first place can be seen as symptomatic of failures by agencies within and outside the criminal justice system to address their multiple, often complex, needs. The detailed stories of six of the children and young people who died in prison which feature in this report vividly illustrate the extent of their vulnerabilities and the shortcomings of their treatment both within the justice system and by agencies outside. The information and evidence collated for this report revealed common themes in the experiences and treatment of children and young people who died in prison between 2003 and 2010. These overlapping findings included that they: 1 were some of the most disadvantaged in society and had experienced problems with mental health, self-harm, alcohol and/or drugs; 2 had significant interaction with community agencies before entering prison yet in many cases there were failures in communication and information exchange between prisons and those agencies; 3 despite their vulnerability, they had not been diverted out of the criminal justice system at an early stage and had ended up remanded or sentenced to prison; 4 were placed in prisons with unsafe environments and cells; 5 experienced poor medical care and limited access to therapeutic services in prison; 6 had been exposed to bullying and treatment such as segregation and restraint; 7 were failed by the systems set up to safeguard them from harm. Our analysis also found there had been: 8 inadequate institutional responses to the deaths of children and young people in prison. Our findings indicate there have been failures in how the state treats children and young people in conflict with the law and that the learning and recommendations from inquests and investigations into previous deaths have not been properly implemented. The question this report addresses is whether the State can learn lessons from the deaths of children and young people in prison and act now to put right the flaws identified in order to prevent further deaths in the future. Details: London: Prison Reform Trust and INQUEST, 2012. 76p. Source: Internet Resource: Accessed October 25, 2012 at: http://www.prisonreformtrust.org.uk/Portals/0/Documents/Fatally%20Flawed.pdf Year: 2012 Country: United Kingdom URL: http://www.prisonreformtrust.org.uk/Portals/0/Documents/Fatally%20Flawed.pdf Shelf Number: 126797 Keywords: Deaths in Custody (U.K.)Juvenile DetentionJuvenile InmatesSuicides |
Author: Independent Advisory Panel on Deaths in Custody Title: Independent Advisory Panel on Deaths in Custody: Statistical Analysis of All Recorded Deaths of Individuals Detained in State Custody Between 1 January 2000 and 31 December 2010 Summary: The Independent Advisory Panel has published their statistical analysis of all recorded deaths in state custody between 1 January 2000 and 31 December 2010. This represents an important piece of work for the Panel as this is the first time that all recorded deaths in state custody will be broken down by ethnicity, gender, age and cause of death, and presented together in a single format. The statistical analysis covers deaths in: Prisons, Young Offender Institutes (YOIs), Police custody, Immigration Removal Centres, Approved Premises, Secure Children’s Homes, Secure Training Centres. Whilst not specifically a custodial sector, the report also contains data on the deaths of patients who died in hospital whilst detained under the Mental Health Act. The report found that: In total, there were 5,998 deaths recorded for the 11 years from 2000 to 2010. This is an average of 545 deaths per year. Of these deaths, 72% (N=4,291) were of males and 28% (N=1,676) were of females. A total of 607 deaths were reported in 2000 compared to 512 in 2010 (this represents a 16% reduction between the beginning and the end of the reporting period). Deaths of those detained under the Mental Health Act (MHA) and those in prison custody, account for 92% (N=5,511) of all deaths in state custody, at 61% (N=3,628) and 31% (N=1,883) respectively. Sixty-six percent (N=3,974) of deaths were recorded as natural causes. Of these, 71% (N=2,814) of deaths were of patients detained under the MHA. Nine percent (N=553) of the 5,998 deaths were of individuals from Black and Minority Ethnic (BME) groups, with 5% (N=305) classified as Black, 3% (N=184) as Asian, 1% (N=52) as Mixed Ethnicity and 0.2% (N=12) as Chinese. Eighty-seven percent (N=5,192) were classified as White. Ethnicity was either not known, or not stated in 3% (N=180) of cases, 1% (N=76) were classified as ‘Other’. These figures need further analysis to understand whether there is any disproportion between race and ethnic identity and types of death. In 0.3% (N=19) of deaths, the application of restraint by custodial staff was attributed to the cause of death during the Coroner’s inquest. This publication will be developed in future years to provide more of an in-depth analysis. Details: London: Independent Advisory Council on Deaths in Custody, 2011. 17p. Source: Internet Resource: Accessed December 16, 2012 at http://iapdeathsincustody.independent.gov.uk/wp-content/uploads/2011/10/IAP-Statistical-Analysis-of-All-Recorded-Deaths-in-State-Custody-Between-2000-and-2010.pdf Year: 2011 Country: United Kingdom URL: http://iapdeathsincustody.independent.gov.uk/wp-content/uploads/2011/10/IAP-Statistical-Analysis-of-All-Recorded-Deaths-in-State-Custody-Between-2000-and-2010.pdf Shelf Number: 127225 Keywords: Deaths in Custody (U.K.)Demographics |
Author: Prisons and Probation Ombudsman for England and Wales Title: Learning from PPO Investigations: End of Life Care Summary: This report presents a review of 214 Prisons and Probation Ombudsman (PPO) fatal incident investigations into foreseeable natural cause deaths in custody. These deaths were due to terminal or incurable diseases in prisons in England and Wales between January 2007 and October 2012. - The review of end of life care in the 214 investigations is placed in the wider context of an ageing prison population. The national and local responses to the changing prison demographic are considered. - The average age at death was 61 years old. Fifty eight per cent of these deaths were of prisoners aged 60 years and over (123 of 214). - The majority of prisoners (85%) in the sample received care which was judged by investigators and their clinical counterparts to be equivalent to that they could have expected to receive in the community. - However, the level of end of life care provided to prisoners varied between prisons. Over a quarter (29%) of prisoners in the sample did not have a palliative care plan in place to support them and their families with their terminal illness. - Eight fatal incident investigations are summarised as case studies, with learning highlighted. The cases address the following themes: - Palliative care plans - The use of restraints - Compassionate release and release on temporary licence - Family involvement - The learning identified is categorised into four groups - The importance of implementing an end of life care plan from the point of terminal diagnosis to support for the family after death. - The need for prisons to place sufficient weight on a prisoner's current health and mobility when assessing the risk they pose to justify any use of restraints. The concordat between the Prison Service and NHS should be followed by every prison to assess the level of restraint required - Where appropriate, applications for early release on compassionate grounds should be completed at the earliest possible opportunity. - The need for families to be involved, where appropriate, in the care planning and how prisons can facilitate and support this. Details: London: Prisons and Probation Ombudsman for England and Wales, 2013. 32p. Source: Internet Resource: Accessed May 14, 2014 at: http://www.ppo.gov.uk/docs/Learning_from_PPO_investigations_-_End_of_life_care_final_web.pdf Year: 2013 Country: United Kingdom URL: http://www.ppo.gov.uk/docs/Learning_from_PPO_investigations_-_End_of_life_care_final_web.pdf Shelf Number: 132352 Keywords: Deaths in Custody (U.K.)Health CarePrisoners |
Author: Equality and Human Rights Commission Title: Preventing Deaths in Detention of Adults with Mental Health Conditions: An Inquiry Summary: Our Inquiry was launched in June 2014 to examine how compliance with human rights obligations can reduce 'non-natural' deaths of adults with mental health conditions in state detention. We looked at deaths in three state detention settings - prisons, police cells and hospitals - consulting with inspectorates, regulators and others with responsibilities in this area. The Equality and Human Rights Commission's (the Commission's) Inquiry examined the available evidence in relation to the deaths of 367 adults with mental health conditions who died of 'non-natural' causes while in police cells or as detained patients over the period 2010-13, plus a further 295 who died in prison custody, many of whom also had mental health conditions. This is a large number in itself, yet for each individual who died there are family members and other loved ones who suffer as a result of these deaths. Previous inquiries, investigations, inquests and court cases have established that, too often, the circumstances surrounding deaths in detention involve breaches of people's most basic human rights - including the right to life. We wanted to establish whether a focus on increased compliance with Article 2 of the European Convention on Human Rights, including the State's positive obligation to protect people's life, would reduce avoidable deaths. One in four British adults experience at least one mental health condition, and one in six are experiencing a mental health condition at any given time. Some people will experience more than one mental health condition. While many people continue to lead productive and fulfilling lives with very little involvement from the State, the Government recognises its role to provide specific care for people experiencing mental health conditions at a time of vulnerability. Details: Manchester, UK: Equality and Human Rights Commission, 2015. 84p. Source: Internet Resource: Accessed February 26, 2015 at: http://www.equalityhumanrights.com/sites/default/files/publication_pdf/Adult%20Deaths%20in%20Detention%20Inquiry%20Report.pdf Year: 2015 Country: United Kingdom URL: http://www.equalityhumanrights.com/sites/default/files/publication_pdf/Adult%20Deaths%20in%20Detention%20Inquiry%20Report.pdf Shelf Number: 134723 Keywords: Deaths in Custody (U.K.)Medical CareMental Health ServicesMentally Ill InmatesMentally Ill Offenders |
Author: INQUEST Title: Stolen Lives and Missed Opportunities: the deaths of young adults and children in prison Summary: Between 1 January 2011 and 31 December 2014, 65 young adults and children died in prison whilst in the care of the state. Of this number, 62 were young adults aged 18-24 years and three were children under 18 (one 15 year old and two 17 year olds). This report analyses the deaths drawing upon the evidence-base accumulated through INQUEST's specialist casework with bereaved families and associated policy work over the last 30 years. It supports the work of the Transition to Adulthood (T2A) programme, which, like this report, is funded by the Barrow Cadbury Trust. Moreover this report supports the independent review into self-inflicted deaths in National Offender Management Service custody of 18-24 year olds. The independent inquiry is chaired by Lord Harris and seeks to make recommendations which will reduce the risk of future self-inflicted deaths in custody. As with earlier INQUEST reports on youth custody, it exposes a litany of systemic neglect, institutional complacency and shortsighted policies which have contributed to the deaths of children and young adults. Our analysis is situated within a contextual frame which argues that understanding deaths in prison requires examining their broader social, political and economic context. It builds upon arguments developed in 2005 by Goldson and Coles and in a range of other publications. First, the number of deaths is high because prison is overused as the societal solution to a range of social problems that need to be addressed elsewhere. Second, there are so many deaths in prison because prison is by its very nature, dehumanising and violent. The limits to which they can be changed or reformed means that prison as currently constructed will continue to be a place where people lose their lives. This report argues for a fundamental rethink about the use of prison for children and young adults that requires political boldness and a more steadfast willingness to implement evidence-based change. Recent attention has been focused on the prison system following concerns expressed about the rising number of prison deaths, staff cuts and the implications of regime change. The vulnerabilities of young prisoners have been well documented, yet they continue to be sent to unsafe environments, with scarce resources and staff untrained to deal with, and respond humanely to, their particular and complex needs. At a practice level, establishments do not seem to have learned lessons from previous deaths in prisons; too many deaths occur because the same mistakes are made time and again. This in turn raises questions about the adequacy of the investigation, inspection and monitoring systems and process of accountability for institutions linked to the state. In the light of these concerns, this report considers the implications and reasons behind the prison deaths of children and young adults since 2011, stressing the need for new thinking and new strategies if such deaths are to be avoided in the future. Details: London: INQUEST and Barrow Cadbury Trust, 2015. 43p. Source: Internet Resource: Accessed March 9, 2015 at: http://www.barrowcadbury.org.uk/wp-content/uploads/2015/02/Inquest-Report_finalversion_Online.pdf Year: 2015 Country: United Kingdom URL: http://www.barrowcadbury.org.uk/wp-content/uploads/2015/02/Inquest-Report_finalversion_Online.pdf Shelf Number: 134757 Keywords: Deaths in Custody (U.K.)Inmate SuicideJuvenile DetentionJuvenile Inmates |
Author: Webber, Frances Title: Hidden Despair: The deaths of foreign national prisoners Summary: This report examines recent suicides of foreign national prisoners in the UK, showing how the prison regime exacerbates the risk of self-harm and suicide through despair. A full report of the IRR's research into BME deaths in police custody, prisons and immigration removal centres, between 1992 and 2014, will be published in February 2015. Hidden despair exposes a catalogue of failure in the penal system: failures by prison staff to recognise the high vulnerability of some foreign offenders, especially young men; failures by immigration officers to communicate decisions, and failures to act on indications of suicidal intent. Details: London: Institute of Race Relations, 2014. 9p. Source: Internet Resource: Briefing paper No. 9: Accessed March 26, 2015 at: http://www.irr.org.uk/wp-content/uploads/2014/12/UKBP_9_Hidden_despair_FNPs.pdf Year: 2014 Country: United Kingdom URL: http://www.irr.org.uk/wp-content/uploads/2014/12/UKBP_9_Hidden_despair_FNPs.pdf Shelf Number: 135062 Keywords: Deaths in Custody (U.K.)Prisoner SuicidesPrisoners, Foreign |