A place of safety?

a red prison cell door viewed through another cell door

My son lies under a grave stone.  He died by suicide in HMP Manchester, suffocated by a plastic bag while alone in a segregation unit.  He was 33 years old.

13 years before his death in Manchester Prison Richard had graduated from Manchester University with a first class degree in physics.

Sadly at the age of 22 while studying for a PhD in astrophysics he suffered a nervous breakdown.  It began with serious suicide attempts – including setting himself on fire, resulting in serious burns and 6 weeks of treatment and skin grafts in a burns unit.  Schizophrenia was diagnosed soon after this.  From this time on Richard was seriously disabled by his mental illness.  He spent the next 10 years in and out of psychiatric wards in Newcastle – sectioned for months and years at a time.

The suicide attempts continued and he became increasingly dependent on alcohol as a means of self medicating.  Alcoholism and mental illness are a common dual diagnosis.

Mental illness is no respecter of background or intelligence.  Richard’s background was middle class; he was a bright, able, highly educated young man.

How did a highly intelligent young person with a long and well documented history of serious mental illness end his days in prison? 

Our society is failing many vulnerable mentally ill people who cannot cope with living alone.  The long term mental hospitals or asylums (here we should not lose sight of the fact that asylum means place of safety) were closed following the introduction of modern anti psychotic drugs.  The care provided by the asylums has not been adequately replaced.  There is no longer a place of safety for people like my son.

When he was very ill Richard was an inpatient and safely cared for in a hospital environment.  With specialist care and modern drug treatment he would reach a stage when he was considered ready to leave the acute ward.  He would then be discharged home with a written care plan in place. In reality the care plan provided him with a one hour visit per day from a health care worker.  He lived alone in a council flat. He was often anxious, lacking in motivation, with disrupted sleep patterns and a serious drink habit.  Social isolation and the effects of stigma and fear by his local community increased his fragile mental state. 

There were numerous attempts at rehabilitation and care in the community but the options available for the care of the mentally ill with an addiction are woefully lacking.  Vulnerable mentally ill people are often without sufficient support.  Their disordered and chaotic thinking often results in arrest.

I will describe to you how Richard was arrested.

Richard lived in Newcastle – there he was well known to the mental health services.   Any incident would be dealt with by his care team and would usually result in hospital admission.  At one point his psychiatrist was listed as one of my friends and family most called telephone numbers!

He met and began visiting a girlfriend at her Manchester home.  During this time he was drinking excessively and smoking cannabis.  While in Manchester chaotic and disordered thinking resulted in his purchasing a replica Beretta air-pistol.  He was fascinated by guns and the idea of suicide by shooting.  He threatened to shoot himself during a phone conversation with his sister.  She called the police as she was in fear for his safety.   My daughter explained that her brother was mentally ill and threatening suicide.  She asked the police to remove the gun safely from him and to keep her informed of the outcome.  They did not - and we – we foolishly believed that he would be safe in a psychiatric unit.  Richard had no history of violence and had only ever harmed himself.  5 days later we discovered that Richard had resisted arrest and in a struggle the gun was discharged twice.  Richard was taken to a police station and from there to HMP Manchester.

Following his arrest there appear to have been no systems in place to give Richard appropriate care. 

His psychiatric history in Newcastle was not investigated – despite the information provided by his sister. He was not given a list of mental health specialist solicitors The criminal justice system was unable to recognise his mental disorder and to respond to it appropriately.

Government policy is to promote the diversion of mentally ill offenders from the criminal justice system to health or social services at the earliest opportunity.  For whatever reason: lack of hospital beds, poorly informed lawyers, pressure on the system, communication failures, poorly trained judges, lack of funding – Richard was entirely failed by this “policy”.

Once in the prison system – there was nothing we as a family could do for Richard.  Visiting was difficult, applications have to be made in advance, and restricted to one hour only.  We were unable to telephone him – prisoners are not allowed incoming calls.

The period of remand was far too long - from October through to May. There were serious breakdowns in communications between Manchester and Newcastle. The judge in the final hearing either through ignorance or prejudice was unable to see beyond the replica firearm.  Richard was sentenced to 5 years.

Richard did not cope well with prison.  Care for the mentally ill should be therapeutic and in surroundings conducive to peace and recovery – not the barred, noisy, stressful and gardenless prison.  Those of you who have visited prisons will be aware of how unpleasant and entirely unsuitable a place they are for the mentally ill.

Prisons spend more than half their health budget on mental health care.  They have health care units, employ psychiatric nurses and have in-reach teams – who do their best, but prison can never be appropriate for the mentally ill.  His treatment was drug based. 

Richard was locked up for up to 15 hours a day and had only 2 hours of “association” with other prisoners per day.  He was bullied and treated with suspicion by most of his fellow prisoners – partly because of his illness and partly through the fact he just did not “fit”.  Middle class graduates are not the norm in HMP Strangeways.

Prior to his death Richard was placed in the segregation unit for his own safety after a rumour spread among the prisoners that he was a racist.  
This is an extract from a letter written the day before he died:

    You must understand that one of my beliefs, at a deep level, is that the world is a dangerous and malevolent place – this is common with my illness.  As a result, I do assume that everyone is out to get me (hence the olanzapine) (the drug Richard is treated with) and it does not help when everyone is.  I do not want to go to another jail, except Grendon Underwood where I am supposed to go, and I definitely do want to stay on Rule 45, as I am vulnerable because of my mental illness.

    You can see that I am in a terrible situation, segregated, hated by the entire jail it seems and not knowing what will happen next.  Someone could come to my door at any time and tell me I am off to some alien jail, unwanted by this establishment, only to find myself clawing out some kind of existence amongst a new set of threatening criminals.  I hate this kind of life and I have considered actual suicide.  I am by myself and the cell is cold.

    The rumour that I am a racist may well travel from jail to jail and I do fear for my life.  I don’t want to be battered or slashed, and I don’t see what I have done to deserve all this.  My crime was a few seconds of behaviour while intoxicated.  The whole penal system is geared towards breaking people down, and segregation is an extra ordeal.  On top of that there is no TV or radio.

My son was not a criminal he was in prison because there was no alternative place of safety.