Table Of ContentThe defi nitive guide from two leading authors central to developments in the fi eld. An
invaluable book which covers everything from theoretical and community research
to precisely what is known about prisoners and the risk of their completing suicide.
Covers the Haris Review and Government Response to it as wel as the stance of Suicide in Prisons
politicians, reform groups and other leading experts on what in 2017 is an escalating
problem for UK prisons. Contains analysis and data from over 30 years, bringing
together key knowledge and information at a critical time of concern and attention. Prisoners’ Lives Matter
A superb publication and coming at exactly the right time… cuts through
“ the rhetoric with a forensic analysis of the problems coupled with prac- Graham J Towl and David A Crighton
tical, low cost and rapidly achievable recommendations”
— John Podmore, International Prisons Consultant and former prison Governor.
Rarely has a book been more timely or pertinent than this one… a thorough, wide-
“ ranging and nuanced account… which contextualises, describes and analyses 36 years
of data… a call to arms for those working in penal research, policy and practice”
— Philippa Tomczak, University of Sheffi eld.
Places the issue fi rmly in the context of theoretical perspectives, recent research and expert
commentaries… A book for practitioners, policy-makers, researchers and students alike”
“
— Carol Robinson, University of York.
An important book about a subject that receives too little attention”
— John Bateson, San Francisco, author and former suicide prevention counsellor.
“
Can be the starting point for changing opinions, policies, systems and lives for the better”
— Elizabeth Scowcroft, Nottingham Trent University/The Samaritans.
“
Particularly valuable for students interested in this important topic”
— Dominic Aitken, Oxford University
“
David A. Crighton is a Consultant Psychologist and Hon. Professor
of Psychology at Durham University. Graham J. Towl is Professor
of Forensic Psychology at Durham University and Visiting Clinical
Professor at Newcastle University. USD $34.95/GBP £22.50/AUD $34.95
WATERSIDE PRESS
Put ing justice into words WATERSIDE PRESS Foreword Lord Toby Harris
www.WatersidePress.co.uk
Suicide in Prisons Prisoners’ Lives Matter Towl & Crighton
Suicide in Prisons
Prisoners’ Lives Matter
Graham J Towl and David A Crighton
Foreword Lord Toby Harris
WATERSIDE PRESS
Suicide in Prisons: Prisoner’s Lives Matter
Graham J Towl and David A Crighton
ISBN 978-1-909976-44-3 (Paperback)
ISBN 978-1-910979-29-7 (Epub E-book)
ISBN 978-1-910979-30-3 (Adobe E-book)
Copyright © 2017 Tis work is the copyright of Graham J Towl and David A Crighton. All
intellectual property and associated rights are hereby asserted and reserved by the author in
full compliance with UK, European and international law. No part of this book may be cop-
ied, reproduced, stored in any retrieval system or transmitted in any form or by any means,
including in hard copy or via the internet, without the prior written permission of the pub-
lishers to whom all such rights have been assigned worldwide.
Cover design © 2017 Waterside Press by www.gibgob.com
Printed by Lightning Source.
Main UK distributor Gardners Books, 1 Whittle Drive, Eastbourne, East Sussex, BN23
6QH. Tel: +44 (0)1323 521777;
Table of Contents
Copyright and publications details ii
Acknowledgments vi
About the authors vii
Te author of the Foreword viii
Reviews ix
Foreword ..............................................................................................................xi
1 Setting the Scene .......................................................................................... 15
Introduction 15
Human rights 16
Fresh perspectives 18
2 Teoretical Perspectives on Suicide .........................................................25
Introduction 25
Rationalist approaches to suicide 26
Medical models of suicide 27
Social Models of Suicide 31
Psychological theories of suicide 34
A theoretical model of suicide in prisons 39
Causation 40
Methodological problems in prison suicide 41
Similarities between suicide and suicide attempts 42
Protective factors 46
Te two-stage model of suicide 48
Applying the theory 48
3 Community Research into Suicide ..........................................................53
Introduction 53
iii
Suicide in Prisons
Defning suicide in the community 53
Epidemiological studies 54
Access and methods 65
Comparative Research 68
Conclusions Chapter 3 73
4 What We Know About Prisoners .............................................................75
Introduction 75
Family, Attitudes and Self-Control 76
Conclusions Chapter 4 89
5 Te Management of Suicide in Prisons ................................................... 91
Introduction 91
Prisons Service Instruction (PSI) 64/2011 92
Assessment, Care in Custody, Teamwork (ACCT) 93
6 Political and Expert Commentaries on Prisoner Suicide ................. 103
Introduction 103
Te Ministerial Council on Deaths in Custody 103
Te Harris Review 107
Government Response to the Harris Review 109
Prisons and Probation Ombudsman (PPO) 110
HM Inspector of Prisons 112
Howard League for Penal Reform (HL) 115
Refections upon the ideas to reduce suicide of the IAP, PPO, HMCIP
and Howard League 116
7 Suicide in Prisons: Early Literature ........................................................121
Introduction 121
Early empirical studies 121
Australian studies 126
Prison suicide: studies of self-injury 129
Studies of completed suicides 132
Conclusions Chapter 7 139
iv
Graham J Towl and David A Crighton
8 Suicide in Prisons: Modern literature .................................................... 141
Introduction 141
Gender 142
Ethnicity 142
Legal status 142
Mental Health 143
Ofence type 144
Time in custody 145
Care and support 145
Key fndings 146
Post-millennial studies 148
Conclusions Chapter 8 149
9 Suicide in Prisons an Empirical Study of Prisoner Suicides from 1978 to
2014 ................................................................................................................ 151
Introduction 151
Te data 152
Teoretical Implications 162
10 Future Directions ....................................................................................... 167
References 179
Index 194
v
Acknowledgments
We would like to acknowledge with grateful thanks Dr Camila Caiado
for her help with formatting the chapters.
Our thanks also go to to those experts in various areas of the feld of
prisoner suicide who read the manuscript ahead of publication and whose
individual comments appear before the start of the book.
vi
About the authors
Professor David A Crighton MA MSc PhD FBPsS FAcSS Chartered
Psychologist, HCPC Registered Psychologist.
David Crighton is a Consultant Psychologist and Honorary Profes-
sor of Psychology at Durham University. He is also a Visiting Professor
at Roehampton University, London and a number of other universities.
He has longstanding research and practice interests in suicide within
a range of forensic settings and has published extensively in this area.
He has previously been a member of the World Health Organization
Working Group on Suicide in Prisons and also contributed to the Royal
College of Psychiatrists’ Working Group on Violence in Secure Settings.
He has previous experience of working in National Health Service foren-
sic, mental health and forensic learning disability services and has been
employed as a Consultant Clinical Psychologist in the NHS, as Regional
Psychologist for Prisons and Probation in Kent, Surrey and Sussex, Lon-
don, and as Deputy Head of Psychology for Prisons and Probation and
Deputy Chief Psychologist in the United Kingdom’s Ministry of Justice.
Professor Graham J Towl RMN, BA, MSc, MBA, DSc, FRSA, FBPsS,
FRSM, FAcSS, Chartered Psychologist, HCPC Registered.
Graham Towl is Professor of Forensic Psychology at Durham Univer-
sity and Visiting Clinical Professor at Newcastle University. Uniquely
he is the recipient of both the British Psychological Society’s Award for
Distinguished Contributions to Professional Psychology and for Distin-
guished Contributions to Forensic Academic Knowledge. He was peer
nominated as the most infuential forensic psychologist in the United
Kingdom. His interest in prison suicide has spanned nearly 30 years with
experience in practice, policy and research. He co-edited the standard
British Psychological Society handbook on Suicide in Prisons in 2000
(with Martin McHugh and Louisa Snow). Along with David Crighton
vii
Suicide in Prisons
he was the frst person in the UK to highlight the data on ethnicity
when considering prisoner suicides. In the 1990s, he was a practitioner in
prisons and chaired the National Research Forum of the Suicide Aware-
ness Support Unit (SASU) within HM Prison Service. In 2000 he was
appointed as Head of Psychological Services in Prisons and Probation
for England and Wales. He remains an advocate of, evidence informed
policy and practice implemented with kindness and a compassionately
based professionalism. His publications include Preventing Self-injury and
Suicide in Women’s Prisons (with Tammi Walker) (Waterside Press, 2016).
The author of the Foreword
Lord Toby Harris was Chair of the Independent Advisory Panel on
Deaths in Custody from 2009 to 2015. In February 2014, he was asked
by the Minister for Prisons to lead the review into self-inficted deaths
in National Ofender Management Service (NOMS) custody. Tis was
completed in April 2015, published in July 2015, and made recommen-
dations to reduce the risk of such deaths.
viii
