Suicide in prison has long functioned as both symptom and symbol of underlying and intractable problems in the penal system.1 This is yet more clearly the case when a young person in detention takes their own life. Such events can serve to delegitimise systems of prison discipline and even the recourse to imprisonment for children, reconfiguring the oft-feared juvenile ‘offender’ as pitiable ‘victim’ of institutional abuse or neglect.
In England and Wales, the standard mortality rate for suicide increased five-fold among adult prisoners between 1978 and 2003; for boys aged between 15 and 17 the increase during the same period was significantly in excess of this.2 In Britain, suicide amongst young prisoners has led to considerable governmental concern, review, and policy development, especially since the 1980s. Of note was the inquiry into the suicide of the 18-year-old James Heather-Hayes in Ashford Remand Centre in 1982, which returned a verdict of ‘lack of care’. This death prompted the first ‘thematic review’ of prison suicides by the Inspectorate of Prisons in 1984, the establishment of a Parliamentary Working Group, and the issuing of new protocols on suicide prevention to prison departments in 1987.3
Disquiet over prison suicide predates the latter part of the twentieth century. In 1881, John Lentaigne, former Inspector General of Prisons in Ireland, recounted an instance in 1871 when an incarcerated 12-year-old boy tasked with picking oakum in a separate cell hung himself with the very rope he was to unpick. Lentaigne became convinced that separate cellular confinement was unsuited to juvenile prisoners.4 Likewise, the then newly appointed medical inspector of English and Welsh prisons, R.M. Gover, was sufficiently concerned about prison suicide to undertake a study of the problem in 1879. Many of his conclusions – that prisoners were most vulnerable to suicide early on in their sentence or when on remand – are still pertinent.5 Gover’s successor, Herbert Smalley, undertook a similar analysis in 1911; he found that the age distribution of prison suicides was significantly younger than that of the general population.6 Smalley attributed this to the ‘physiological instability of youth’ arguing that such suicides could be understood as an often-impetuous reaction to the emotional ‘shock of detection or imprisonment’.7 He concluded that imprisonment should be used sparingly for young offenders and that their treatment should be ‘educative and reformatory rather than merely punitive’.8
Smalley’s report was published in the same year that Britain’s second borstal opened at Feltham. It has been contended that the borstal’s rehabilitative emphasis may have reflected Smalley’s own preference for a less punitive system for juvenile prisoners. 9 Whether borstal provided any prophylactic against suicide is difficult to ascertain. Available records, however, allow us to explore the institutional response to self-harm among juvenile prisoners at Feltham Borstal during a later period – the 1950s. They indicate that self-directed violence by juvenile prisoners was neither necessarily interpreted as evidence of mental abnormality nor on a continuum with suicide; rather, these were acts perpetrated ‘within the limits of mental health’ and treated largely in a disciplinary framework of surveillance and restraint.10
Feltham was an institution reserved for juvenile male offenders deemed physically or mentally ‘inadequate’.11 Inmates who self-harmed were placed in the borstal hospital under restraint for up to 24 hours. Such incidents occurred about every two or three months and were not typically seen as requiring psychiatric intervention. One inmate, was placed in the hospital under restraint ‘for his own safety’ in 1950 having ‘cut his legs several times with a piece of glass’. The governor reported that although he ‘was in a most sullen and truculent mood’ and had ‘threatened to make a better job the next time’ he was not ‘depressed’. The inmate was released the next day, apparently ‘in a much better frame of mind’ and ‘sent back to carry on with his [training]’ as before.12
The reluctance to view such events as symptomatic of mental illness might reflect the later medicalization of the borstal system relative to the wider penal estate. This response was not qualitatively different from that of a later period after Feltham had become a more medicalised institution with the establishment of its own psychiatric unit in 1958. The borstal regime had long been valourised for its flexibility in accommodating various ‘misfits’.13 This flexibility was realised in Feltham’s calibrated regime of care which provided ‘every gradation’ for its inmates ‘from complete hospitalization to training in the same circumstances as other inmates, with adequate supervision at every stage and as much useful work as the mental state allows’.14 In other analogous institutional contexts, there was likewise a tendency not to interpret self-harm as evidence of mental illness. A survey of the quarterly medical returns for St Christopher’s Approved School for Boys in Middlesex for the years 1948–64, details various instances where boys were removed following nervous breakdowns for treatment in mental hospitals, and records minor instances of ‘nervous debility’.15 However, instances of self-harm, including wrist-cutting, swallowing foreign objects, and the ingestion of poisons,16 were never recorded as symptomatic of mental morbidity. Nor did these inmates typically receive psychiatric treatment subsequent to these actions. The suicide of juveniles in detention was a medical matter insofar as at it was cause of mortality, but neither it nor self-harm were overtly pathologised or seen as prima facie evidence of mental illness.
Notes
1 Louisa Snow, ‘Suicide Prevention: Policy and Practice’, in L. Snow, G. Towl and M. McHugh (eds), Suicide in Prisons (2000), 24.
2 Seena Fazel, Ram Benning and John Danesh, ‘Suicides in Male Prisoners in England and Wales, 1978–2003’, Lancet, 366:9493 (2005), 1301–2.
3 Alison Liebling, Suicides in Prison (1992), 4–5.
4 John Lentaigne, ‘The Treatment and Punishment of Young Offenders’, Journal of the Statistical and Social Inquiry Society of Ireland, 8:63 (1884), 32–3.
5 Third Report of the Commissioners of Prisons (1880), 54–62.
6 Report of the Commissioners of Prisons and the Directors of Convict Prisons (1911), 40–2.
7 Ibid., 41.
8 Ibid., 42.
9 Alison Liebling and Tony Ward, ‘Prison Doctors and Prison Suicide Research’, in R. Creese, W.F. Bynum and J. Bearn (eds), The Health of Prisoners (1995), 127.
10 Report of the Commissioners of Prisons and the Directors of Convict Prisons (1911), 41.
11 Lord Moynihan, House of Lords Debates, 4 May 1955, vol. 192, col. 741-806.
12 London Metropolitan Archive (LMA) 4465/A/01/004, Governor’s Journal, 10-11 August 1950.
13 Report on the Work of the Prison Department 1965 (1967), 46.
14 Report of the Commissioners of Prisons for the Year 1961 (1962), 65.
15 London Metropolitan Archive (LMA), MCC/CH/APS/01/006, Medical Returns for St Christopher’s Approved School, 31 December 1963, 13 April 1954, 13 January 1960, 16 January 1961. LMA has permitted access to records which contain sensitive personal data & which are currently closed under Data Protection legislation on the written understanding that no identifiable information on any individual is disclosed. Access to these records is at the discretion of the LMA, subject to strict confidentiality agreements, and not granted automatically to research applicants.
16 Ibid., 19 January 1959, 15 April 1962, 31 March 1963, 15 October 1956.
Exploring the history of prisoner health 