19 April 2017

Today’s report by the Council of Europe’s Committee for the Prevention of Torture and Inhuman and Degrading Treatment or Punishment (CPT) reflects some of the ongoing concerns of INQUEST on issues in UK places of detention. The CPT visited adult and youth prisons, police custody, immigration detention and psychiatric institutions in England between March and April 2016. They identified a number of systematic failings, to the extent that in the case of prisons, none of the establishments they visited could be considered safe.

As part of their reporting on the UK the CPT consulted both governmental and non-governmental organisations, including INQUEST. We provided the delegation with briefings on issues arising from deaths in prison, deaths in and following police contact, and deaths in mental health settings, in detention and de facto detention. We also provided background notes on a number of individual cases, as well as statistics on police deaths broken down according to our casework and monitoring.
 

POLICE 

The CPT share INQUEST’s concerns on the lack of oversight and consistency in use of force and restraint by police (p.17), finding that “at Doncaster Police Station, the CPT’s delegation observed first-hand that a so-called ‘spit helmet’ and velcro fixation/straps were in regular use (in combination), whereas the same equipment had been withdrawn from service by the Metropolitan Police Service, apparently because of health and safety concerns.”

They found Doncaster police use ‘spit helmets’, also known as spit hoods, and Velcro/fixation straps (sometimes in combination) approximately once a month on detained persons in the cells. Tools like spit hoods and Emergency Response Belts (ERB) are potentially fatal, particularly when used on the most vulnerable detainees such as those in mental health crisis. They noted the case of Thomas Orchard who died while in custody after having being restrained by the police with an ERB.

The CPT recommends that the authorities review the safety of the use of ERBs, ‘spit helmets’ and ‘velcro straps’ in police custody suites, and that the authorities regularly remind police about the regulations governing the use of means of restraints established in PACE Code C and other relevant regulations. These are important steps that could prevent further deaths and should be undertaken with urgency.

They also recommend that additional measures be taken, including of a legislative nature, to avoid holding mentally ill persons in police cells as far as possible, and that interagency co-operation between police and mental health services in respect of those patients detained pursuant to Sections 135 and 136 of the Mental Health Act should be strengthened. INQUEST reported on similar concerns in May 2014and continue to call for improved police response to vulnerable people suffering from ill mental health.

 

PRISON AND MENTAL HEALTH

In the prisons they visited the CPT found “that the duty of care to protect prisoners was not always being discharged given the apparent lack of effective action to reduce the high levels of violence.” They found the cumulative effect of systematic failings meant none of the establishments could be considered safe, highlighting the detrimental effects of overcrowding and understaffing.

Concerns shared by INQUEST are the considerable delays experienced by prisoners with mental health problems awaiting transfer to psychiatric hospitals; and failures to provide adequate mental health care within prison. The CPT observed that in some cases prisoners waited several months because of a lack of beds in specialised health facilities. In cases like that of Dean Saunders the ongoing lack of mental health provision both inside and out of prison can be fatal.

They noted that the 2009 Bradley Report recommended that prisoners suffering from severe mental health illnesses should be transferred to a hospital within 14 days. The CPT believe the 14 day limit is still too long, yet found even the maximum target of 14 day waits for transfers was not being met.  As well as this they found that within prison, ill mental health, which is prevalent, may be dealt with as a behavioural rather than health problem, noting that a punitive rather than a therapeutic response may only worsen the prisoner’s underlying mental ill-health.

The CPT recommend that high priority should be given to increasing the number of beds in psychiatric hospitals, and prisoners suffering from severe mental health illnesses should be transferred to hospital immediately. They also echo calls from multiple bodies, including INQUEST and the Prison and Probation Ombudsman that the authorities ensure that all prison staff are trained to recognise the major symptoms of mental ill-health and understand where to refer those prisoners requiring help.

The CPT also found that prison policy on dealing with mental health crisis was not properly applied: “The delegation was informed by the authorities that the official policy was that only in very exceptional circumstances would prisoners identified as being at risk of self-harming or attempting suicide and thus placed on an ‘ACCT’ (Assessment, Care in Custody and Teamwork) review be held in segregation. This was not the case in practice.” INQUEST agree with the CPT that the use of segregation for a prisoner at serious risk of attempting self-harm or suicide is totally unsuitable and unacceptable for such vulnerable persons. Chris Beardshaw died whilst in distress and placed in segregation, even though he was on an ACCT. The CPT recommend that this practice stops.

 

RECOMMENDATIONS

In summary INQUEST supports the recommendations of the CPT in this report and wish to echo their call for:

• A review into the safety of the use of ERBs, ‘spit helmets’ and ‘velcro straps’ in police custody suites
• Regular reminders to police about the regulations governing the use of means of restraints established in PACE Code C and other relevant regulations
• Additional measures to be taken to avoid holding mentally ill persons in police cells as far as possible
• Strengthened interagency co-operation between police and mental health services in respect of those patients detained pursuant to Sections 135 and 136 of the Mental Health Act
• Priority to be given to increasing the number of beds in psychiatric hospitals
• Authorities to ensure that all prison staff are trained to recognise the major symptoms of mental ill-health and understand where to refer those prisoners requiring help
• Prisoners suffering from severe mental health illnesses should be transferred to hospital immediately
• Segregation not to be used on inmates at serious risk of attempting self-harm