28th January 2014

A jury has found a string of failures contributed to the death of 17 year old Ryan Clark on 18 April 2011at HMYOI Wetherby.  A damning conclusion highlighted the failure to extract from available documents details of his vulnerabilities and susceptibilities; that not all support that could have been available to Ryan, for example through the personal officer scheme, was implemented; and Wetherby’s scheme to quell bullying and intimidation by way of a ‘shout out’ policy was ineffective.

The jury concluded that Ryan’s actions were more of a ‘cry for help’ due to the amount of verbal abuse and physical threats he was experiencing, and ruled by majority that his death was accidental.

But the jury's conclusions had to be limited to factors which directly caused or contributed to Ryan's death. The inquest had heard from Jane Held, Independent Chair of Leeds Safeguarding Board, that the system failed Ryan, as a ‘looked after’ child, who was in care since he was 16 months old. She said that during the last 12 months of his life, there was no single consistent professional responsible for him, his housing situation prior to his remand was dire, his care plan was insufficient, and he was treated as troublesome rather than troubled, vulnerable and emotionally damaged.

Sonia Daggett, Ryan’s mother said:

“I’m so glad the jury has recognised that Ryan never intended to kill himself. Lessons must be learned to stop pretend self-harm turning to tragedy.”

Ruth Bundey, solicitor for Ryan Clark’s family said:

“It is welcome that the jury has recognised the very serious failings in the lead up to Ryan’s death. However it is also clear that he was failed by those who were supposed to protect his welfare for a long time before that.

“Over 50% of the children held in Wetherby Young Offenders Institution are ‘looked after’ children. Ryan’s death has raised serious questions about the protections afforded by the state to very vulnerable young people.”

Deborah Coles, co-director of INQUEST said:

“The jury’s conclusion is a serious indictment of a system that fails time and again to protect children in its care.  It is clear that basic safeguards that should have been implemented to protect Ryan, a vulnerable 17 year old, were either absent, ineffectual, or simply ignored.

“Deaths of children and young people do not just raise criminal justice issues but important issues outside the prison walls such as the role of social services, support for ‘looked after’ children and questions as to why a vulnerable child was imprisoned in the first place. There have been a pattern of deaths of children and young people with worryingly familiar themes which is why we are calling for an independent, wide ranging and holistic review into the deaths of children and young people in prison.”

Ryan was 17 years old when he was remanded on 30 March 2011. Ryan had always maintained close contact with his mother. He had lost his father, who died in 2010, not long after he had begun building a positive relationship with him. 

The Personal Escort Record (PER) completed by police indicated self harm in the police station by banging his head on the cell wall. He was remanded to HMYOI Wetherby. He was generally described by all, trainees and staff, as quiet, kept himself to himself, reclusive - but on 3 April he became aggressive towards a prison officer, saying he was upset because couldn't contact his mum on Mother’s day and believed the officer insulted his mother. The incident was adjudicated and he lost his privileges for 7 days and was moved to a different wing.

The last few nights of his life Ryan said he was being bullied and was tearful.  He talked about stringing up to the boys in neighbouring cells. No one rung their cell bell. Ryan was found dead the following morning, 18 April 2011.

The family is represented by INQUEST Lawyers Group member Ruth Bundey from Harrison Bundey solicitors.


Notes to editors:

  1. INQUEST first called for an independent reviewof the deaths of children and young people in prison in November 2003, following the death of 16 year old Joseph Scholes.  The call received overwhelming support from children’s charities, the Prison Reform Trust (PRT) and other penal reform groups, human rights organisations, leading members of the legal establishment, and over 100 MPs and Peers.  Since then, 168 children and young people aged 24 and under have died.
  2. In October 2012 INQUEST and the PRT published Fatally Flawed: has the state learned lessons from the deaths of children and young people in prison?. Our evidence based report drew on INQUEST’s casework on the 143 deaths of children and young people (aged 24 years old or younger) who died between 2003-2010. The report concluded that there needed to be an overhaul of the use of imprisonment for vulnerable children and young people and recommended that: “an Independent Review should be established, with the proper involvement of families, to examine the wider systemic and policy issues underlying the deaths of children and young people in prison”.

This recommendation was influential in the Justice Committee inquiry into Youth Justice (to which INQUEST gave written and oral evidence). In their March 2013 report the Committee stated “it is imperative to draw together and act upon lessons arising from the deaths of vulnerable young people in custody” because it “is unacceptable that vulnerable young people continue to die in the custody of the state”.

Since then, the Prisons Minister Jeremy Wright MP has agreed to consider holding a review. His decision on whether to do so is expected in the next two weeks.