In Stavanger prison, we have recently had to use the security cells daily to prevent inmates from taking their own lives. Having to use coercion and isolation against mentally ill inmates is unsustainable and undignified, but a necessary evil in an attempt to keep these prisoners alive. Where acutely suicidal inmates are in many cases taken care of both in law and regulations, and also in the form of psychiatric admissions, those who attempt to take their own lives time and again are either refused admission or discharged after a short time. The reason is often that the person in question is “chronically suicidal”, in the professional community called “inmates with recurrent suicidality”. Since 2013, 50 inmates have taken their own lives in Norwegian prisons. Of these, 32 were in custody, while 18 were serving a sentence. We know that the risk of suicide is increased during detention. Many are then in an extremely vulnerable situation and in an acute life crisis. If the hospital and prosecution disagree about whether the accused should be placed in custody or in a psychiatric hospital, very strong arguments are needed today to have the accused admitted. The accused must be in “a strongly deviant state of mind”, and the decision must be based on a “unequivocal expert investigation” in order for that person to be admitted. The needle’s eye for getting detainees into psychiatry in these cases is almost impenetrable. The result is very often that the inmate ends up in correctional facilities. Also in cases where inmates have received their sentence, we see that more should have been in psychiatry. And the times when the prisons actually manage to get inmates transferred to the health care system, unfortunately they are often returned. The main question becomes; who will take responsibility for the group of “chronically suicidal” who fall between all the seats, and whom no one wants on their conscience to succeed in their suicide attempt? The social mission of the Correctional Service is that punishment should have a rehabilitative effect, and that it should lead to change. To achieve that, we must accept some form of risk in sentencing people with serious mental health problems. Facing self-harm with force offers the greatest safety, but the least rehabilitation. Using coercion is also very stressful for both inmates and employees. Mentally ill inmates should therefore receive treatment from the healthcare system to a greater extent and be more stable, before they can serve their sentence. Only then will the punishment work as it should. Civil ombudsman Hanne Harlem has previously said that people who self-injure themselves so badly that they are put in seat belts are primarily in need of health care and should be transferred to a greater extent to the specialist health service. This is in stark contrast to the steady downsizing of psychiatric beds we see today. It is not appropriate to admit inmates in an emergency and then send them back to prison the next day. But the agencies must talk better together, and make arrangements for the inmates to have good enough mental health that the punishment can be carried out in line with the social mission of the correctional service. The Correctional Service has conscientious and competent prison officers, who watch over suicidal inmates. There are situations where one moment officers are cutting inmates free from homemade ropes, then the next they are sitting with them playing cards. The vast majority of inmates are doing well in Stavanger prison, as I think they are in other Norwegian prisons. Staff do their utmost to treat all inmates with respect, trust and empathy. It is then difficult to see that the financial allocations do not correspond to our mission. According to European human rights, we should preferably not use coercive measures. And as an institution, we must prevent psychological stress injuries for our employees. Today, there are no systems that look after people with recurrent suicidality well enough, either within the health or justice sectors. We need to put a better system in place to handle this. A good start is to equip psychiatry so that they can look after mentally ill offenders.
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Suicide in prison – Statement
