Date: 16^th June 2009

Dear Sir/Madam,

You sent in a query, under the Freedom of Information Act, to the Ministry of Justice, asking:

1) [Author ID1: at Tue Jun 16 10:13:00 2009 ]“How were the recommendations, made to and accepted by, the Secretary of State, in the thematic review entitled "Suicide is Everyone's Concern" published in 1999 implemented?”[Author ID1: at Tue Jun 16 10:13:00 2009 ][Author ID1: at Tue Jun 16 10:13:00 2009 ]

2) “What will replace suicide indicators in prisons after the proposed national withdrawal of suicide indicators by 2011?”[Author ID1: at Tue Jun 16 10:13:00 2009 ]

After some discussion, it was deemed that this query should not be dealt with as a freedom of information query but as “business as usual”. It was then sent to my group as policy lead on the subject matter. Please see our response below. For sake of clarity[Author ID1: at Tue Jun 16 10:13:00 2009 ], I will address each element of your request, separately.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

1) [Author ID1: at Tue Jun 16 10:13:00 2009 ]“How were the recommendations, made to and accepted by, the Secretary of State, in the thematic review entitled "Suicide is Everyone's Concern" published in 1999 implemented?”[Author ID1: at Tue Jun 16 10:13:00 2009 ][Author ID0: at ]

[Author ID0: at ]

[Author ID0: at ]

The thematic review titled "Suicide is Everyone's Concern", by HM Chief Inspector of Prisons (HMCIP) for England and Wales, was published in May 1999 with recommendations for the attention of the Secretary of State [for Home affairs] and the Director General of Prisons. These recommendations were addressed through delivery of a three-year implementation strategy.[Author ID0: at ]

[Author ID0: at ]

In June 2000 the Prison Service commissioned a review of the suicide awareness and prevention procedures in place at that time. The Terms of Reference for the review were:[Author ID0: at ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]To review the impact of the current Prison Service strategy for the identification and management of self harm and suicide[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]To make recommendations for a revised three year strategy designed to achieve a year on year reduction in suicide and self harm[Author ID1: at Tue Jun 16 10:13:00 2009 ]

[Author ID1: at Tue Jun 16 10:13:00 2009 ] [Author ID1: at Tue Jun 16 10:13:00 2009 ]To review the current organisation and staffing of the Prison Service Suicide Awareness and Support Unit, (SASU), and to make recommendations for any changes to deliver the revised strategy.[Author ID0: at ]

[Author ID0: at ]

The review reported in February 2001. It asked the Prison Service to embrace the concept of suicide prevention and to target, within a holistic approach, those prisons where prisoners are most at risk. In completing the report the review team drew on findings from the HMCIP thematic review. This was seen as a rich source of data. It was supplemented by findings of the extensive research literature in this field, the statistical data held on the Prison Service database and the results of audits of the Prison Service Standard on suicide and self-harm reduction. In addition, Lord Ramsbotham himself contributed to the review.[Author ID0: at ]

[Author ID0: at ]

Key headline deliverables which address concerns raised in the thematic review include:[Author ID0: at ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]The establishment of a multi-disciplinary Safer Custody Group.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]A Safer Local Prisons Programme.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]New suicide screening, care plan and staged risk management systems by April 2003.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Establishment of clear, reliable self-harm definitions and measures b[Author ID1: at Tue Jun 16 10:13:00 2009 ]y September 2001 and implementation of intervention strategies for repetitive self-harm by April 2003.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Strengthened investigation procedures and investigation/inquest follow ups - (since 2004 the Prison and Probation Ombudsman (PPO) has been responsible [Author ID1: at Tue Jun 16 10:13:00 2009 ]for investigating deaths in custody).[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Greater inter-agency liaison and integration of suicide/self harm approaches, including improved information sharing with Health interests and other parts of the criminal justice system.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Extended use of prisoner pe[Author ID1: at Tue Jun 16 10:13:00 2009 ]er support.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Partnership links with a range of prison interest groups (such as the Samaritans) and voluntary and community based organisations.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]National suicide prevention recognition arrangements.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Learning from a three-year suicide and self-harm rese[Author ID1: at Tue Jun 16 10:13:00 2009 ]arch strategy.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Enhanced generic and targeted suicide prevention and self-harm training, including mental health training for Prison staff.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Reports and bulletins on suicide prevention/self harm statistics and trends, strategy developments and learning a[Author ID1: at Tue Jun 16 10:13:00 2009 ]nd good practise.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Revised standards on suicide and self-harm and developed safer prisons environment standards by December 2002.[Author ID1: at Tue Jun 16 10:13:00 2009 ]

 [Author ID1: at Tue Jun 16 10:13:00 2009 ]Revision of all prison service orders (PSOs) and guidance on or related to suicide prevention and self-harm to reflect less[Author ID1: at Tue Jun 16 10:13:00 2009 ]ons of strategy implementation, (by April 2004).[Author ID0: at ]

[Author ID0: at ]

[Author ID1: at Tue Jun 16 10:13:00 2009 ]

2) “What will replace suicide indicators in prisons after the proposed national withdrawal of suicide indicators by 2011?”[Author ID1: at Tue Jun 16 10:13:00 2009 ]

[Author ID1: at Tue Jun 16 10:13:00 2009 ]

The self-inflicted deaths performance indicator was introduced in 2002-03 as part of the NOMS Safer Custody Strategy and linked to the Department of Health led PSA 18 regarding better health and well-being for all. The aim was to achieve a 20 per cent redu[Author ID1: at Tue Jun 16 10:13:00 2009 ]ction on the 1999-00 baseline rate of 140.4 self-inflicted deaths per 100,000 prisoners. This target (112.8 deaths per 100,000) was achieved in 4 of the last 5 financial years. The rolling three-year average rate, which is a better indicator of the general trend, continues to reduce. It is currently 91 self-inflicted deaths per 100,000 prisoners.[Author ID0: at ]

[Author ID0: at ]

However, given the tragic impact on families, staff and other prisoners, Ministers were concerned that having a target could be misinterpreted as there being an acceptable level of suicides. Consequently, maintaining such a target was deemed inappropriate and discontinued.[Author ID0: at ]

[Author ID0: at ]

A clear commitment to suicide prevention still remains across NOMS. Reducing self-inflicted deaths continues to be a national objective for the agency. It is linked at a high level to reductions in the rolling three year average rates. Work continues on activities that contribute most to reducing the distress linked to self-inflicted deaths; and to utilising alternative measures to monitor progress in improving prisoner safety. These include:[Author ID0: at ]