Prison deaths - Psychiatric services are not optional

MOST of us will be surprised to learn that a prisoner has died in an Irish jail every six weeks for the last two years. This figure — 16 deaths — is not the kind of statistic that we imagine defines our society.

No matter what a prisoner has been convicted of he or she is entitled to the full protection of the State, in whatever form that protection might take.

The Department of Justice has confirmed these figures, two of which represent deaths by natural causes, two more represent deaths by misadventure. Only five inquests have been concluded, with 11 more investigations, some almost two years old, incomplete.

These deaths are a cause for great concern especially as they occurred amongst a relatively small prison population of around 3,600.

We have all heard the stories of budgies, mobile phones, plasma screens and widespread drug abuse in our jails, especially in Mountjoy where a third of these deaths occurred. No doubt drugs are a factor in some deaths. No doubt some are suicides. Deaths like these, though they are no less tragic and regrettable, occur in every prison system in the world and there is no realistic possibility of eliminating them.

Undoubtedly our prisons are far more crowded than is ideal but the prospect of an immediate resolution to that great difficulty diminishes every day. Unions and management insist that staffing levels are too low and that more people must be recruited if an improved service is to be provided while cutting overtime. Those proposals are firmly rooted in the “pending” tray too.

There is one trend however that is unacceptable even in these chastened times.

The Irish Association of Suicidology (IAS) say an estimated 40% of female prisoners and 60% of their male counterparts suffer mental health issues, leading to the genuine risk of self-harm or even suicide.

The IAS tells us our suicide levels are below British norms but that we do have “a very high level of self-harm and suicides that have not been completed”.

This situation might have been avoidable if there had been appropriate and timely intervention by psychiatric services. In reality far, far too many of our prisoners are more in need of psychiatric attention than the punishment imposed by the loss of their freedom. We have already said that prisoners are entitled to protection from the State while in custody. That includes protection from themselves.

How can our health service provide these vital interventions while slashing hundreds of millions from its budget? By asking hard questions.

Answers to two simple questions might be a good start. Why are five out of every eight HSE employees administrators? Why do we pay our hospital consultants multiples of what their EU counterparts are paid?

The answers to these questions are not academic. They will explain why so many desperate people, inside and outside of prison, cannot get the psychiatric help they need. They contribute to these deaths.