New Zealand has the fourth highest number of suicides in the OECD - a statistic that like the country, prisons are facing head-on.
Prisoners' risk of suicide and self-harm is higher than that of the general population so preventing both is a high priority for Corrections.
Corrections has spent many years refining and improving its policies and procedures around prisoner self-harm and suicide - a process that has seen the introduction of several targeted initiatives including staff awareness training, and the integrated and effective management of prisoners assessed as being at risk of self-harm.
Both initiatives were adopted following the 1995 Justice Department Review of Suicide Prevention in Prisons and the 1996 joint Department of Corrections and Te Puni Kokiri Māori Review Group report Reducing Suicide By Māori Prison Inmates.
Waikeria Prison is a good example of how a prison has grappled with suicide and found solutions. In addition to running a highly successful At Risk Unit for prisoners, Waikeria-based Regional Health Services Manager Sharon Young was instrumental in developing advanced suicide training for nursing staff and unit managers and, encouraging nursing and custodial staff to share information and work together to identify at risk prisoners.
There is no getting away from the fact that Sharon has had huge input into suicide prevention. Her qualifications and experience in forensic mental health and psychiatric nursing certainly made her the ideal person to project manage the establishment of Waikeria's At Risk Unit in 2000.
Senior Inspector of Corrections Gren Bell describes it as a 'fantastic unit' - well run, results-driven and an excellent example of staff pulling together.
"Sharon was very clear about the need for robust risk assessment so she looked carefully at the assessment process we had in place then adapted and played with it to develop an improved process that would work well for both new and existing prisoners," says Gren.
"She has trained staff to be extremely vigilant in their record-keeping and she’s impressed on them that the assessment process is not just a matter of ticking the boxes."
Sharon has encouraged staff to be meticulous in observing the risk assessment process requirement to cross-match information on the assessment form with other information.
This might be a prisoner's previous records, pre-sentence reports prepared by probation officers, any concerns passed on by Courts, or any concerns raised by nursing staff.
"Sharon's also been very focused on the need for staff to gain clarity around yes/no responses - not to take them at face value. If a prisoner receiving mental health services says yes, they're okay at the moment, it is wrong to assume that they are so.
"Sharon would say to an assessor: 'Contact health services. They might present a very different picture'.
"She also recognised instinctively that custodial staff had to work closely with nursing staff and vice versa."
Gren says Sharon was instrumental in encouraging custodial and nursing staff to pass information freely among themselves and it's paid off.
She made it clear to both parties they have nothing to fear and their responsibilities and compliance requirements are clearly defined.
Sharon represented the prison health service during the development of advanced suicide training for nursing staff and unit managers. Then fittingly, she co-facilitated the first training course at Waikeria.
"Waikeria has had it's share of suicides but I know we've saved lives," says Sharon.
"One man told me how grateful he was to the staff who saved his life and for the support systems we put in place for him while he recovered in the At Risk Unit."
Gren says great work has also been done by Auckland Central Remand and Christchurch Men's Prisons which like Waikeria, have significantly reduced the suicide rate in their respective regions.
"All our prisons recognise the extent of the problem and they have worked very hard to address it. I'm proud of Corrections' contribution to suicide prevention. We are never going to prevent someone absolutely determined to end their life from doing so.
"Regrettably, an average of six to eight prisoners a year do commit suicide but that figure would be a great deal higher if Corrections' was not committed to finding solutions."
What are the statistics?
Apparent suicides in prisons have dropped significantly in the last ten years. In the 1997/98 financial year apparent suicides were 0.11 per 100 prisoners. That figure had almost halved to 0.06 in the 2006/07 financial year. Suicides are recorded as 'apparent suicide' until the coroner's report is completed. This can take up to 12 months.
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ISSN 1178-8453