A Listener's Perspective

One of the most devastating failures of the criminal justice system is the high rate of suicide among people in prison. Each life lost represents not just an individual tragedy, but a deep systemic failure. Prisons, by their very nature, can be incredibly isolating and damaging environments, but for those already struggling with mental health challenges, they can become unbearable.

The numbers alone are shocking. In the UK, people in prison are six times more likely to die by suicide than the general population. According to the Ministry of Justice, in the 12 months to June 2024, there were 85 deaths by suicide in prisons across England and Wales, but this doesn’t account for the countless incidents of self-harm and suicide attempts that never result in death. In recent government data, there were 1,886 reported incidents of self-harm among people serving an Imprisonment for Public Protection (IPP) sentence, and since 2005, 86 IPPs have taken their own lives while in prison.

But! These are not just statistics; they represent real people—mothers, fathers, sons, daughters—who felt so overwhelmed by despair that they saw no other way out. These deaths are preventable, and every suicide in prison is a failure of the system to provide adequate care, support, and hope to those in its custody.

According to a report by the Prison Reform Trust, 70% of people in prison suffer from two or more mental health disorders. Many enter prison already grappling with conditions like depression, anxiety, PTSD, and substance use issues. Half of the adult prison population is considered neurodivergent, but some organisations, like ADHD Liberty, believe this number could be even higher—possibly around 80% or more.

It's heartbreaking to hear about such struggles within the prison system.

Imagine someone who is already struggling with trauma, neurodivergence, or mental health issues, and then being placed in an environment where you are isolated from your family, confined to a cell for long hours, and deprived of meaningful human interaction. The conditions inside prison, such as overcrowding, lack of access to mental health care, limited support, and a lack of purposeful activity can trigger or worsen mental health crises.

I saw this firsthand during my own time in prison. I had the privilege of serving as a Listener for the Samaritans. Many of the people I spoke to felt trapped; physically by the walls around them, but also mentally by their circumstances, their trauma, and their isolation. The conversations I had with these men often revealed a deep sense of hopelessness. Some felt abandoned by society, while others were haunted by the guilt and shame of their past actions.

One of the biggest barriers to addressing suicide in prison is the culture of silence and stigma surrounding mental health. Many people in prison don’t feel comfortable speaking up about their struggles. They fear being seen as weak or worry that revealing their vulnerabilities will make them targets for bullying or violence. In a prison environment, showing emotional distress can feel dangerous.

Even when people in prison do reach out for help, the system itself is often not equipped to handle their needs. Mental health services in prison are underfunded and understaffed. Prison officers, while doing their best under incredibly difficult conditions, are not trained mental health professionals. As a result, signs of mental distress are often missed or misinterpreted. Someone acting out because they are in the throes of a mental health crisis might be punished with solitary confinement, which only worsens their mental state.

Solitary confinement, referred to as segregation, is one of the most psychologically damaging practices in the prison system. Being locked in a small cell for 23 hours a day with minimal human contact can quickly deteriorate anyone’s mental health, but for those already at risk of suicide, it can be deadly.

Numerous studies have shown that prolonged isolation can lead to increased anxiety, depression, hallucinations, and paranoia. For people in prison who are already vulnerable, the isolation and sensory deprivation of solitary confinement can push them to the edge. This is especially troubling when you consider that solitary confinement is often used as a punishment for people in prison who are already exhibiting distressing behaviour. In effect, we are punishing people for being unwell.

Prisons should not be places where people in crisis are left to suffer alone. Yet, many people in prison with serious mental health issues are housed in conditions that are not conducive to their recovery. There is often a lack of dedicated mental health professionals available in prisons, and the mental health services that do exist are often overwhelmed and under-resourced.

For example, while some prisons have access to mental health services or counselling, the demand far exceeds the supply. People in prison may wait weeks or even months to see a mental health professional. In the meantime, their symptoms can worsen, leading to self-harm or suicide attempts.

Also, medications for mental health conditions are sometimes poorly managed in prisons. There have been numerous reports of people in prison not receiving the correct dosages, missing vital prescriptions, or even being taken off their medications entirely without adequate monitoring. This can lead to dangerous withdrawal symptoms, increased instability, and an elevated risk of suicide.

One of the most effective ways to combat suicide in prison is through peer support programs, like the Samaritans' Listener scheme. As a Listener, I was trained to provide emotional support to people in prison, offering a safe, confidential space where they could talk about their struggles without fear of judgement or punishment.

Services like the listeners are crucial because they provide people in prison with someone who understands their experiences, someone they can relate to on a personal level. In an environment where trust is hard to come by, peer support can make all the difference. Listeners can offer empathy and prevent crises from escalating.

However, while these peer support programs are invaluable, they are not enough on their own. They need to be part of a broader strategy that includes better mental health care, more trained staff, and a system that prioritises rehabilitation and support over punishment.

The current prison model, rightly or wrongly, focuses heavily on punishment rather than rehabilitation, but in doing so, it fails to address the root causes of why many people end up in prison in the first place. For those struggling with mental health issues, prison can feel like a dead end—a place where their problems are ignored or punished rather than treated.

We need to rethink how we approach prison, particularly for people with mental health conditions. Instead of locking people away in environments that exacerbate their distress, we should be looking for alternatives, such as community-based treatments, mental health diversion programs, and rehabilitation services that give people the tools they need to heal.

Suicide in prison is not inevitable; it is preventable. But it requires us to look beyond the bars and recognise the people inside—people who are often deeply troubled and in need of help. If we continue to treat people as disposable, as mere numbers in a system, we will continue to see these tragic deaths. But if we treat people with compassion, if we provide people with the mental health care they need, we can start to turn the tide.

It’s time to rethink what prison is for. It should not be a place where people go to die, but a place where people can heal, reflect, and eventually reintegrate into society.

Every suicide in prison is one too many, and it’s up to all of us to demand a system that prioritises life, rehabilitation, and hope.