Prison suicides swept under the Cornerstone

The suicide rate in New Zealand prisons is eleven times higher than in the general population – and since 2008, more than 75 prisoners have died . This self-destructive slaughter has much to do with high rates of mental health problems combined with poor quality psychiatric care in prison. Doctors and nurses who treat prisoners are simply unable to provide an equivalent level of care to that received by patients in the community. In 2011, the Ombudsman called this a “serious concern” and recommended responsibility for healthcare of prisoners should be removed from the Corrections Department and given to district health boards.

Prison managers don’t like that idea as it might lead to a small loss of control over their caged in kingdom. The Department would rather paper over the cracks by having its 19 prison health centres awarded Cornerstone accreditation. Cornerstone is a seal of approval granted by the Royal New Zealand College of General Practitioners to health and medical centres that meet a defined set of standards called Aiming for Excellence – standard for New Zealand general practice.”

The standards for ‘general practice’

In order to meet the standards, a health centre first has to meet the definition of “general practice”. The RNZCGP has 12 criteria which define general practice. The first is that the centre must provide “personal, family and community oriented comprehensive primary care…” That should rule out every prison health centre in the country – since none of them are ‘family or community oriented’. The treatment is not exactly ‘personal’ either – which medication prisoners receive is dictated by Corrections’ Medicines Policy which states that doctors are ‘discouraged’ from prescribing opiate pain killers (like morphine and tramadol), anti-anxiety medications (such as valium), sleeping pills like zopiclone and mood stabilisers like ritalin – because these are  considered drugs of abuse.

The second criterion is that the health centre must provide ‘open and unlimited access to its users…”  That should also exclude every prison health centre – since prisoners don’t have open and unlimited access to anything.   Despite the fact that prison health centres do not appear to meet any of the criteria for a ‘general practice’, five prisons in the country have been granted Cornerstone accreditation. What’s more, Corrections is aiming to have all 19 prison health centres in the country accredited in the next two and a half years.

Suicides at Otago prison

The health centre in Otago Corrections Facility (OCF) is one of the five. How did that happen when the Department’s own ranking system puts  Otago prison at the bottom of its’ performance ratings.  Health care in Otago prison is so poor that about two years ago, two prisoners died within three months of each other.  Richard Barriball was a victim of Corrections ‘discouraged’ medication policy; they took away his methadone, his tramadol and his diazepam.  In severe pain from a serious arm injury, he committed suicide a week later. The coroner said the prison  failed “to provide delivery of prescribed pain relief” and that Mr Barriball received “sub optimal care”.

Jai Davis died in OCF in February 2011.  He came in over the weekend – when the prison doctor was off duty – suspected of ‘internally concealing’ drugs.  He should have been taken directly to hospital to be examined, x-rayed, and monitored. Instead, he was taken to OCF which is 45 minutes’ drive from the nearest hospital. He was placed in the at risk unit where he was supposed to be observed every 15 minutes. No one bothered to call the doctor – the nurses just ignored him and he died two days later.

These deaths were described as suicides, so at the time, police never bothered to investigate. Soon afterwards, the Otago Daily Times reported that the health centre at the prison was given Cornerstone accreditation.  Prison nurse Jan Horne was quoted in the story saying that accreditation “put the health centre and the staff on par with other medical centres around the country”.  Yeah right! But  that’s Corrections plan for suicides in prison – get the RNZCGP to rubber stamp the process and hide the bodies under Cornerstone accreditation.

The process of accreditation

Why does the RNZCGP collude with the Corrections Department in this cover up?  I contacted the College and asked how the accreditation process works.  I was told that when the College evaluates a prison health service, no one actually talks to any prisoners; no one asks whether they are satisfied with the service; no one finds out how many complaints have been made; no one contacts the Health and Disability Commission to find out if any complaints have been investigated; no one contacts the Ombudsman to see if prisoners complain about health care more than any other aspect of prison life; no one even asks if any prisoners being treated by the prison health centre have died recently.

But there is a process – prisoners can make a written complaint. Great – except that 90% of prisoners can barely read and write.  And there is a box to put the complaints into.   Great – provided the nurses don’t throw the complaint in the bin. So there is a process – and as far as RNZCGP is concerned, that box is ticked. But prisoners are still dying. When they do, the box is a really big one – it’s called a coffin.

5 thoughts on “Prison suicides swept under the Cornerstone

  1. I spent 12 months in Auckland Regional Corrections facility , the med centre there also received a Cornerstone award.These are my personal observations:
    * The doctor never looked at anyone, she would face her computer screen and talk to you.
    * The doctor was anti any vitamin supplements despite inmates being menopausal, alcohol affected, iron deficient etc….
    * Panadol was the only pain relief available
    * One prisoner fell off a sofa because staff did not provide a ladder to take down Christmas decorations (OSH issue) She waited 3 weeks for her broken foot to be taken seriously.
    * Prisoners are denied prescribed psychiatric medication.
    * Parasuicide or suicidal thinking is considered “attention seeking”
    * Many women are suffering from post traumatic stress disorder. Nothing is done for them.
    * Women are too scared to admit to depression, trauma for fear of being put under obs in an inhumane policy “until they come right” still with no real help.
    * Anyone who challenged the doctor was labelled offensive and confrontational (as was my shy 62 year old roommate)
    * Written communication to the Human Rights Commission disappeared.

    On a positive side “most” the nursing staff were good, and several were outstanding. The dentist, while pleasant, gave me the most painful oral health tooth clean I have ever had!

    Here are some other considerations for women’s health in prison.

    * While mammogram checks are offered, few women want to go through the indignity of yet another strip search after going to the offsite clinic, they are cuffed and escorted in the clinic.
    * Our bodies are not shaped like male body’s . So a 1″ mattress on a steel bed frame has in my case caused ongoing hip problems, caused sleep deprivation at the time and back problems.

    Generally though society does not care…they only see bad arsed criminals who deserve everything they get. In actual fact many of the women should not be there, they are not all thugs and violent criminals, many are older; mothers, grandmothers, some are physically disabled, most are poor. In a civilized society they would have help for their addictions, unwellness, abuse and lack of education and lack of suitable legal representation.

    From my personal experience NZ Prisons are run by despots living in their own little kingdom, they are emotionally and rationally retarded, have small regard for the United Nations Declaration of Prisoner Rights, no regard for Human Rights, pay lip service to the Treaty of Waitangi and break nearly every legislative requirement from occupational safety to medical care….sometimes I wonder…just who are the criminals?

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  2. Where do you get the prison suicides statistic? You cite Wikipedia, but the reference has been removed, probably for good reason.

    From what I can find, the actual rate is 0.053%, compared to 0.011% in the general population. That’s 5 times higher, not 11 times higher. See eg. http://www.nzdoctor.co.nz/media/1978444/suicide_data_2011_2012.pdf and http://www.stats.govt.nz/browse_for_stats/snapshots-of-nz/yearbook/society/crime/corrections.aspx

    A quick Google shows mainstream media gets it right while the blogosphere tends to use this mysterious 11 times figure.

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    1. Chris, There is no ‘right’ as the rate varies from year to year. Generally the prison rate is between 4 to 6 times higher than the community rate. In 2011, there were 12 suicides in prison so that year the rate was 11 times higher.

      And don’t forget, committing suicide in prison – with limited access to ways and means and constant supervision – is a lot harder than killing yourself in the community where mostly no one is watching. Prison officers also stop many prisoners in the middle of trying. If they didn’t stop them, the prison rate would be about 30 times higher than the community rate – every year.

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        1. In 2012 the rate in the community was 12.34 suicides per 100,000 of population.’

          The Departments Annual Report for that year (Page 15) shows there were 12 suicides and 23 “self-harm threat to life incidents”. That’s a total of 35 suicides and near suicides (out of total of 8,500 prisoners) giving a rate of 411 per 100,000.

          411 divided by 12.34 gives a suicide/attempted rate which is 33 times higher than the community rate.

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