Diabetic dying to get out of prison

Jane Wilson is 36 year old drug addict. She was referred to me for an alcohol and drug assessment after being charged with possession of methamphetamine for supply. She started using meth about ten years ago and began selling to friends and acquaintances to fund her habit. She had also been smoking cannabis since she was 14 – usually on a daily basis. I interviewed her in July 2012 in Arohata prison – by which time she had been on remand for three months as her case slowly winds its way through the courts.

This is not an uncommon story – except that Ms Wilson has diabetes, diagnosed at the age of 11. So for 25 years she has been injecting herself with insulin on a daily basis and usually requires five injections a day.

Diabetes requires careful management. Diabetics are supposed to test their blood sugar levels four or five times a day in order to know how much insulin to inject. A normal reading is between 4.00 and 7.00 mmol. Readings below 4.00mmol are potentially dangerous as the brain is being starved of oxygen – a condition known as hypoglycaemia. The patient becomes weak, anxious and confused and if the blood sugar level continues to drop, they may become comatose and die.

Diabetics generally carry barley sugars or something sweet to give their sugar level a rapid boost if it drops too low. Soon after arriving in Arohata, Ms Wilson was given a supply of glucose tablets and the prison nurse gave instructions that she was to have these with her ‘at all times’. The nurse then went on leave for eight weeks. Apparently believing that inmates cannot be trusted, even with glucose, prison officers took the tablets off her and kept them in the office. So whenever her blood sugar tested low, Ms Wilson had to press the emergency button in her cell and ask for help.

These requests were met with a variety of unhelpful or insulting responses such as: “I hope you’re not cunting us around Wilson.” On another occasion when her blood sugar was down to 2.4mmol, an officer said: “We can’t be doing this every night Wilson.” On yet another occasion, about half an hour before dinner was due to be served, her blood sugar dropped to 3.4mmol. She pressed the buzzer twice and was ignored twice. She had to ask the officer who brought the dinner to give her some sugar as well. Next day Ms Wilson told a nurse what had happened and was assured the officers would be spoken to. Later that day, a male guard said: “We don’t appreciate being complained about so don’t be expecting any favours.” Another officer told her: “It’s not all about you Wilson.”

In the report which I provided to the judge, I pointed out that this situation was making Ms Wilson very anxious. She was so upset she cried virtually every day, and became so depressed she needed antidepressants. She was afraid she might die from a hypoglycaemic attack because the prison officers just didn’t care. In my report I wrote:

1) Ms Wilson’s situation is complicated by diabetes. Her concerns about the quality of care she currently receives significantly exacerbate her underlying anxiety. Ms Wilson worries that she might die in prison because prison staff either don’t care or don’t know how to assist her regulate her blood sugar levels – especially at night when medical staff are not available.

2) Corrections Department rules make it difficult for Ms Wilson to gain effective control of her blood sugar levels. I spoke to the specialist diabetic nurse (at Kenepuru Hospital) who expressed particular concern about the last meal of the day in prison being served at 4:30 p.m. She said that to maintain control of their blood sugar levels, diabetics need to eat six meals a day and need supper before going to bed in order to avoid developing low blood sugar during the night. She said that ‘low blood sugar is an extremely dangerous condition’ for Ms Wilson.

3) In a recent report on the health of prisoners, the Ombudsman reported that: “Prisoners continue to complain that the national menus implemented by the Department do not consider the specific health needs of prisoners, especially diabetics.” Ms Wilson’s GP and the specialist diabetes nurse both expressed concern about the fatty prison food which is not good for diabetics. They both felt that the prison regime with limited physical activity makes it even more difficult for a diabetic to manage blood sugar levels which require an appropriate balance between food intake and physical activity.

After nearly four months on remand, numerous hypoglycaemic attacks and one emergency visit to hospital, Ms Wilson eventually appeared in Court. The judge showed compassion and released her on electronic bail while her case proceeds. But if she receives a sentence of more than two years, she will have to go back to prison where she will be exposed to the same kind of treatment all over again.

The IPCA – police watch dog is a real puppy

The Independent Police Conduct Authority (generally known as the IPCA) has just released a comprehensive report on police deaths in custody. There were 27 deaths in the last ten years – ten of which were suicides. Seven deaths occurred when police were overly vigorous in the use of restraint. Another seven were “caused by the detainees medical condition” (which got dramatically worse in police custody), and three deaths were drug related (because police failed to ascertain the detainees were even on drugs). But of the 27 deaths, the IPCA claims that only four involved serious neglect of duty or breaches of policy by police. Really?

On top of deaths in custody, the police shot and killed seven people in the last ten years. One was an innocent bystander, another two were not even carrying firearms. It seems they were killed for acts of vandalism and behaving in a threatening manner. The police were exonerated in all seven cases. Really!

Then there are the people who die in the course of police car chases. During the five years starting in December 2003, 24 people died and 91 received serious injuries in police pursuits. Over this period, the IPCA made numerous recommendations to change police protocols which made no difference at all – the death rate shot up even higher. In 2010, 18 drivers fleeing police were killed. In 2011, 15 drivers died in the course of police pursuits.

These figures don’t seem to take into account innocent bystanders or other drivers killed by these drivers which makes it hard to get accurate figures of the total numbers killed. But it seems to average out at about seven or eight deaths a year, although the numbers have escalated dramatically in the last two years.

Total number of police related deaths

This would suggest that altogether police have been involved in the deaths of about 100 people in the last ten years – 70 of them on the road. The number of injuries appears to be ten times that figure. A few police were told off, but apparently not one was charged with a criminal offence. Yes – really! Imagine would happen if the shoe was on the other foot. What if the police investigated 100 deaths but failed to prosecute even one offender? There would be a commission of inquiry and heads would roll.

Many would argue that the police are just doing their job. Even the IPCA believes these deaths are justified. For instance, in its report into the deaths of Norman Fitt and Deidre Jordan following a police pursuit, the IPCA found: “The Police pursuit of a driver who killed two other motorists in Christchurch in August 2010 was justified and was conducted according to law and policy.” What that seems to mean is that when the police do their job, 100 dead bodies is just collateral damage.

The police certainly seem to think so. Police Association president Greg O’Connor even says police should be exempt from laws which apply to everyone else. Senior police management seem to agree. In an internal review of police pursuits in 2010, the police concluded: “There is insufficient evidence to support the banning of pursuits. (Banning pursuits) is not likely to improve or guarantee public safety.” This shows a truly remarkable lack of insight. If police did not pursue these alleged offenders, approximately 70 people killed on the road in the last ten years would still be alive. That would be a huge contribution to public safety.

Which crimes justify dying?

This begs the question: what criminal offences committed by these drivers actually justify police action which leads to someone’s death – especially the deaths of innocent bystanders? Afterall, many if not most, police pursuits begin over fairly trivial offences – or simply when police try to pull someone over to ascertain if an offence has even occurred. Psychologist, Peter Coleman, an expert in youth offending, says teenage drivers who refuse to stop for police are often just addicted to the adrenaline rush. But if the offender flees, the police then pursue them out some macho need to be in control of the situation – all justified in the name of law and order.

IPCA inquiries which legitimise the policy of pursuit over minor infractions of the law simply add to the number of New Zealanders who get killed. In other words, the principle of law and order has become more important than life itself and agencies of the state actively sanction this slaughter. What the IPCA should be doing is questioning the entire policy of pursuit and holding the police accountable. Now let’s get back to their report on deaths in police custody.

Failure of police to assess risk

The report is highly critical of the way police assess the detainees’ risk of suicide or risk of death – from medical complications exacerbated by alcohol and drugs or from overly vigorous restraint by police. It says 55% of those who died were assessed by police as being at ‘no risk’. Another 30% were ‘not formally assessed’ at all. In other words, when it comes to assessing medical and suicide risk of vulnerable detainees, the police haven’t got a clue. But that’s not surprising; they’re not health professionals. But nurses are – and the IPCA recommends that the Police work with the Ministry of Health “towards extending the watchhouse nurse programme so that custody staff nationwide have better access to medical advice for detainees.” What the IPCA is suggesting is that we need to put nurses into every police station in the country.

Unfortunately, there are 19 other recommendations in the report and the IPCA has not prioritised any one recommendation over another. And the recommendation for more nurses is contradicted by another recommendation which says that “detainees who are unconscious or semi-conscious, unable to answer the risk assessment questions, and/or physically unable to look after themselves, must be taken to hospital.” The problem is the police don’t seem to know which detainees need to go to hospital.

The watchdog is a puppy

Let’s not forget that prisoners managed by the Corrections Department also have limited access to health care. Despite years of inquiries and recommendations by the coroner into (Corrections) prison deaths, the suicide rate is still going up. In 2011, the suicide rate in Corrections prisons was eleven times higher than the rate in the community. Prisoners keep dying no matter what coronial inquiries or the IPCA recommend. Perhaps that’s because they have the power to recommend – but not the power to prosecute. The IPCA is supposed to be a watchdog. Turns out to be more of a puppy – and very eager to please.

Prison protesters – all they need is a decent meal

A couple of prisoners at Paremoremo have just come down from a tower in the yard after a ‘peaceful protest against the Department’ – according to the message they apparently wrote with toothpaste on a black board. One of them was well known, Aaron Forden, aka ‘Houdini’ for his previous escapes. According to Peter Williams QC, who the prisoners wanted to contact, they were complaining about inhumane conditions and inadequate food.

This doesn’t make any sense. Prisoners live a life of luxury, don’t they, with underfloor heating, flatscreen TV, and three square meals a day. They don’t have to work or attend rehabilitation programmes – just sit around chatting with their mates planning what crimes to commit when they get out. Well that’s the stereotype.

The reality is something else entirely. In 2009 a report on Paremoremo described conditions at the prison as ‘putrid’ and found shortages of guards, lax security, and poor hygiene. The Ombudsman has also documented inadequate health and dental treatment of prisoners, including the denial of pain medication and pointed to breaches of the United Nations Standard Minimum Rules for the Treatment of Prisoners.

UN Minimum Standards for food

But let’s talk about the food. Article 20 of the UN Minimum Rules says “every prisoner shall be provided … with food of nutritional value adequate for health and strength, of wholesome quality… and drinking water shall be available to every prisoner whenever he needs it.”

The notion that prisoners get three square meals a day is a myth. Most inmates seem to think the food is barely fit for pigs – which is not surprising considering the Department spends only $4.50 a day on food for each prisoner. That’s $31.50 a week. That might have been a realistic figure 30 years ago but today it would barely buy bread for a week let alone three square meals a day.

Prisoner complaints about food

Prisoners frequently complain about the quality of the food. Last year one prisoner wrote to chief executive Ray Smith claiming that that prison food was ”high-salt, high-fat, high-sugar rubbish” and the meals were often inedible. The Ombudsman reported recently that “Prisoners continue to complain that the national menus implemented by the Department do not consider the specific health needs of prisoners, especially diabetics.”

Former Corrections Minister Judith Collins responded to these concerns with this churlish comment: “Stay out of jail if you don’t like the food.” The police seem equally uninterested in providing a healthy diet for prisoners. The Wairarapa Times recently reported that a young man who spent a weekend in the police cells was given nothing but noodles and cold water.

The link between diet and violence

Prisoners tend to have poor health and nutritious food is important. Recent research in the US suggests that the modern diet may be a factor contributing to violent behaviour in Western society. The study investigated the effects of omega-3 fatty acid supplements and hypothesises that modern industrialised diets may be changing the very architecture and functioning of the brain. It suggests the influence of poor diet is such that individuals may not always be responsible for their aggression – bringing into question the very foundations of criminal justice and the notion of culpability

Another study at Aylesbury prison in the UK raised prisoners’ intake of nutrients up to the level recommended by government guidelines. It was a placebo-controlled double blind randomised trial. The researchers found 231 volunteer prisoners and assigned half to a regime of supplements and half to placebos. It showed that when young men there were fed multivitamins, minerals and essential fatty acids, the number of violent offences they committed in prison fell by 37%. The prisoners taking the placebos showed no change in their behaviour.

A Dutch research team repeated the experiment and released this report “Effects of Nutritional Supplementation on Aggression, Rule-Breaking, and Psychopathology among Young Adult Prisoners.” The researchers urged caution in interpreting the results but said: “The prospect of influencing aggression and rule-breaking behaviour with nutrients in moderate doses is important enough to warrant further research. This is particularly true as adequate supplementation may also have beneficial effects on mental health and cognitive functioning.”

Although these studies do not suggest that poor diet alone can account for complex social problems, the former chief inspector of prisons Lord Ramsbotham says that he is now “absolutely convinced that there is a direct link between diet and antisocial behaviour, both that bad diet causes bad behaviour and that good diet prevents it.”

Violence in New Zealand prisons

It’s not entirely clear if the two prisoners who protested at Paremoremo were complaining about the food. But one thing is certain – violence in New Zealand prisons is on the rise. In 2011, 241 prison staff were assaulted and 862 prisoners were assaulted by other inmates. In May 2010, Jason Palmer, became the first officer to be killed in a New Zealand prison after he was punched by an inmate. Surely it wouldn’t do any harm to give prisoners decent food with adequate vitamins and minerals. It might even help reduce the number of assaults. It would certainly add to our reputation as a civilised country – instead of one that breaches basic human rights.

Suicide and abuse of power at Otago Correctional Facility

Debra Kaye has a young son in prison at OCF. On April 17, she wrote on BrookingBlog: “Currently in Otago Correctional Facility there are five men that have been locked up for twenty three hours a day in their punishment cells. They have been put into the management (punishment) wing for over three months and denied any freedom other than an hour a day of basic exercise. ”

They were put into the management wing because they “raised a peaceful objection to the fact that they were being unfairly treated in the wing they were previously in. The power was turned off by the wardens, the water was cold when showering, and they were left outside in freezing weather, rain and snow for long periods. They were also given meagre (amounts of) food which does not allow for growth development in young men.”

When the men complained, “This led to accusations and unfounded allegations directed at them and a serious beating and assault on one or more of them. They were put into lock down and their basic human rights denied for months on end!”

“The youngest (of these men) is 19 years old and has spent two years in OCF without attending any rehabilitation programmes. Apparently Corrections officers believe a prisoner has to earn the right to attend rehabilitation and they believe this is an acceptable way in which to teach prisoners about their wrong doing.”

The Coroner’s findings

Debra Kaye, who wrote this, is the mother of the 19 year old. As such one might wonder whether she is able to provide an objective account. Isn’t she just a naïve parent inclined to believe anything her son tells her. I don’t think so. She’s right about one thing at least. Prisoners who ‘misbehave’ are not allowed to attend rehabilitation. If the ‘misbehaviour’ is a trumped up, that’s just one of the many ways in which prisoners are denied access to rehabilitation programmes.

She also seems to be right about the abuse of prisoners at OCF – indeed, the coroner, David Crerar, has backed her up. Mr Crerar has just released his findings into the death in prison of Richard Barriball in which he was highly critical of Otago Corrections Facility (OCF) staff.

Barriball was found dead in his cell in conditions indicative of suicide on October 9, 2010. He was on remand at the time of his death. The coroner wrote that: “Richard Barriball considered that he was ‘set up’ in respect of the charges he was facing. The term of imprisonment he expected was uncertain. He also suffered from an underlying fear that he would be the victim of a prison assault.”

The coroner also noted that as a result of a recent operation on his arm, one of his arms was in a sling and Barriball was in a ‘considerable amount of pain’. However, the prison doctor withdrew three different painkillers which had been prescribed for him in the community. The coroner wrote:

“The causes of the death and the circumstances of the death of Richard Barriball have shown suboptimal care by OCF in two respects. One was the failure of OCF to provide delivery of prescribed pain relief at a time deemed most appropriate by clinicians”.

The other was that “his family’s concerns over his state of mental health went ignored by prison officials.” The coroner said two separate communications were made by family and by the prison chaplaincy expressing concerns to OCF about Barribal’s mental state. “This intelligence was not collected, recorded, reported or acted upon.” In the days leading up to Barriball’s death, Crerar said the stressors faced by Barriball, were overwhelming and this led to his suicide. In a separate case, the coroner was also highly critical of the way prison officers treated Anna Kingi who died in prison in 2008.

Systemic psychological abuse

In the Annual Report of Activities under the Optional Protocol to the Convention against Torture (OPCAT), which New Zealand signed in 2007, the Ombudsman expressed concerns about the treatment of vulnerable prisoners by the Corrections Department. Corrections refusal to provide medication to prisoners who are in pain has been discussed in this article: The prison health system – maybe it’s not torture, but it hurts like hell. The use of sleep deprivation and the ‘naked squat’ on mentally ill prisoners in New Zealand, is discussed here: Officers look up prisoner’s anus – 84 times in three weeks.

Are prison officers abusing their power and psychologically torturing the inmates? The evidence is mounting and it’s time for an inquiry – especially at the Otago Corrections Facility.

Officers look up prisoner’s anus – 84 times in three weeks.

Kim Dotcom recently spent a month on remand in Mt Eden prison after the Solicitor General bowed to pressure to have him extradited to the United States. The police took away his cars and froze his bank accounts. In prison, Corrections took away his blankets and deprived him of sleep – they woke him up every two hours. Dotcom said he was treated like a convicted criminal – as if depriving convicted criminals of sleep was a legitimate practice.

Sleep deprivation cells

It’s not legitimate. Sleep deprivation was declared illegal under Article 3 of the United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. New Zealand signed the convention in 1985. Then there’s Section 5 of the Corrections Act (2004) which requires the Department to ensure prisons are “operated in accordance with rules (and regulations) in this Act and… are based, amongst other matters, on the United Nations Standard Minimum Rules for the Treatment of Prisoners.” Rule 31 states: “All cruel, inhuman or degrading punishments shall be completely prohibited.”

The management of Corrections just ignore all this – sleep deprivation is a deliberate and daily practice in New Zealand prisons. What’s worse, it’s reserved primarily for those who are least able to cope with it – prisoners who are suicidal and psychologically vulnerable. The Corrections Department even has special cells for suicidal prisoners with camera surveillance 24/7 so the prisoner can be observed at all times – including on the toilet. Anything the prisoner might use to commit suicide is taken away; they’re not allowed underwear, clothes, sheets or blankets – in case they rip them up to use as a rope. All they get to wear is a canvas tunic. It’s so tough it can’t be ripped – and it’s very uncomfortable.

Throughout the night, the lights come on automatically every 30 minutes, so staff can see if the prisoner is doing anything – other than sleeping. Euphemistically, the Department calls these ‘At Risk’ cells. In reality, they’re Sleep Deprivation cells and Corrections has 160 of them.

The naked squat

Sleep deprivation is not the only breach of UN Rule 31. Another is ‘the naked squat’. I heard about this from a prisoner who spent a weekend in these so-called ‘At Risk’ cells. Immediately after being sentenced, he was taken to the Receiving Office at Rimutaka prison. There he was told to strip naked in front of four officers, and crouch down so the cheeks of his bum spread apart. Two officers got down and looked up his anus – to see whether he had a cell phone, drugs or other contraband hidden up there. Then he had to stand and hold up his penis and scrotum so they could see if he was hiding anything under his genitals. Finally they looked under his armpits and into his mouth.

After this inspection, the prisoner was asked: “How are you feeling?” He replied: “A bit delicate.” That was enough to warrant a trip to the ‘At Risk’ cells. Two officers escort him, and hand him over to another set of officers – who tell him to strip off once again. He protests – somewhat timidly – saying he’s just been searched five minutes ago. But it’s in the rules. All prisoners being admitted to the At Risk/Sleep Deprivation cells have to be searched. So once again, he strips off and does ‘the naked squat’ while more officers eagerly examine every orifice.

In the morning, he’s taken to the shower block – where pretty much everything he does can be observed. Once he’s brought back to his cell, he has to do the squat again. Then he’s taken to a different cell to have breakfast. He asks why? No one seems to know. After breakfast, he’s brought back and once again, the officers examine his anus and genitals. The same thing happens after lunch and after dinner. He’s required to perform ‘the naked squat’ every time he comes back to his cell. Why? Because he’s a prisoner, a species less than human, and it’s in the rules. In the course of one weekend, he had to spread his cheeks 11 times.

Another extremely vulnerable prisoner was kept in these Sleep Deprivation cells for three weeks. Imagine that – anxious and suicidal, nothing to do, no TV, no distractions for three weeks on end – except the lights turning on and off all night; and nothing to look forward to except the intense embarrassment of performing the naked squat in front of prison officers who want to examine every orifice four times a day. Don’t forget, this is all happening in a secure environment where the prisoner has no contact with the outside world – where it is simply not possible to find anything to put up your arse, except perhaps a piece of soap from the shower. But why would you want to do that? This prisoner endured this indignity four times a day for three weeks – that’s 84 times. How degrading is that?

Anal analysis

The ideal treatment for depressed or suicidal patients would generally include emotional support, counselling and/or antidepressant medication. For such patients, getting a good night’s sleep is paramount. Treatment should focus on improving the prisoner’s state of mind.

But the prisoner is not really human. He’s barely an animal, so the treatment is focused on his anus – and keeping him awake for days on end. This is an appalling abuse of power – and a breach of the Corrections Act and United Nations Conventions. Dotcom was right. He was tortured. When this sort of abuse happens in other countries, Amnesty International and a few academics are quick to point out the perpetrators. Meanwhile, the abuse of sleep deprived prisoners in New Zealand has been going on for years. The Corrections Department is obsessed with this anal analysis – unfortunately, the rest of us don’t seem to give a shit.

Roger Brooking

Author of Flying Blind – How the justice system perpetuates crime and the Corrections Department fails to correct

The prison health system – maybe it’s not torture, but it hurts like hell

Section 5 of the Corrections Act requires that prisons are “operated in accordance with rules … that are based on the United Nations Standard Minimum Rules for the Treatment of Prisoners.” However, in its report titled “Investigation of the Department of Corrections in relation to the Access and Availability of Prisoner Health Services”, the Ombudsman found numerous failings in the delivery of health services. He also said the Corrections Department does not meet Article 22(1) of the UN Minimum Standard Rules – which requires every prison to have at least one qualified medical officer, who should also have some knowledge of psychiatry.

Mental torture

This rule appears to be breached by virtually every prison in the country. The Ombudsman found that “Many medical officers have limited training in psychiatry and… some prison healthcare teams had no mental health nurses to provide specialised care to those who fell beneath the threshold of severe and enduring illness.”

To put it bluntly – this is crazy. More than half of prisoners have had mental health problems; 60% have a personality disorder; almost two thirds have had a serious head injury and 90% have a history of alcohol and drug abuse. But the level of psychiatric care in prison is minimal. In an interview with psychiatrist and Parole Board member, Dr Phillip Brinded, the Sunday Star Times reported that “If a prisoner is so psychotic they can’t be managed, they will join the ‘acute’ list and get to hospital within days, but those who are just quietly off their rocker can languish on the ‘sub-acute’ list for many months. It seems that in order to get treatment in prison, you have to go really mad.”

Dental torture

This is not the only UN Rule breached by the Corrections Department. For instance, Article 22 (3) states that “The services of a qualified dental officer shall be available to every prisoner.” That sounds reasonable. Prisoners tend to have chronically poor oral health care and the Prisoner Health Survey (2005) found that one third of those interviewed reported having a toothache in the previous month. However, Corrections has difficulty securing the services of dentists – presumably because the Department doesn’t pay dentists as much as they can earn in private practice. Because of recruitment difficulties, the Ombudsman reported that the Department has been flying a dentist from Wellington to Christchurch to provide dental care for prisoners at all three Canterbury prisons.

Even in those prisons where dentists are available, the waiting list is up to three months. But here’s the real toothache. The Department has a “minimum dental services policy” whereby pain relief only is provided to most prisoners – which may include medication, extraction, or drainage of an abscess. Early treatment with amalgam fillings – which would prevent further decay – is not provided. Now that’s really crazy.

But the pain gets worse. Prisoners near the end of their sentence are not eligible for any dental treatment at all – they just get medication. The Ombudsman gave case histories of prisoners who had severe tooth decay who were not allowed by prison nurses to even see the dentist. For some of these prisoners, the decay eventually turned into an abscess. One prisoner reported that “his jaw ached, his glands were swollen, and he had a sore ear – and he couldn’t sleep.” All he got was panadol and told to “see a dentist when you get out.” That may not be torture – but it sure as hell hurts – night and day – for months on end.

Lets ratchet up the screws

The Ombudsman concluded his report with a recommendation that responsibility for the health care of prisoners should be removed from the Corrections Department entirely and given to the Ministry of Health. The MOH agrees. A study released by the Ministry in 2010 says “An inherent tension exists between a custodial role and the delivery of comprehensive, high quality health services… current institutional arrangements prevent medical professionals from fully exercising their duty of care.”

Corrections Minister, Anne Tolley, and chief executive, Ray Smith, are clearly unconcerned. They want to reduce, rather than increase, the role of medical professionals in prison. Legislation was introduced to Parliament in February giving nurses rather than medical officers (doctors) overall responsibility for the healthcare of prisoners. Up till now, Medical Officers who are contracted to Corrections have been responsible. Being on contract, they have some independence and can make decisions based on ‘best practice’. But prison nurses are employees not contractors – they can be told what to do by prison managers who have no medical training whatsoever.

This legislation will increase the ‘inherent tension’ which already exists and further erode the standard of medical care in prison. Some would say – but they’re all crims in there, so who cares? No one in the Corrections Department, that’s for sure. Their attitude seems to be – if we can’t torture them, let’s make sure they feel the pain.

Howard League calls for 50% cut in prison population

The Howard League for Penal Reform is calling for a 50% reduction in the prison population. On Monday April 2^nd the Wellington Branch of the League held its inaugural meeting at Parliament hosted by Labour’s Charles Chauvel. Other speakers at the opening included the Deputy Leader of the Labour Party Grant Robertson, VUW criminologist Dr Elizabeth Stanley and Peter Williams QC.

At the meeting spokesman Roger Brooking pointed out that New Zealand’s rate of imprisonment is about 200 people per 100,000 of population. According to the International Centre for Prison Studies in London, this gives New Zealand the second highest rate of imprisonment in the Western world. On a population basis, we lock up more people than Britain which has an imprisonment rate of 155, Australia at 124 and Canada at 117.

New Zealand’s rate puts us in the company of Third World countries like Mexico and Libya – where thousands have died in a civil war and drug related violence – but which have similar rates of imprisonment to New Zealand. Our rate puts us ahead of South American countries like Argentina, Venezuela, Colombia and Honduras.

Mr Brooking pointed out that Honduras is one of the most violent countries in the world with an average of 20 murders a day. Mr Brooking said: “In 2011 there were 39 murders in New Zealand, which is less than one murder a week. One a week is still too many – I know – but guess what. NZ locks up more people per capita than Honduras. Their rate is only 154 per 100,000.”

‘We like locking people up’

“There is no doubt that we are a very punitive society” said Mr Brooking. “We like locking people up”.

This is very strange when you consider that from an international perspective, New Zealand is perceived as a peaceful country. For the last two years in a row, New Zealand has topped the Global Peace Index – out of 149 countries.In 2010, New Zealand was also ranked third by the United Nations out of 169 countries in terms of ‘human development’ – defined as ‘the economic and political freedoms required to live long, healthy and creative lives’.

Mr Brooking pointed out that altogether more than 20,000 New Zealanders spend time in prison each year. 80% are given short sentences and are in and out of prison in less than six months. Mr Brooking said: “Our prisons have become a revolving door for those who repeatedly commit relatively minor offending – usually under the influence of alcohol and drugs. Our prisons have become a holding tank for alcoholics and drug addicts. We use them to provide warehousing for the mentally ill and those with brain damage. The majority of these people should be in treatment, or in supported accommodation, not in prison.”

The Government is planning to build a new prison at Wiri at a cost of $900 million. Mr Brooking said: “We don’t need another prison. According to the Corrections Department, there are currently 1,600 empty beds in New Zealand prisons already. If the government is willing to spend $900 million, let’s put that money into early intervention programs, drug courts, increased treatment facilities in the community, and supported halfway houses for prisoners on release. Let’s put more fences at the top of the cliff instead of building yet another prison at the bottom.”

Open letter to Gerry Brownlee – and his little piece of Finland

Dear Gerry,

Thank you for comparing New Zealand to Finland and bringing these remarkable differences between our two countries into the open. Professor John Pratt, a criminologist at Victoria University has been making similar comparisons for years – but no one seems to listen. That’s a shame because Prof Pratt is recognised by those in his field as a world authority on the subject.

What’s more, Prof Pratt actually knows what he’s talking about. He’s been to Finland, undertaken extensive research and written numerous articles and books on the subject – so if you want to make another speech about Finland, perhaps he could help you out.

Here’s something Prof Pratt could tell you.

In 1950, the Finns had an imprisonment rate of 187 inmates per 100,000 of population. New Zealand’s rate in 1950 was less than a third of that – at 56 inmates per 100,000.In the latter half of the 20^th century, the Finns became concerned that they were out of line with their more civilised Scandinavian neighbours, which had low rates of imprisonment. This led to dramatic changes in penal policy, as a result of which the number of people in prison slowly began to drop. By 2001, the rate was down to only 40 people per 100,000 – an extraordinary reduction of 78% in the prison population.

During the same 50 years, New Zealandwent in the opposite direction. In 2001, instead of being three times less, our rate of imprisonment was three times higher than Finland’s – at 150 inmates per 100,000. Since then, the New Zealand rate has continued to grow and in November 2011, the figure was at an all-time high of 199 per 100,000. During this time we’ve had to build five new prisons – and even put prisoners into shipping containers.

How did the Finns manage to reduce their prison population? Commenting on the Finns’ success, Prof Pratt wrote:

“Key people in that society – people who actually knew something about penal policy and the consequences of imprisonment: academics, judges and senior civil servants – felt that the high prison population was shameful”.

In New Zealand, the media (and the politicians) mostly seem to consult Garth McVicar – a self-proclaimed cow cocky from Napier with no qualifications in psychology, sociology, criminology or anything else remotely connected with penal policy. No wonder our prisons are overflowing and your government is going to build another one at Wiri – with $900 million of our money.

Ironically, your Government has also announced a reduction in reoffending as one of its ten key goals. If you’re serious about that – go to Finland and see for yourself. Anne Tolley went – and now she’s the Minister of Corrections. The two of you could compare notes. And another thing – Finland has the most comprehensive victim compensation system in the world. You could take Garth McVicar with you. He might learn something about helping victims instead of spouting off about locking up more and more people.

So my advice, Gerry, is give Prof Pratt a call on your Nokia – on your little bit of Finland. You might learn something about how to reduce reoffending, help victims and save the country billions in prison costs.

Drinking too much water to be an offence

A Bill has just passed its first reading in the New Zealand Parliament which will enable prisoners to be charged with an offence for drinking too much water. Corrections Minister Anne Tolley said: “The Bill will make it an offence for a prisoner to ‘waterload’ prior to a drug test. This means that a prisoner can be disciplined if they are found to be attempting to dilute their urine sample by intentionally drinking large amounts of water prior to being tested.”

This is nonsense – prisoners don’t know when they’ll be tested. The drug tests are generally random so it’s virtually impossible to ‘intentionally’ drink large amounts of water prior to being tested. If a prisoner is thirsty and drinks a lot of water, and if a random drug test is done soon afterwards, this will now constitute ‘misconduct’.

Double jeopardy -‘bashful bladder’

When prisoners are made to do a drug test, there are usually two or three prison officers watching. Some people find this so off-putting they can’t pee. The inability to pee in front of others is a well-known psychological condition called paruresis – sometimes referred to as ‘bashful bladder’. The condition affects around 7% of the population. Those with mild paruresis are able to urinate in certain circumstances but incapable in others. In British prisons, paruresis is considered a valid reason for a prisoner’s inability to produce a sample and is not to be construed as an offence. However, in New Zealand, failing to supply a sample in prison is classified as ‘misconduct’ – and is automatically assumed to indicate a positive result.

If a prisoner has any misconduct offences on their file in the six months before appearing at the Parole Board, their chances of being released are substantially diminished. In prison you have to keep your nose clean (and now your bladder empty) to have any chance of release. One female prisoner I worked with developed paruresis after being sexually abused. She was charged with misconduct when she failed to produce a sample in front of three officers. She appealed to a visiting Justice of the Peace to have the ‘misconduct’ removed from her file but the process took so long she ended up serving her whole sentence.

Another case involved a young female prisoner who has been in prison for seven years without using drugs. She was doing well and had been given privileges such as a minimum security classification, living in a self-care unit within the prison and for the last two years working outside the wire on day-release. She was almost ready to be released. When asked to provide a random urine sample, she was watched by an officer for 5 hours. She couldn’t provide enough urine for the test and was deemed to have refused. She was charged with misconduct and punished. Her security classification was raised to medium-high; she lost her job; she was taken out of self care and put back into a mainstream unit. Now she is so depressed she feels like giving up.

A male prisoner diagnosed with prostate cancer was also affected by paruresis and told me can’t pee when officers are watching. The prison medical staff know he has had cancer but won’t accept that he has paruresis. They told him he would have to pay for a private psychiatrist to come into the prison to make a diagnosis – at a cost of about $5,000.

Denial of rehabilitation

This Bill provides one more mechanism for punishing rather than rehabilitating prisoners. Any ‘misconduct’ in prison (such as a positive drug test or failing to provide a urine sample) leads to a denial of privileges – including attendance at rehabilitation programmes. Prisoners with drug problems have to give up drugs first and have a record of good behaviour before being allowed to attend drug treatment. Now it seems they have to stay thirsty as well. If they drink too much water and have diluted urine – that’s misconduct – meaning no rehabilitation.

There is no need for this punitive piece of legislation. The number of prisoners caught smoking cannabis is on the decline. In the last few years, Corrections has tightened up security and fewer drugs are smuggled in. In 2010, only 10.5% of prisoners tested positive on random drug tests – the lowest result since drug tests began in 1998. In contrast to this, in 2011, only 1,255 prisoners attended rehabilitation programmes targeting their offending. That’s about 5% of the 20,000 people who end up in prison each year. The Department doesn’t need to be more rigorous about drug testing. It needs to stop putting up barriers and put more prisoners into rehabilitation.

Roger Brooking: Author of Flying Blind – How the justice system perpetuates crime and the Corrections Department fails to correct

It doesn’t add up – the muddled mathematics of prison closures

The Government has announced that two old prisons will close – Wellington’s Mount Crawford Prison (which holds 120 prisoners) and the New Plymouth prison (which holds 112). That’s a total of 225 prison beds that will go – permanently. And about time too – those places are pre-historic. However, the closures are being used to justify building a new prison at Wiri which will house 960 prisoners. 960 new places to replace 225 old ones. That’s ridiculous – there are already 1,200 empty prison beds across the country. Once the new Wiri prison is built there will be 2,000 empty beds. This just doesn’t make sense. Mount Crawford, New Plymouth, Arohata and Rolleston hold 700 prisoners between them. They could all be closed tomorrow and there would still be spare capacity.

Instead, the Government announced that some units in Arohata, Rolleston, Rangipo and Waikeria prisons will also close. Does adding (or subtracting) a few units from the equation justify a new prison? Not really. Units which close can be opened again. Mount Crawford closed for 12 months between June 2008 and July 2009 but reopened when the prison muster went through the roof. So unless these old units are torn down, they’re not really closing at all. The Government is just hedging its bets with a dollar both ways – actually $900 million – which is the anticipated cost of the new prison. This is what punters do when they don’t know which way to go.

The lack of direction

Corrections Minister Anne Tolley and chief executive Ray Smith should be providing direction. But they seem really confused. In an attempt to justify the closures, Mr Smith said: “Every attempt would be made to ensure as many inmates as possible were housed in prisons near to their families.” He must be joking. The Department makes very little effort to place prisoners near their families. It’s closing two small prisons which actually enable prisoners to be near their families and moving them into mega prisons away from their families. Corrections moves prisoners around for all sorts of reasons. It moves them away when rehabilitation programmes it wants to put them into aren’t available in the local prison. It also moves them away from their families when the local prison is full – which it usually is. The Department moves prisoners around for whatever reason it chooses and in 2011 spent over $1 million transferring prisoners from once place to another.

Mr Smith’s vision has been clouded by the Department’s overpaid policy analysts and spin doctors. He went on to say: “The changes … will give Corrections a strong platform from which to target re-offending rates.” Yeah right! In 2000, the Department introduced “Integrated Offender Management” (IOM) system which was described at the time as “the biggest single initiative the department has undertaken to reduce reoffending”. It made no difference whatsoever. Canterbury University criminologist Dr Greg Newbold described it as “Another wreck on the scrapheap of abandoned fads of criminal rehabilitation.”

In 2006 the Department dropped a rehabilitation programme called Straight Thinking after an evaluation found it increased reoffending rather than reducing it – after putting over 10,000 offenders through it. In 2008, the Department introduced a new programme called the MIRP – or Medium Intensity Rehabilitation Programme. This is described on the Department’s website as: “A generic programme to teach offenders how to alter the thoughts, attitudes and behaviours that led to their offending and assist them to develop strategies for maintaining any positive changes made”. More prisoners now do the MIRP than any other rehabilitation programme. The problem is – it doesn’t work either. Corrections recently discovered it doesn’t reduce re-offending at all. They just haven’t told anyone yet.

Because these programmes don’t work, over 50% of those released from prison are back inside within five years. The reality is that nothing the Department has ever done has changed these figures. It makes no difference whether the prisons are old, new, small or large. These stats remain the same.

In the meantime, Finance Minister Bill English says the Government is facing the biggest deficit in its history. Thousands of public servants are being laid off, the gap between rich and poor is growing and more and more Kiwis are leaving the country. These stats are all going up. Meanwhile, crime is on the decline, the prison population is dropping and there are 1,200 empty prison beds. These stats are all going down. But the new prison at Wiri is going ahead anyway – at a cost of $900 million. This just doesn’t add up.

The MIRP doesn’t work

The Government has set 10 targets for the public sector over the next three to five years. One of those targets is a reduction in criminal reoffending. The responsibility for this clearly falls on the Corrections Department – which currently provides a number of rehabilitation programmes focussed on different aspects of offending such as anti-social thinking, drug addiction or a propensity for violence.

Most offenders are referred to the MIRP (Medium Intensity Rehabilitation Programme) which is available both in prison and to offenders in the community. The MIRP was introduced by Corrections in 2008 and replaced a programme called Straight Thinking which had been the cornerstone of the Department’s rehabilitation efforts for years. The Department’s website says: “The aim of (Straight Thinking) is to assist offenders address one of the main causes of their offending – that is the lack of critical reasoning required for social integration”.

Between 2000 and 2006, over 10,000 offenders were required by Corrections to attend Straight Thinking. The problem was – it didn’t work. The Department cancelled it in 2006 after an evaluation found it increased the likelihood of offending rather than reducing it.

The flaws in the programme

One of Straight Thinking’s flaws was that it was a cognitive skills programme requiring better than average literacy skills – a bit of a rarity among those in prison. According to Corrections executive prison manager, Dr Brendan Anstiss, such programmes ‘have at best a modest effective on recidivism’. And yet the Department went on to introduce the MIRP – described on its website as: “A generic programme to teach offenders how to alter the thoughts, attitudes and behaviours that led to their offending and assist them to develop strategies for maintaining any positive changes made”.

This sounds remarkably similar to the description of the Straight Thinking programme it replaced. In 2010, the Department completed an initial evaluation which indicated the MIRP reduced subsequent re-imprisonment by 2%. The Department seemed to think this was a good outcome – the Annual Report for 2010 described the result like this:

“The results reflect a period of delivery (2008-09) during which this programme was rapidly expanded across the country, involving considerable training and support provided to the programme delivery workforce, which suggests that, once fully bedded in, this programme will produce significantly positive outcomes”.

One of the Department’s critics, Roger Brooking, was not so sure. In Flying Blind – how the justice system perpetuates crime and the Corrections Department fails to correct, Mr Brooking wrote: “This sounds like more managerial spin. The reality is that the MIRP is just another cognitive skills programme, which according to Dr Brendan Anstiss ‘have at best a modest effective on recidivism’. In that it doesn’t treat drug and alcohol problems, it seems doubtful that it will be much more effective than the programme it replaced.”

Mr Brooking was right. The programme is now bedded in and the Department’s Annual Report for 2011 (on page 16) shows the MIRP is no more effective than the programme it replaced. Although there is a small reduction in reoffending in the first 12 months, after two years, the reduction in the rate of imprisonment by those completing the programme is reported at 0.0%. It has no long term benefit.

Corrections Department’s double standard

In other words, if the Government is to achieve any reduction in re-offending, it will not be achieved by the Corrections Department. Government will have to rely almost entirely on Serco which currently runs the Mt Eden prison and will soon be given the task of running the new prison at Wiri. Making sure that Serco performs better than Corrections, the private provider will be punished by the Department if they don’t. The NZ Herald reported: “Serco will face stiff financial penalties if it does not meet rehabilitation targets – which will be set at 10 % lower than public prisons.”

Serco (but not Corrections) also faces penalties if prisoners escape – they had to cough up $150,000 to Corrections in February when a prisoner escaped from Mt Eden – even though two prisoners escaped from Corrections prisons on the same day. It seems there’s one rule for Corrections (we don’t have to achieve anything) and another rule for Serco (you have to do better than us).

Anyway, Serco has to reduce reoffending by ten per cent less than zero. Sounds like a walk in the park – well it will be if more prisoners escape.

Financial crisis solved – govt finds $900 million for new prison

The Government has just given the go ahead to Corrections to build a new 960 bed prison at Wiri – to be run by Serco. The prison is expected to cost over $400 million to build with another $500 million in operating costs. In other words, nearly $1 billion of taxpayers’ money is going to be spent at a time when the government is facing the biggest deficit in its financial history and public servants are being laid off left, right and centre. The chief executives of the 30-plus departments and ministries who have head offices in Wellington are under huge pressure to produce what the Treasury calls “efficiency dividends”. Even the police are not exempt and have been told to save $350 million in the next three years.

But financial restictions don’t seem to apply to the Corrections Department. New Zealand has built five new prisons in the last ten years – four under the previous Labour Government and one under National – the new Mt Eden prison also run by Serco. Corrections is about to become the biggest Department in the country and the bill to the New Zealand taxpayer for locking all these people up has more than doubled since 2004-05.

But in 2011, for the first time ever, the Justice Sector forecasts indicated that crime was on the decline and the prison population was beginning to drop. The forecasts show the prison population should drop by 3000 by the time the new Wiri prison is complete in 2015. In other words, New Zealand doesn’t need a new prison.

Corrections propaganda

But Governments like building prisons – just in case they decide to be ‘tough on crime’. So they need to make up excuses – well lies really. One of the justifications given for the new prison by Corrections Minister Anne Tolley is that it will allow the Department to close down Mount Crawford prison in Wellington. This makes no sense whatsoever. Mount Crawford has only 120 prisoners – while the new prison at Wiri will hold 960. Because of the declining prison population, Mount Crawford could be closed right now without the need for another prison to be built.

The other justification given by the Government is that the new prison will be run by Serco who will run it more efficiently than the Corrections Department. That doesn’t seem likely. They’ve just been fined $150,000 because a prisoner escaped. They will also be fined if they fail to reduce reoffending by 10% more than the Corrections Department prisons. Good luck with that.

And let’s not forget that Serco runs the Federal Detention Centre for asylum seekers on Easter Island and has an international record of abusing prisoners even forcing them to sleep in toilets. New Zealand prisoners also sleep in the toilets – but do we really want to fork out $900 milion so that Serco can be more efficient at abusing New Zealand prisoners than the Corrections Department.

The $900 million could be better spent on early intervention programs, funding drug courts, extending addiction treatment in the community and building a system of halfway houses to support inmates leaving prison. But it won’t be. It’ll be spent on the new prison. Who said crime doesn’t pay? It certainly does. If I was a public servant in some other government department and had just lost my job, I’d feel seriously aggrieved.

Sleep deprivation and pain medication – how Dotcom was ‘tortured’ in prison

Internet tycoon Kim Dotcom recently spent a month in the Auckland Central Remand prison (ACRP) after the US government persuaded New Zealand police that his file sharing company, Megaupload, was infringing US copyright laws. ACRP is run by Serco, an international conglomerate which runs prisons in a number of countries including New Zealand. In Britain, Serco prisons have been criticised for institutional meanness and forcing prisoners to sleep in toilets. In 2011, the company was criticised over the suicide of a 14 year old boy who was mistreated by staff in one of its British prisons. Serco also runs the overcrowded Australian Federal Detention Centre for asylum seekers at Christmas Island. In November 2010, 230 asylum seekers in the island prison began a hunger strike; 20 prisoners sewed their lips together and one Iraqi Kurd, a man in his 30s attempted to commit suicide. In 2011, the New Zealand Government allowed Serco to take over the management of ACRP which is primarily used to hold prisoners on remand.

14,000 New Zealanders are sent to prison on remand every year. Mr Dotcom was also on remand, denies he has done anything illegal, and appears to have a good case. But according to the NZ Herald, he was treated like a convicted criminal. He reports that on the first night he wasn’t allowed blankets or toilet paper and was woken up every two hours. The mattresses used by prisoners are really thin (about two inches) and the beds are solid concrete. Most prisoners find them uncomfortable – let alone someone as big as Dotcom. In other words he was subject to sleep deprivation – which he said felt like torture.

The Minimum Prison Standards

Sleep deprivation is no joke. In fact it is an enhanced torture technique used by the CIA because it leaves no scars or visible signs. When taken to extremes, it drives the victim insane. New Zealand legislation covering the treatment of prisoners is contained in the Corrections Act passed in 2004. Section 5 of the Act requires the Department to ensure facilities are “operated in accordance with rules (and regulations) in this Act and… are based, amongst other matters, on the United Nations Standard Minimum Rules for the Treatment of Prisoners.” UN Rule 31 states: “All cruel, inhuman or degrading punishments shall be completely prohibited.” Such treatment is also illegal under Article 16 of the United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment which New Zealand signed in 1985.

Sleep deprivation is not the only inhumane treatment Dotcom was subject to. He was also taken to and from court in a prison van – chained to a metal seat inside a small cage. This aggravated a back injury. He told the NZ Herald that one trip caused shockwaves of pain up his back, after which he required treatment in the prison medical unit. He couldn’t walk so Serco staff dragged him to the unit on a blanket where he was given Paracetamol and a wheel chair.

Violence and suicide in NZ prisons

Despite such incidents, the Corrections Department would have us believe that NZ prisons are safe and humane. Let’s look at the facts. The number of inmates with gang affiliations has doubled in the past five years and, what a surprise – the number of prisoners attacking other inmates has also doubled. In May 2010, James Palmer (an American) became the first prison officer to be killed in a New Zealand prison after he was punched by an inmate and cracked his skull on the concrete floor. In 2011, the number of serious assaults on staff went up by 600% on the on previous year. Prisoners are raped and many commit suicide.

The stress of being on remand while waiting for police to bring the charges to court is often a contributing factor to these suicides. In 2010, four residents from Feilding killed themselves while awaiting trial or sentencing in the space of three months. Statistics released by the chief coroner’s office found that 27 prisoners on remand have killed themselves in the last few years and the number of remand prisoners who commit suicide has more than doubled in the last two years. In 2010 in addition to those who died, another 190 prisoners attempted suicide.

Denial of appropriate pain medication

Because of increased levels of violence, prisoners sometimes end up in hospital – with broken limbs, head injuries or perhaps an eye poked out. Prisoners also get sick with cancer, heart disease, abscesses and infected teeth. Sometimes they have back injuries like Kim Dotcom. But no matter how bad the pain, Paracetamol is all they get. If they have an operation in hospital and need morphine for pain relief, when they get back to prison, the morphine is taken away.

The Ombudsman recently conducted an investigation into the health and medical treatment of prisoners. His report makes it clear that prisoners are entitled to the same level of health care as anyone else in the community but cites numerous incidences where prisoners in severe pain were denied medically prescribed pain killers. The Ombudsman reported: “We were told by prisoners that they are frequently advised by custody staff, ‘to take paracetamol and lie down’ or ‘paracetamol will fix everything’. Many prisoners told us that paracetamol does not relieve the level of pain they experience.” In a previous post, it was reported that the Corrections Department denies access to certain psychiatric medication; for instance hundreds of prisoners in New Zealand have ADHD but are not allowed Ritalin in prison.

Conclusion

So let’s get the story straight. New Zealand prisons are far from ‘safe’; neither are they ‘humane’. There is no doubt that Kim Dotcom was subject to cruel and inhuman treatment by Serco. He was not the first – and he will not be the last. Cruel and inhuman treatment is a daily occurrence in our prison system; by denying prisoners medication prescribed by specialists, prison health services are complicit in this torture. And let’s not forget that Dotcom’s prosecution is being driven by the United States – a country which endorses the use of enhanced torture techniques at Guantanamo Bay and flights of rendition to allow prisoners to be tortured in other countries. We should keep a close eye on what happens at Serco-run prisons in New Zealand.

The ritalin rules in prison

ADHD stands for attention hyperactivity disorder. Kids who’ve got it are either inattentive, hyperactive, impulsive or sometimes all three – and it affects between 3% and 5% of school age kids. As at July 2009, there were 760,859 children attending school in NZ which means somewhere between 23,000 and 38,000 children have the disorder.

According to a New Zealand support group, as many as two-thirds of children with ADHD have additional problems. 30-50% will have conduct disorder – a childhood behavioural problems which sometimes leads to anti-social personality disorder in adults. 20-25% of those with ADHD will have anxiety problems. Generally 20-30% of ADHD children also have learning problems and struggle to read and write. For approximately 75% of those with ADHD their symptoms continue into adulthood, although levels of hyperactivity may decrease with age.

What causes it? It may be genetic. But whatever the cause, the majority of evidence suggests that in those with ADHD, the frontal cortex of the brain under-performs leading to a loss of attention, planning and impulse control. It responds to stimulant medications (including ritalin). Although ritalin is a stimulant, paradoxically it has a calming effect on people with ADHD. This is because it stimulates the frontal cortex which generally improves concentration and impulse control for the sufferer.

Dr Paul Taylor, a paediatrician in Nelson, estimates that about 43% of those who end up in prison have ADHD. That means in New Zealand prisons, there are currently about 3,700 prisoners who may benefit from ritalin or a similar medication. In 2012 I made an official OIA inquiry to the Corrections Department asking how many prisoners were currently prescribed ritalin (or an equivalent). The answer was 17.

Risk factor for substance abuse and offending

When ADHD is not treated, it becomes a significant risk factor for substance abuse and criminal offending. So treating it is especially important for those who end up in the justice system. When left untreated, prisoners with ADHD struggle to concentrate in rehabilitation programmes and may become disruptive. This happened to Mr Chris Wills, an inmate in Mt Crawford prison, who I interviewed prior to his parole board hearing in 2012. Mr Wills has a long-standing drug problem and for many years self-medicated his ADHD with methamphetamine (another well-known stimulant). Eventually he sought help from mental health services in the community and was prescribed ritalin. He ended up in prison shortly thereafter, and without consulting a doctor, prison management took him off it.

Sometimes prisoners’ behavioural problems become so bad, the prisoner ends up in 24 hour lock-up. This happened to Mr Kurt Winklemann who was sent to prison for an assault in 2008; he had ADHD and was also denied ritalin when he got to prison. His behaviour deteriorated and he ended up in the ‘management unit’ for difficult prisoners. Rehabilitation programmes are not available in the management unit. To get into rehabilitation, you have to behave yourself first – without your medication.

Drugs of abuse

The Department generally justifies the denial of ritalin to prisoners on the grounds that it is a drug of abuse. So is methadone. But offenders who are sent to prison while on methadone still get it – because opiate addicts on methadone are less likely to re-offend when they get out. In 2011, 89 prisoners were on methadone. It’s dispensed in a controlled environment under strict supervision – and there is absolutely no reason why ritalin could not be dispensed in the same manner.

Inmates are also not generally allowed opiate based pain killers either – no matter how much pain they’re in. If a prisoner requires hospital treatment and is given morphine for pain relief, once they return to prison, the morphine will be terminated. This is because the Department regards opiates as drugs of abuse. So if a prisoner gets stabbed, has a broken leg, or a tooth removed, no matter how bad the pain is, probably all he will get is Panadol.

Back to the ‘ritalin rules’. On February 12, 2012 the Herald on Sunday ran a story about Mr Wells and Mr Winklemann. Acting National health manager for the Corrections Department, Bronwyn Donaldson, was quoted as saying that “Ritalin was available for some prisoners. An alternative was given to inmates who are at risk of abusing the drug.” Really? In 2010, there were 560 teenagers in New Zealand prisons and over half have ADHD. In my work as an alcohol and drug counsellor, I have interviewed dozens of prisoners with this condition. Not one was on ritalin or any other medication.

Prisoners set up to fail

What this all means is that prisoners with ADHD (and other mental health problems) are set up to fail. Not only does Mr Wills struggle to focus while attending rehabilitation in prison, he also needs to attend a drug treatment program when he gets out. He comes up for parole shortly but two community-based treatment programs have already declined to accept him until he is stabilised on medication. Catch-22. Mr Wills is likely to relapse to methamphetamine or other drugs as soon as he gets out. He needs to be stabilised now – while he’s still in custody.

One more point. Appropriate medical treatment is a basic human right and the Department has a statutory obligation to provide it. Section 75 of the Corrections Act 2004 states that: “A prisoner is entitled to receive medical treatment that is reasonably necessary” and “the standard of healthcare that is available to prisoners in a prison must be reasonably equivalent to the standard of healthcare available to the public”.

By denying prisoners access to appropriate medication, not only does the Department set them up to fail, it is also in breach of the Act. The Department should get its Act together – and read the rules instead of making up its own.

Corrections escapes but punishes Serco

The NZ Herald reported today (February 21) that Serco, the operator of Mt Eden prison has been fined $150,000 after a prisoner escaped. Serco is an international conglomerate based in Britain and given the contract to run the Mt Eden prison.

The Corrections Department has carried out a review of security after notorious inmate Aaron Forden escaped from the prison in the early hours of October 10, 2011. Corrections and Serco say both operational security and the physical security of the building infrastructure have now been enhanced.

Department of Corrections Chief Executive, Ray Smith, says a portion of the payment to Serco for the management of Mount Eden prison is performance-related and that it’s appropriate to levy a financial penalty for the escape. It seems that Corrections is not only responsible for administering punishments imposed on offenders by the courts, it is also responsible for punishing its approved private prison partner.

What about Corrections’ performance?

Does this mean that if anyone escapes from a prison run by the Corrections Department, they will pay the Government $150,000? Of course not. What a shame. Two escaped in the last 24 hours – one from Rangipo prison and the other from hospital in Chrischurch while undergoing medical treatment. It seems that between five and ten prisoners escape every year so if Corrections had to pay up every time, it would be penalised about $1.5 million a year.

Shouldn’t Corrections also be performance related for its (lack of ) success at rehabilitating and reintegrating prisoners. 70% of prisoners re-offend and 52% are back in prison within five years; nothing the Department has done it in its entire history has reduced recidivism one iota. Shouldn’t the Department be required to pay back $150,000 to the government every time a prisoner re-offends and returns to prison. That would buck up their performance.

Maybe that’s too much to ask. With that level of accountability, given its current record, the Department would have to pay back its $1 billion budget every year.