WORMWOOD SCRUBS PRISON (RICHARD HOLMES) (Hansard, 4 July 1968)

§ Mr. Austen Albu (Edmonton)

The case of the suicide in prison of Richard Holmes has been the subject of correspondence and discussion between my noble Friend, Lord Stonham, and myself, and I am grateful to my noble Friend for the care and attention which he has paid to it. My hon. Friend the Member for Barking (Mr. Driberg), who knows the parents of Richard Holmes, has taken a great interest in the case as well and attended the inquest. He would have been here, but he happens to be abroad.

Richard Holmes was by all accounts a very attractive young man, known to many of my friends in my constituency, and at one time he was active in our Young Socialist movement. I have no doubt that he was also a very sick boy. He had treatment for mental illness in several hospitals over a number of years.

On his nature I can perhaps not do better than to quote a letter from a young man who was for a short time a fellow patient of his at Roffey Park mental hospital and is now in the United States. He wrote: Dick had the natural ability to bring out the best in everybody. All who knew him at Roffey were charmed by him, and many, in the short time he was with us, came to love him. But he added: When Dick walked into a room, for me, at least, a feeling of serene happiness entered with him. Yet there was no serenity within him. His whole life was a constant inner struggle: one of self-questioning and self-doubt. For heaven knows what reason he felt himself a failure. On 20th February, 1967, this very sick boy, in a fit of jealous despair, made a violent attack on his girl friend. He was taken to Brixton Prison and charged with attempted murder. On 22nd March he appeared at the Old Bailey and was put back on remand pending psychiatric reports. Here the first tragic error in his history occurred, because he was sent back to Brixton as a convicted per- 1860 son and treated as such. Nevertheless, because he injured his hands while injuring his girl friend, he was all that time in the prison hospital. The senior medical officer examined him, and also wrote to the Prince of Wales Hospital and Roffey Park and North Middlesex Hospital, in all of which he had been treated.

There is some confusion about this correspondence. The senior medical officer said at the inquest that he had received no reply from the first two, but the consultant who attended the boy at the Prince of Wales Hospital says that there is no record of any letter from the senior medical officer at Brixton, while the hospital secretary of Roffey Park confirmed to the boys' parents in a letter on 29th January, 1968, a copy of the medical report sent to the medical officer of Brixton Prison on 28th February, 1967.

However, the medical officer received reports from the two consultants at the North Middlesex Hospital who treated or examined Holmes on separate occasions. The senior medical officer therefore prepared a report which referred to the views of these doctors, and I believe that he came to much the same view about the boy's condition, that is, that Richard Holmes was very sick and had a psycho-pathological personality and suicidal tendencies. In fact, by that time he had already made one or two suicide attempts.

The defence asked that the boy should see another consultant, and this took place on 6th May. The consultant, a psychiatric consultant, reported his findings in a letter to the defence solicitor, but not to the prison authorities. I have reason to believe that his findings were very similar to those of the doctors who had previously examined Holmes.

Further confirmation of the boy's condition is that on 28th March he told another prisoner on exercise in Brixton Prison that he would commit suicide. He was thereupon put in a special room in a special canvas suit, which, by some barbaric custom, is still used on these occasions. The next day, according to the medical officer he "promised to behave", and this apparently satisfied the medical officer. That is a most extraordinary judgment by somebody supposed to be judging the condition of a very sick boy. 1861 There was no doubt by that time of his condition.

On 26th May Holmes appeared at the Old Bailey. The Brixton senior medical officer and the psychiatrist whom the defence had asked that the boy should see both gave evidence. The recorder sentenced Holmes to life imprisonment, but made it absolutely clear that he did so on the basis that Holmes should receive psychiatric treatment, and would be released when the medical authorities thought it safe to do so. Incidentally, the defence psychiatrist had warned of the possibility of attempted suicide if Holmes lingered in prison and stated that he thought that he should be transferred to Grendon psychiatric prison immediately. Holmes was sent to Wormwood Scrubs Prison.

It is not clear whether the prison staff at Wormwood Scrubs were immediately informed of the seriousness of Holmes' condition. The recorder had ordered that the doctors' reports should be sent with the papers, but there appears to have been some delay about this. However, the boy went straight into the prison hospital, I think because of the injuries to his hand, but he was not seen by a medical officer until ten o'clock in the evening. The medical officer slated at the inquest that he had carefully interviewed Holmes to ascertain the state of his mind. There is some doubt as to the length of this interview as the prison officer present at the interview changed his original report, in particular, in this respect before the inquest at the suggestion, apparently, of the medical officer.

The medical officer found Holmes' condition "apparently good—not actively suicidal." He was therefore kept in a room on a medical observation landing, but no special precautions such as are normally taken in suicidal cases were taken in this case—that is, a light was not kept on in his room, certain articles of clothing were not removed, there was no instruction for half-hourly observation. In the morning, Holmes was found hanging dead from his belt.

At the inquest, the medical officer at Wormwood Scrubs admitted that his diagnosis was tragically wrong. In view of the massive previous evidence, I do 1862 not know how to take this statement. It certainly was tragically wrong. But I feel that it was a good deal more than that.

This is not the only suicide which occurred that year in that prison. There were four in the same year. The jury at the inquest recommended a review of the observation landing procedure, but I suggest that this is not enough. What is needed is a drastic overhaul of the methods of dealing with mentally sick prisoners. I am forced to the conclusion that some prison officers lack interest in these cases. I know nothing of their qualifications to deal with mental illness, although I know from my experience as a member of a hospital management board about the very great difficulty in obtaining doctors with adequate psychological training.

However, something is drastically wrong with a system that allows a desperately sick boy, sentenced by a judge for the express purpose of getting him cured, to be taken to prison and treated in such a way that on the night he killed himself he could write to his parents: Nobody here is at all interested in what the judge said or recommended or the reason he sentenced me to life. All they know here is I have a life sentence and will be treated the same as anybody else with a life sentence. In the utter despair of that belief, Richard Holmes killed himself.

What I want to hear from my hon. Friend is, not a defence of the indefensible, but what measures have been taken to carry out the promise which Lord Stonham gave me that steps would be taken to ensure that avoidable tragedies like this do not occur again.

§ The Under-Secretary of State for the Home Department (Mr. Elystan Morgan)

I am sure that everyone who has been concerned with this tragic case will share the deep sense of loss in seeing a young man of undoubted intelligence and very considerable potential end his life in this way. Our deepest sympathy goes out to his parents and with our admiration of their courage and the way in which they have tried to ensure, through the efforts of my hon. Friends the Members for Edmonton (Mr. Albu) and Barking (Mr. Driberg), that their 1863 tragedy might be the means of preventing similar tragedies in the future.

My hon. Friend the Member for Edmonton has outlined the events which led up to the death of Richard Holmes, and I will not dwell on them. I would, however, say that on the day of his admission to prison Richard showed no signs of stress when examined by the medical officer at Wormwood Scrubs, and that doctor decided that, despite his history, there was no need for special precautions beyond keeping him on the mental observation landing at the prison hospital for further assessment. As we have heard, however, during the night Richard took his life by hanging.

At the inquest, to which allusion has been made by my hon. Friend, the jury added a rider to their verdict to the effect that while no one had failed in his duty under the existing system, there should be a review of the arrangements for observation on the mental observation landing during the time that the night patrol officer is in charge.

I am sure that my hon. Friend would wish me to concentrate, as he has said, on the measures which have been taken during the year since Richard Holmes's death to eliminate as far as is humanly possible the risk of suicide in prison generally and in prison hospitals in particular. I think it is generally agreed that the prevention of suicide has to be tackled on three levels.

In the first place, practical steps must be taken to ensure that the obvious and most frequently used means of suicide are kept out the reach of patients. Secondly, there must be provision for early recognition of the potential suicide and adequate and carefully-planned supervision of such patients. Thirdly, there is the need for research and long-term planning to throw more light on the phenomenon of suicide and to create the kind of atmosphere in which potential suicides will be able to come to terms with themselves and with society.

I should like to take first the strictly practical measures which have been taken to prevent suicides. By the end of last year, action had been taken to make available for all male prison hospital patients special clothing which 1864 avoids the use of belts, braces and shoelaces and is worn without a tie. Belts have been found to be the most frequent means of suicide in prison service establishments.

It is important in dealing with the mentally disturbed or those with suicidal tendencies to avoid giving any impression that they are being singled out for special treatment. To circumvent this difficulty, the special clothing is now standard dress in prison hospitals and is issued to all patients whether or not they are suspected of having suicidal tendencies. It is not practicable to provide such clothing for the whole of the prison population, but it is open to the medical officer to order this special clothing for prison inmates with suicidal tendencies even when they are not in hospital. Another means of reducing suicide is the increased use of locking razors which prevent the removal of blades by the patients.

The design of cell doors and the planning of hospital accommodation are also important factors in this problem. Cell doors are being altered to provide much larger flaps, allowing better all-round observation of the interior of the cell and ward accommodation, as opposed to single cell accommodation, is being incorporated in planning development for prison hospitals.

The practical measures which I have described will, I am sure, go a considerable way towards lessening the risk of suicide, but to be really effective they must be accompanied by constant vigilance on the part of prison and medical staff to identify the potential suicide at an early stage and keep him under close supervision.

That brings me to the second part of action which has been taken. The standing orders for prison establishments relating to the suicide problem have now been redrafted so as to highlight the dangers, and the revised orders were issued in the form of a special circular instruction early this year. The circular provides for patients admitted to prison hospitals to be placed in one of the following three categories after examination by the medical officer. The first category is that in respect of which there must be a special watch and, indeed, continuous supervision. Patients in this category are kept 1865 in staff wards or other suitable rooms and are under continuous supervision by staff at all times.

The second category is those in respect of which a special watch has to be kept. Patients in this class are kept under close supervision but they may be let out of sight for brief periods if circumstances make this necessary. If the patient is let out of sight, however, the officer responsible is required to take frequent looks at him and to ensure that close supervision is resumed as soon as possible. The third category is that in respect of which no special arrangements for supervision are required and, indeed, only general supervision is exercised.

The circular also provides that a patient exhibiting marked depression or emotion, with or without suicidal tendencies, should be located, if possible, in association in the hospital under special watch and continuous supervision by hospital officers, unless the medical officer considers that, because of a danger of violence to himself or to others, it is not safe to locate him in association and orders him to be located in a room under special watch.

Particular attention is drawn to the requirement that any officer, including the medical officer, chaplain and minister of any religious denomination, who has direct contact with a prisoner, should report in writing to the governor any statement by a prisoner which might imply that he would be likely to attempt to commit suicide.

Finally, the circular gives the following guidance to officers in recognising suicide risks. I quote here five points from that part of the circular. First, attention should be particularly paid to previous suicide attempts, gestures or threats, as a substantial proportion of those who commit suicide have such an earlier history. Secondly, a history of aggressive behaviour, recent withdrawal from drugs, impulsive or hysterical temperment and complaints of anxiety and despondency are all features of importance. Thirdly, in the older age group the often concealed and not readily detectable severe depressive illness may lead to suicide in the early morning. Fourthly, inmates under remand or awaiting trial are equally 1866 liable to commit suicide as those who have been sentenced. Fifthly, inmates in prison for the first time are equally liable to commit suicide as those who have been in custody previously.

I should like to conclude with one or two general remarks about the suicide problem in prison establishments and to give some indication of the longer term measures which are being taken by the Home Department. The total number of suicides in England and Wales each year is of the order of 6,000 persons, and of these no more than 12 take place in prison establishments. I concede that this is 12 too many cases of the destruction of human life and personality. Each is an episode which challenges authority to tackle this problem which has been mentioned by my hon. Friend. I stress that these are averages that have occurred over the last ten years. The figure of 12 suicides a year in prison must be viewed against the background of a constantly shifting average prison population of some 33,000 persons. A very high percentage of these have a history of broken homes, social isolation, criminality, propensity to violence, alcoholism and drug addiction, and these are the same factors which are commonly found in the history of those who take their own lives.

The prevention of suicide in prison requires not only physical measures to deprive the potential suicide of the means of killing himself, but also the creation of a climate of hope and incentive and the early recognition and treatment of prisoners with depressive or other mental illness. With these aims in view the prison medical service is conducting a research project from central returns into the problem of suicide in prison establishments to try to evaluate the many factors involved and to discover any trends or patterns which might indicate the kind of preventive action which ought to be taken. It would be misleading, however, to suggest that there is ever likely to be a completely foolproof safeguard against the patient determined to take his own life.

I think it will be clear from the measures I have outlined that much has already been done to avoid a repetition of the tragic death which has led to this debate, but my right hon. Friend the 1867 Home Secretary and those of us concerned with this problem are aware that it is a long way from being resolved and we shall keep the results of the measures I have announced under constant review and not hesitate to strengthen them at 1868 any time if this should appear necessary in the light of experience.