IAPDC finds death rates in prisons and under the Mental Health Act disproportionately high

We have today published our latest statistical analysis of deaths in custody which finds that people in state detention are at a significantly increased risk of death compared with the general population, with the rates of deaths in prisons and Mental Health Act (MHA) detention particularly high. Our analysis – which was carried out by IAPDC member Professor Seena Fazel along with his colleague Dr Amir Sariaslan at the University of Oxford – assesses and presents deaths in custody through the calculation of population rates.

The report looks at deaths from all causes, including self-inflicted deaths, which took place in prisons, police custody, immigration detention, and under the MHA between 2017 and 2021. This is the only research of its kind and is part of a series of analyses of deaths in custody we have carried out since 2011. You can read coverage of the report in the Independent.

While prisons have the highest number of deaths, with an average of 322 deaths per year, our report finds that patients detained under the MHA have the highest mortality rate across all places of custody – including three times higher than prisons – when taking into account estimates of time in custody and numbers of people in each setting. The report also finds that despite the low number of deaths in police custody, its rate of deaths is comparable to deaths in prisons when the approximate time spent in detention is factored in.

People in custody under the age of 40 have the highest rate of suicide and other unnatural deaths, while men continue to have a significantly higher rate of overall deaths across all custody settings. Gaps in the availability of published data, especially on deaths under MHA detention, mean it is not possible to identify the rate of deaths by race, ethnicity, or gender across hospitals and police custody. Information on the time that each individual spends in custody is not available but necessary to add precision to these findings. Poor data has been an issue for a number of years and has been directly linked to patient safety. Urgent improvements to the way data is recorded, published, and shared are needed to foster a culture of continuous progress in MHA detention.

Further, there remains an ongoing and troubling issue around the lack of independent scrutiny of deaths of individuals detained under the MHA. Unlike deaths in prisons, police custody, and immigration detention which are independently investigated prior to an inquest, deaths in secure health settings are often investigated by the same trust responsible for the patient’s care. Independent investigation of these deaths is needed to address the significant gap in learning and accountability needed to help prevent future deaths.

Professor Seena Fazel, IAPDC member, said:

“Our analysis shows that the number and rate of deaths in custody remain high. The availability, accessibility, and transparency of high-quality data is integral to our understanding of these deaths to help inform effective interventions. Despite the substantially elevated rate of deaths of individuals under the Mental Health Act, data in this area remains poor and inconsistent compared with other custody settings”

Lynn Emslie, Chair of the IAPDC, said:

“Each death in custody is devastating and has far-reaching impact. When a death does occur, it should raise searching questions for public services and the government about their ability to keep people under their care safe. I urge the government and all those involved in the care of people in detention to heed the findings of this report.”

You can read the report here.