Although the deaths of offenders under supervision have received less attention than deaths in other criminal justice institutions, there is evidence to suggest that the mortality rate amongst this group is higher than the general population. The following section provides a review of existing research on this topic focusing on prevalence, official statistics and risk factors.
Pritchard et al. (1997) examined suicide and violent death in a six-year cohort of male probationers in England and Wales for the period 1990–1995 and found that males (aged 17–54) had twice the death rate and nine times the suicide rate of the general population. In a study for the Home Office, Sattar (2001) found that deaths following release from prison tended to occur soon after release. A quarter of deaths within her sample of 1267 deaths in the community in England and Wales occurred within 4 weeks of release from prison. Over half occurred within 12 weeks of release, and within 24 weeks of release just under three-quarters of all deaths had occurred. The number of deaths in the community was five times the rate of the 236 deaths of prisoners and the mortality rate for supervisees was four times higher than that for the male general population rate. Solomon and Silvestri (2008) found that the rate of suicide of those under probation supervision was nine times higher than in the general population and higher than in prison. King et al. (2015) found that 13% of suicides in the general population in England and Wales were, or had recently been, under supervision by the criminal justice system. They reported a significantly elevated suicide risk among individuals who had received a police caution, recently been released from prison, recently completed a supervised community sentence, served other community disposals, been remanded as a suspect on police bail and/or dealt with by no further action (King et al., 2015: 175). Interestingly, they found that ‘individuals serving a community sentence under the supervision of the Probation Service had a relatively low risk’ of suicide (2015: 175). King et al.’s (2015: 176) findings were not statistically significant but they point to the potential for probation supervision to serve as a protective factor and ‘as a crucial source of support for vulnerable offenders’.
Internationally, a high mortality rate amongst people under criminal justice supervision in the community has been consistently identified. For example, In Australia, Biles et al. (1999) found that people under probation supervision had a higher mortality rate and suicide rate than the general population and people in prison. In Denmark Webb et al.’s (2011) analysis of suicide amongst people in the criminal justice system identified an elevated risk of suicide and Binswanger et al.’s (2011) analysis of deaths after leaving prison shows a mortality rate that is 3.5 times that of the general population.
Trends and themes within English and welsh official data
In 2016 the Ministry of Justice (2016a) published, for the first time, data on deaths of offenders in the community. This means that we now have a better understanding of trends regarding deaths within the offender population in England and Wales. That said, it should be noted there are concerns about the quality of these data, as noted elsewhere (Phillips et al. 2017). For example, data from the years 2010–2013 contained many gaps in terms of type of sentence and offence category and it is worth noting that recording practices changed over this period. Moreover, two (out of 21) Community Rehabilitation CompaniesFootnote 1 (CRCs) failed to report any information by the Government’s cut-off date for the 2016–17 figures (Ministry of Justice 2017a). In order to compensate for this latter point, Government statisticians have adjusted figures for earlier years by removing deaths from the two missing CRCs ‘so as to provide like-for-like comparisons with 2016-17’ (Ministry of Justice 2017a: 5). Thus trends over time should be treated with care.
Nevertheless, the government’s own publication shows that in 2015/2016, there were 725 deaths of offenders in the community, a 30% increase from 557 deaths in the previous year. Of the 725 deaths, 264 were self-inflicted and show an increase of 40% from 2014/2015. A further 68 were accidental and there were 22 apparent homicides. The remaining 371 were from natural causes or unknown (Ministry of Justice, 2017a) Table 1.
The category ‘unclassified’ refers to those deaths for which a cause was unknown at the time of reporting and has not yet been updated. The latest data give some information on deaths of offenders supervised by the National Probation Service as opposed to those supervised by the CRC and there are some points worth noting here. As the Ministry of Justice highlights;
In 2016/17, the proportion of self-inflicted deaths in the NPS was lower than the proportion of deaths due to natural causes. The opposite is true of the CRCs, where self-inflicted deaths accounted for a higher proportion of deaths than natural causes. This is only partly explained by the different age distributions of the supervised offenders. When comparing on a like-for- like basis, CRCs had a drop in the number of self-inflicted deaths compared to the previous year, whereas the NPS saw an increase (Ministry of Justice, 2017a: 8).
Drawing again upon the Ministry of Justice’s analysis, there were 372 deaths of offenders under post-release supervision in the community after a custodial sentence in 2016/17. This represented 50% of all deaths of offenders in the community. Although in absolute terms these were similar between NPS and CRCs (180 and 192 deaths respectively), in relative terms deaths under post-release supervision represented 41% of all deaths in the community while supervised by CRCs, but 65% of all deaths while supervised by the NPS. The Ministry of Justice argues that the ‘sizeable increase in deaths since 2014/15, corresponds with the introduction of ORAFootnote 2’. However, it is worth noting that when we break this down to people on post-release supervision, the number of self-inflicted deaths rose from 40 to 117 (an increase of almost 300% between 2013/14 and 2016/17) whilst the number of people on post-release supervision rose by just 179% (from 39,565 to 70,650) over the same period (Ministry of Justice, 2016b). It is possible that changes to recording methods account for some of this discrepancy but probably not all.
It is also worth commenting on deaths that occur within Approved Premises (AP) which are used to house high risk offenders, normally upon release from prison. APs are akin to bail hostels or halfway houses and are generally run and managed by the National Probation Service, although in recent years there has been some outsourcing of certain tasks, such as staffing night cover and there are a number of independent Approved Premises. According to official statistics (Ministry of Justice, 2017a) there were 13 deaths of offenders resident in Approved Premises in 2016/17. The number of deaths have ranged from 9 to 15 deaths a year since 2010/11 which accounts for 2% of all deaths of offenders in the community. The majority of deaths of offenders in Approved Premises were male, while females accounted for three deaths. Approved Premises fit into our current system very uncomfortably not least because there is acute demand for more space. This is particularly the case for women, so much so that a woman won her case before the Supreme CourtFootnote 3 in 2017 on the grounds that provision of APs constitutes direct discrimination against women which is unlawful unless justified, and that the Secretary of State had shown no such justification (see R (Coll) v Secretary of State for Justice  UKSC 40). At that point there were 94 APs for men, distributed around England and Wales including several in London. There are only 6 APs for women, who constitute 5% of the prison population, and none of them is in London or in Wales. This means that women are much more likely than men to be placed in an AP which is far from their homes and communities. Deaths that occur in Approved Premises are investigated by the Prisons and Probation Ombudsman (PPO) in the same way that deaths that occur in prison are investigated. The people who die whilst residing in an AP are the only probation supervisees whose deaths are investigated by an independent investigatory body in accordance with Article 2 of the Human Rights Act 1998. In our analysis of PPO reports into deaths in APs we found that drug use was a major concern both in terms of the risk associated with problematic drug use that is common to people who are required to live in APs as well as around the poor level of drug treatment available to people in prison in the first place and then during the transition into the community (Phillips et al. 2016). We also raised concerns around staffing levels, especially at weekends, as well as some issues around decision making and partnership working.
In addition to the Ministry of Justice’s analysis we have conducted analysis of the raw data in research on behalf of the Equality and Human Rights Commission which focused on people who died within 28 days of leaving prison. Our analysis (Phillips et al. 2016) showed, confirming findings from elsewhere, that the first week after leaving prison was the highest risk with 66 people dying within 28 days of leaving prison. By far the most common cause of death among this cohort was a self-inflicted overdose (n = 44) and the most common offences were acquisitive (n = 35), an offence type which is commonly associated with problematic drug use. The majority (n = 37) of those 66 deaths occurred in the first 2 weeks after release.
People under supervision have a higher mortality rate than the general population although data for England and Wales are slightly outdated. However, prevalence only tells part of the story and if concerted action can be taken to prevent suicides in the future we need a better understanding of the risks that people face that may increase the chances of them taking their own lives. Again, the evidence here is relatively weak. That said, drugs and alcohol use features highly amongst people who die in the community (Sattar, 2001; Binswanger et al. 2011). Indeed, research consistently finds that many people who have offended have poor physical and mental health, lead chaotic lifestyles and are more likely to misuse drugs (Mills, 2004; Brooker et al. 2009; Canton, 2008; Singleton et al. 2003; Brooker and Sirdifield, 2013 and Denney et al. 2014). This is important considering mental ill health is one of the main predictors of suicidality (Arsenault-Lapierre, Kim and Turecki, 2004). Writing about the situation in England and Wales, Cook and Borrill (2015: 255) found that the key indicators for an offender to be considered at risk of suicide were previous incidents of self-harm or attempted suicide and, to a lesser extent, ‘coping skills, psychiatric treatment/medication, attitude to self, childhood abuse, current psychological problems/ depression, and history of close relationship problems’. Borrill et al. (2017: 12) analysed the case records of 28 people who died by suicide while under probation supervision in England and highlight ‘the complex association of events and experiences that may contribute towards pathways to suicide among probation service users under supervision’.
More recently still, Mackenzie, Cartwright and Borrill (2018) conducted research with seven probation clients who had attempted suicide. Their participants suggested that bereavement, loss of control over their mental state or situation, difficulties relating to their probation sentence, issues around trusting authorities, and an inability to disclose suicidal feelings were linked to their suicidal feelings and behaviours. Pratt et al. (2006) found that within their sample of 384 suicides that occurred within 12 months of leaving prison main risk factors ‘were increasing age over 25 years, released from a local prison, a history of alcohol misuse or self-harm, a psychiatric diagnosis, and requiring Community Mental Health Services (CMHS) follow-up after release from prison.’
It is clear that previous research has uncovered trends and consistent findings amongst people who die by suicide when under probation supervision. However, as MacKenzie et al. (2013) have argued, there is a need for more research on this important social issue because of the consistent finding that people under supervision are at higher risk of dying by suicide than other populations. In order to update Sattar’s (2001) work and to add some context to our understanding of the suicide rate of people under probation supervision we now turn to new analysis of the data that are collected by Her Majesty’s Prisons and Probation Service (HMPPS) on the number of people who die by suicide when under probation supervision.