Deaths in custody

Mental Health Nursing,  Jun 2000  by Coles, Deborah,  Shaw, Helen

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In January last year a young black man, Roger Sylvester, was detained by eight police officers outside his home in north London under the Mental Health Act. By the time he reached hospital, an hour later, he was in a coma and died the following week. Essex police have investigated the conduct of the Metropolitan Police but no decision has yet been made on the question of prosecutions. This, and other similar cases, raises disturbing questions about the treatment of black people with mental illness - especially those in prison or detained by the police. Deborah Coles and Helen Shaw, co-directors of campaigning group Inquest, describe growing concerns.

In the absence of prosecutions, the inquest is the only forum where deaths in custody can be subjected to public scrutiny. It provides the only opportunity for families to find out the truth and to challenge the 'official' version of events. The inquest has a very narrow remit and it is manifestly not a public inquiry. It is concerned primarily with the medical cause of death and consequently the range of issues of concern cannot be properly explored at the inquest.

The restraint-related deaths in custody of two black men, Roger Sylvester and Rocky Bennett, epitomise our concerns. Central to any discussion about black deaths in custody is the question of institutionalised racism.

We have drawn particular attention to the over-representation of black people among those who die, following the use of force by prison officers, police and nurses, citing `institutional racism' within the NHS, police and prison service as being at the heart of the problem. This has been placed firmly back on the political agenda through the Steven Lawrence inquiry. INQUEST has drawn national and international attention to this issue.

Our reports to, and lobbying of, United Nations Committees on the Elimination of Racial Discrimination and Against Torture and the Lawrence Inquiry were instrumental to their findings that there are serious problems relating to deaths in custody and the lack of a fully independent, investigatory process.

We have made submissions about the treatment of people with mental health problems in custody to the Ashworth Inquiry, the Health Select Committee, the Prisons Inspectorate and government ministers. These have highlighted the numbers of people with mental health problems in prison and the link with the continuing rise in the number of self-inflicted deaths in prison from 60 in 1995 to 91 in 1999. In many of these deaths, prison has inappropriately been used as a `place of safety' and the inquests frequently highlight the paucity of health care received by prisoners and the need for diversion from custody.

The Parliamentary Ombudsman recently upheld a complaint made by INQUEST about the death of Kenneth Severin, a young black remand prisoner who died while being restrained by prison officers in November 1995. The inquest held into his death in January 1997 recorded an open verdict with positional asphyxia, following restraint, as the cause of death.

Our complaint raised issues about prison health care, the treatment of the mentally ill in prison, the use of strip cells, the lack of communication between discipline and medical staff. It also exposed failings at a national and local level to ensure that prison officers were properly trained in the dangers of control and restraint.

In a highly critical report, the Ombudsman expressed particular concerns about prison health care and the treatment of a mentally ill man. He found that Kenneth Severin had been treated as a discipline rather than a medical problem.

"Mr Severin received no more care than would have been accorded to a prisoner in the main prison, despite the fact that he was mentally ill and had accordingly been located in the health care centre. I conclude that a combination of inadequate health care staffing and inadequate communication between non-health care and health care staff denied Mr Severin medical consideration at the time when he most needed it, and allowed less well-judged approaches to the situation to prevail. That merits my strongest criticism."

The Ombudsman's report was a vindication of what INQUEST has been saying for years.

The current way in which controversial deaths are investigated serves neither the families of the deceased nor the public interest. The lessons are not learnt and the deaths continue. While Government initiatives on exceptional legal aid and greater disclosure of information to families are to be welcomed, much more needs to be done. INQUEST is calling for a complete review and overhaul of the way in which deaths in custody are investigated, to ensure greater openness, accountability and justice for the bereaved. This is a serious human rights issue that cannot be ignored.

Rocky Bennett

Rocky Bennett was a 38-year-old black man with mental health problems, held as a detained patient at the Norvic Clinic, Norwich. After an incident on 30 October 1998, nurses at the clinic restrained Rocky and he was certified dead at 1.20 am the next day