It is time to end this wilful, harmful gender blindness on prison suicides

Prisons need a profound culture change if they are to address the appalling escalation in suicides, two charities have claimed this week.

The arguments put forward by the Howard League and the Centre for Mental Health are compelling and correct. Prison suicides have soared in recent years and last year a record 119 prisoners took their own lives. In an era of chronic overcrowding and staff shortages, prisoners’ mental health needs are going unacknowledged and unaddressed; acts of self-harm and even suicide attempts are commonly considered to be manipulative rather than symptoms of distress and emotional crisis; a ‘toxic’ and violent prison culture sees staff struggling to maintain their own psychological health, never mind that of the prisoners.  

Unfortunately the release of the report was rather overshadowed on the news agenda by coverage of BBC Panorama’s horrifying undercover exposé of life inside the privately-run HMP Northumberland. Hidden cameras demonstrated the horrendous spice epidemic that is running rampant, with officers willingly admitting that they lose all control of the prison for hours every day. It’s perhaps a measure of how bad things have got that stories about catastrophic failures in the prison system have been pushed off the agenda by other stories about catastrophic failures in the prison system.

The report on suicide does still deserve consideration though, partly for what it says – which is important and useful, but I would argue also for what it misses. First, however, the plaudits. The report raises highly pertinent concerns, many of which are on well-trodden ground. Staff shortages and overcrowding are literally killing people; officers are themselves stressed and struggling to cope; the huge rise in suicide runs parallel to (and quite possibly consequent to) huge rises in violence and self-harm; and the flooding of prisons with spice and other drugs is having appalling effects on prisoners’ mental and physical health. With all of this going on it would be frankly remarkable if the suicide rate was not going through the roof.

A more subtle but no less important point is raised about the culture in prisons, where incidents of evident distress and self-harm are likely to be interpreted as manipulative, and where prisoners with complex multiple social and mental health needs fail to meet thresholds for therapeutic intervention and are left to cope alone as best they can with the stress through isolation or self-medication.

All of this should be heeded urgently by the Department of Justice as they continue their own internal inquiry into horrific rise in prison suicides.

In another respect, however, the new report is deeply disappointing. To explain why, let us step back a moment, outside the prison walls.

Suicide, socially and psychological speaking, is a highly-gendered phenomenon. It is well-known that men are three to four times as likely to take their own lives as women. There is a large and expanding shelf of academic and clinical literature explaining that men and women typically think of suicide differently, approach it for different reasons, use different methods and benefit from different methods of prevention and protection.

Many of the most important and effective developments in suicide prevention in recent years have adopted an explicitly gender-based approach. In the UK recently, national campaigning by the likes of CALM may help to explain why male suicide rates have recently levelled off after a decade of rises – bucking the international trends which see male rates continuing to rise.

More easily quantifiable are short and specific interventions. In Queensland,  Australia suicides amongst construction workers were six times national average in 2008. In response, the charity MATES In Construction began taking an explicitly gender-conscious approach to suicide prevention in the industry, encouraging workmates to protect each other, in old-school manly fashion. In the first five years of the scheme suicides in construction fell 7.8% while rates were rising among other men locally.

I’m only scraping at the surface of the suicide prevention work here. It is an incredibly difficult and complex field, and there is no magic wand or formula that can instantly solve the tragedy of suicide. What we do have is a broad clinical and academic consensus emerging that we cannot begin to understand the social tragedy of suicide, we cannot begin to address the social tragedy of suicide, without considering all the gendered processes that feed it. I cannot recommend enough the detailed papers published by Samaritans a couple of years ago. Over a hundred pages of analysis of the gendered processes of suicide from a variety of different academic angles, packed full of wisdom and insight and immediately applicable to real world interventions. If you want to understand the suicide of men, start here.

It is scarcely an exaggeration to say that trying to address male suicide without considering gender issues is like trying to cure tuberculosis without acknowledging that people have lungs.

Unfortunately, there is one exception to this consensus. Our consideration of male suicide as a gender-based issue suddenly evaporates when it is prison suicide we are talking about.

This wilful blindness to male gender considerations means that our approach to the issue is going to be incomplete and intellectually flimsy at best. If suicide is a profoundly gendered phenomenon, so too is prison. We’re on a slightly different tack here and I’ll try not to digress, but we cannot overlook that everything about our use of prison is gendered. Men are more likely to commit most  offences and more likely to be sentenced to prison when they do. They will be sentenced for longer and to harsher conditions for the same offences, they are more likely to be alienated from their children and other family. They are also more likely to have lived through all the conditions that vastly increase risks of ending up in prison – they are more likely to have been institutionalised as children, more likely to have been subjected to violent socialisation, more likely to be addicted to drugs or alcohol, more likely to be homeless, more likely to be unemployed.

For good measure, once in prison, many of the factors that greatly increase suicide risk are heavily gender-relevant. Bullying, interpersonal violence, rape and sexual coercion; separation from children; cultures of machismo that discourage help-seeking behaviour, all tied up in how gender is expressed and performed outside but especially inside prison.

None of this is to suggest that women in prison are safe or in less need of help and attention. As the new report is keen to tell us, last year 12 women took their own lives in prison, the worst year ever. Last year women made up less than six percent of prisoners but almost 10 percent of suicides. The report does not bother to tell us that for the previous ten years the opposite had been the case. In the decade to 2015 no fewer than 708 men took their lives in prison, accounting for 96% of all prison suicides.

And crucially, there may be a reason for that. Back in 2004/5, six women killed themselves in Styal prison in the space of 13 months. This shocked the nation and the government of the day, leading directly to Baroness Corston’s report into conditions for women in prison. In contrast to our approach to male suicide, this was an explicitly gender-based report. Taking in everything from motherhood considerations to access to sanitary towels, the inquiry took evidence from specialists in women’s mental health, from feminist academics and criminologists. The subtitle to the Corston report was “The need for a distinct, radically different, visibly-led, strategic, proportionate, holistic, woman-centred, integrated approach.”

Not everything that Corston called for was granted. In particular the proposal that women’s prisons be closed altogether was barely given house-room. There remain huge humanitarian and gender-specific issues with women’s prisons. Nonetheless in the years after Corston it is undeniable that there were significant improvements to policies in women’s prisons, and they appear to have lasted up until 2016 when we can presume that the impacts of the barbaric incompetence of Grayling, Gove and Truss finally took grip. In the years between the publication of the Corston Report and 2016, the numbers of suicides in the women’s estate across England and Wales were as follows: 1, 3, 1, 2, 1, 2, 3, 5.

I have been arguing for years that we need a Corston report for men. If that is too much of an ask, I would at least plead that those involved with the management and administration of prisons begin to listen to the experts on suicide prevention and begin to re-think their approach to how they can begin to save lives.

At the same time I can only repeat regular pleas to the prison reform charities to end this wilful, conscious and actively damaging insistence that there are ‘prisoners’ and that there are ‘women prisoners’ – in other words that women in prisons have gender-issues but men do not. Until we actually engage with prison as an overwhelmingly gendered issue we are fighting battles for reform with our ankles tied together and one hand behind our back. It is intellectually lazy, politically inept and it breaks my heart that we still do this while prisoners are literally dying by the dozen.


  1. David S says


    There is a large and expanding shelf of academic and clinical literature explaining that men and women typically think of suicide differently, approach it for different reasons, use different methods and benefit from different methods of prevention and protection.

    Obviously you’re writing a blogpost here not a systematic review. But the paper that you linked to in that paragraph does need to be viewed with quite a few caveats, particularly if you are going to treat as relevant to prison suicide.The first caveat is that it measures a “surrogate outcome”. That is to say that they don’t count how many suicides took place in their sample (you would need a much bigger sample for that). What they measure is the prevalence of suicidal ideation, and various factors that might be linked to it, such as perceived burdensomeness. Statisticians are rightly cautious about drawing inferences from surrogate outcomes, because they often fail to behave in the same way as real outcomes.

    The second caveat is that their sample is derived from male and female volunteers for an Australian study. I doubt that many of them were prisoners, and the differences between male prisoners and unicarcerated men may well be greater than the differences between unincarcerated men and unincarcerated women.

    The final caveat is that the predictive value of any piece of data always depends on what other pieces of data you know. So gender may be predictive of a particular outcome, or the effectiveness of a particular intervention, if gender is the only thing you know about the subject, but the predictive value of gender may completely disappear if you know other things about the subject beside their gender.

    I am aware that you have linked to other bits of research in the post, but there are caveats you could raise about them as well. I am not trying to disagree with your general conclusion about the need to consider gender when thinking about suicide either, just suggesting that it’s important to be pedantic and pick those nits.

  2. says

    Along with overcrowding, there’s also (in the US) arbitrary use of solitary confinement. According to “solitarywatch” (probably biased) 70% of prison suicides were in solitary. It may be a matter of opportunity or inattention, but that’s significant. It may also be an inverse causality – more people who are potentially suicidal wind up in solitary. The obvious answer is to stop use of solitary confinement without due process.

  3. Ally Fogg says

    Perfectly reasonable David [1]

    If anyone feels inclined to challenge the truth, accuracy or validity of any point I make, feel free to challenge & I’ll dig out some evidence.

    But as I hint at in the piece, it is incredibly difficult to quantify & evaluate the epidemiology of suicide and suicide prevention methods. I’m not saying there is a single study anywhere that proves X Y or Z is the specific best approach to take to prevent suicides. What you can say is that if you look at the body of literature and talk about an emerging consensus.

  4. secondtofirstworld says

    @Ally Fogg #3:

    The way I see it, prison or not, the following things need statistical corroboration (as they are independent of culture): men make fewer attempts, and succeed more violently, women take more attempts. The emotional nurturing of men depends on family dynamics, peer pressure, and how the culture of society views men expressing emotion and distress. It’s no surprise most of us don’t open up and talk about it, when many around us claim only pussies whine, real men don’t.

    The difference doesn’t seem to be between genders, rather gender stereotypes. In a dominantly female environment, women are far from the silent, homely nurturing type, they too have hierarchy, so when a women does decide to seek help, a more gender balanced group runs to rescue either out of genuine concern, or because of the perception of gender stereotypes. Men on the other hand feel abandoned in this apartment even without abuse, and thus, seek little to no help. I should have been more clear before: large organizations within a company or the state are de facto their own state, so even if society in itself is socially liberal, a more conservative prison system still can and does mistreat them.

    Lastly, yes, certain types of mental illnesses, like borderline personality disorder really does involve self harm for manipulation. The problem is, generally prison staffs are ill-equipped to deal with it, lacking experience and knowledge, so such inmates should rather be institutions. One caveat however: there’s a different form of manipulation, self harm or self mutilation to earn transportation into a less guarded place to escape. From the outside looking in, the only thing we can do is to support such investigations, and demand deeper and further ones.

    Even if we can bring about shift change in culture, that’s not the terminal, it also needs how we men act with the world and with each other. It should go without saying, that it requires the halt of mocking fun of safe spaces, triggers and PTSD in general.

  5. Marduk says

    “there are ‘prisoners’ and that there are ‘women prisoners’”

    This is very much the case. I’m not sure its meant to say men have no gender (or gender-specific needs), I think its more about the political exposure game that Nusrat Ghani was playing two blog posts ago. If you can make it about women specifically, you can hide from most of the exposure.

    Its a method of breaking down the issue and accessing the ‘overton window’. We haven’t had a government in my lifetime that was prepared to be ‘soft on prisoners’ but we’ve never not had a government in my lifetime that didn’t want to address sexism wherever it is found. So there is way through, but only for women. I think when people talk about the various patterns that exist in male prisoners they instinctively know this to be honest. So again, no government will be soft on criminals, but it might be persuaded to show compassion for the mentally ill say, everyone is playing the same game whether they know it or not.

    I think if you want to go full bore advocate for this you actually have to drop any reference to those patterns, widely manifest as they are. It has to apply the most unapologetic swaggering arrogant scumbag as much as anyone else or it means nothing. But I concede, chances of success are virtually nothing.

  6. Groan says

    I cannot thank you enough for this I sincerely hope you have success in your modest request that some concerted effort is made to look into suicide in prisons. The Bradley report and its follow ups really sets out the way our prisons are progressively becoming the institutions for care of those for which there isn’t any other “home”. From my perspective the development of community care in mental health as effectively reduced MH services ability to treat really troublesome (“challenging”) people safely (and size makes the challenge that much greater if the challenger is a male) while the development of new offenses of being “offensive” or “conspiring” on the internet is hoovering up individuals with all sorts of conditions that once would have labelled them “socially inadequate” “eccentric” or just obnoxious. Having research from the 1950s onwards at how damaging large institutions can be we are collecting ever more vulnerable men (including now an unprecedented cohort of old men) into large and overcrowded institutions. Men are more likely to take definitive action to die because they are absolutely convinced a “cry for help” will be unheard. In prison increasingly this is a fact not a perception.

  7. Marduk says

    Just wanted to say Groan that I thought your post was very insightful.

    I have had this concern about the invention of new crimes and have noticed, albeit anecdotally and unsystematically, that the people they are supposed to target aren’t the people who wind up getting locked up. People have in mind jackbooted thugs and terrorists, but ironically they more than any other group in politics are aware of the issues (it might even be argued that these laws have caused them to conceal their nature before the public in a way they wouldn’t have done unprompted). In reality it seems to be a much older, often semi-homeless or substance addicted/addled cohort that are getting locked up. These people are often troublesome, can be frightening — if typically harmless — and have always been with us and always will, particularly in the absence of meaningful social care.

  8. Marduk says

    …indeed, a 70s-style sociologist (Berger?) would suggest that far from us locking them up because we’re ashamed of their behaviour, we’re really locking them up because we are ashamed of how the rest of us have failed to help them.

  9. StillGjenganger says

    Off topic, but I would like to signal an interesting arcile on gender preferences for children.
    I am limited to summarise the newspaper article where I saw it.

    Essentially, the increased gender equality should have led from an old preference for boys to, not a loss of prefernce, but a fairly clear preference for girls, wit numbers o the order of 10-20% prefence for girls. The chnage coming in over the last 20-25 ywars. The conclusions build on thinsg like a YOuGoc poll, the Swedish Generations and Gender Survey, and populaation analyses – things like how nlikely families are to have an extra dchild if tehy already have 1 boy / 1 girl / 2 boys / 2 girls. Data are also quoted form gneder preferences in adoption and sex-selection in the US. And even in Asia the strong preference for boys is atleast falling, apparently.

    Explanations of hte henomenon seem to be speculative, anecdotical or both, but interviewed experts apparently agree to see this as an important trend with potential demographc consequences, rather than a funny blip.

    The original reference seems to be
    “Andersson, Gunnar, 2016. “Boys, girls, preferences and the links between past and present”
    In: Matthijs, K., Hin, S., Kok, J., and Matsuo, H. Eds
    The Future of Historical Demography
    Upside and Down and Inside Out
    pp. 67-70
    Leuven/ Den Haag AccoPublishers ISBN 978-94-6292-722-3.

  10. StillGjenganger says

    Sorry for the spelling – I clicked on commit rather than preview by mistake.

  11. WineEM says

    Back on topic, admittedly somewhat uncharacteristically for me! 😉

    Just heard this on BBC news. Using ‘time rewind’ function here on Freeview to transcribe verbatim.

    (I mean what the f*cking shit!)

    Presenter announces:

    “Back here [i.e. here in the UK] more must be done to address a sharp rise in the number of suicides among women prisoners in England, according to the prisons watchdog. The number of female inmates who killed themselves nearly doubled in the last
    year. The prisons and probation ombudsman said reforms recommended a decade ago haven’t been implemented, as Mark Ashdown reports.”

    Erm, so which recommendations haven’t been implemented precisely? Corston herself has given lots of speeches, trumpeting the fact that the vast majority of her 43 recommendations have been put into force. And then, needless to frickin’ well say, what about Ally’s very legitimate points raised above?! Whatever the outlet, why do they never, ever, get any kind of look in?

  12. WineEM says

    Mind you Ally would say the report is worth catching if you happen to have a spare second to use BBC News Iplayer (@15:48), which I’m guessing you probably don’t! 🙂

    ‘Cause it is certainly fricking weird. Starts out with the above introduction, the report itself bangs on about ‘women prisoners’, and then half way through they stick up a photograph of a (quite clearly male prisoner, looking out of a cell onto barbed wire), without changing subject. Bizarre…

  13. Ally Fogg says


    Didn’t catch that report at the time, but presume it was the same as this

    In terms of numbers, worth noting that female suicides doubling means the annual total went up from 6 to 12. This means women prisoners were slightly more likely than male prisoners to take their own lives last year but for the previous 10 years or so male prisoners had been vastly more likely to do so. We’ll need another year or two before we can tell if it is actually a trend or just one terribly bad year. Prison suicides across the board went up 32% last year.

    As for the broader point about Corston, we’ve had this conversation before I think, but as I see it it’s a classic glass half full/empty argument. Yes, the government(s) introduced a lot of the recommended reforms, so when someone wants to talk up Corston they can claim that it was hugely influential, but at the same time goverment(s) did not introduce the most radical (and expensive) reforms – notably closing women’s prisons altogether, stop custoodial sentences for most female offenders and transferring the rest to secure community facilities. So those who want to argue that the glass is half empty can say that government(s) have not done what is necessary and so women are dying as a consequence.

    FWIW, as far as I can tell this story was in the news because the prisons ombudsman highlighted female suicides and linked it to inadequate mental health provision in one of their bulletins.

    I think that is a perfectly reasonable thing for the ombudsman to be doing under the circumstances.

  14. WineEM says

    ‘ I think that is a perfectly reasonable thing for the ombudsman to be doing under the circumstances’

    Ok, but is it reasonable if this guy is meant to be an independent check on government? Surely a spirit of true independence would at least allude to some of the points you’ve raised in the blog entry – that so far there’s been no consideration of male gender specific needs whatsoever. It’s a bit like that time back when Harman re-appointed Trevor Phillips as head of the EHRC, and as soon as he got into office, he started banging the Harman drum, saying that women banking executives were the most discriminated members of society – when he was meant to keep the govt’s equality record in check! How could he do this, when he was chosen by the very Ministers he was meant to be keeping an eye on?

    And of course, as for this thing about women being ‘more likely to take their own lives, whilst being factually true, you know as well as I do that it’s essentially misleading and meaningless when the populations are so different in nature and size. The people most likely to be committing an act, in a general sense, are the ones who are actually doing it, in terms of the weight of numbers on a regular basis. If two members of the Royal Family took their lives this year, you could make an argument that Royals are far more likely than anyone else to top themselves, but essentially it means jack shit in a wider context.

  15. Ally Fogg says

    Yeah I would certainly include the ombudsman’s office as part of the general complaint about the lack of any kind of male-specific gender analyses when it comes to prisons.

    If you look at the full set of Ombudsman press releases, there’s obviously an issue that these things are conceptualised as one large set called “prisoners” and then a load of smaller sets with specific needs – “women prisoners” “transgender prisoners” “travellers in prison” etc etc etc. No sign of any understanding that there are gender-specific issues for the 95% of prisoners who are (cis) male.

    But the solution to that is to identify the issues that they should be addressing and complain when they’re not. It doesn’t help anyone to complain that they occasionally focus on female-specific issues.

  16. Adiabat says

    WineEM (12):

    Erm, so which recommendations haven’t been implemented precisely?

    The really expensive ones, mainly. 2016 saw a sharp rise in both male and female prisoner suicides, moreso for women. But so far it looks like a blip rather than a trend. Considering that for most of the last 10 years the number of female prisoner suicides per year have been just 1-3 people I can understand why the government feels no impetus to spend millions implementing the most expensive recommendations from the Corston report.

    Those pushing for all the recommendations to be implemented need to get some perspective. That money would do more good in the NHS, or a multitude of different areas.

  17. Carnation says

    @ Adiabat

    “That money would do more good in the NHS, or a multitude of different areas.”

    Of course, now that Article 50 has been triggered, your Brexit supporters can rest easy in the knowledge that there will be a lot more money for the NHS. Or, alternatively, there will be a steady economic decline and the rise of the reactionary right will continue to adversely effect the NHS.

    You’re on the wrong side of history, and all because feminists/women hurt your feels and triggered you.

  18. WineEM says

    @17 Erm, occasionally?! 😉

    @ 18. Maybe, although I’ve forgotten how much has been spent on this already. Quite a lot, as far as I can recall, certainly tens of millions (plus all the extra cash from the women’s prison coalition sponsors etc).

  19. Adiabat says

    WineEM (21): Yes, millions has undoubtedly been spent already, which has reduced it by around 2-3 suicides a year (though this may be correlation, not causation). It would likely take hundreds of millions more to build a network of local “community facilities” in the hope of possibly reducing prison suicides by another 1 or 2 people a year.

    I’ll leave it to individuals whether they consider that to be a good investment.

  20. Marduk says

    Well, I don’t know if this is just a blip to be honest. We are told by prison officers that there is a crisis in the country’s prisons as the austerity piper is finally being paid. If they are genuinely more and more fearful for their own safety, that in itself must affect standards of care.

    “If you look at the full set of Ombudsman press releases, there’s obviously an issue that these things are conceptualised as one large set called “prisoners” and then a load of smaller sets with specific needs – “women prisoners” “transgender prisoners” “travellers in prison” etc etc etc. No sign of any understanding that there are gender-specific issues for the 95% of prisoners who are (cis) male.”

    I talk about this in #5 also (I was just on the verge of repeating myself when I saw it!) although I put a slightly conspiratorial spin on why.

    Whatever its cause, is there a name for this kind of thing? It seems to be a serious and dangerous unintended consequence
    of utilising identity as a lens in the realm of social politics. Whatever you think of the specific issue under debate, this kind of thing is bound to happen as a result.

    The inverse would be a fallacy of composition, is this a “fallacy of decomposition” where if you can decompose a thing it makes you blind to the majority and the whole, perhaps by thinking that by engaging with myriad parts you’ve engaged with that whole (only that is the one thing you haven’t).

  21. StillGjenganger says

    This would seem to fit fairly well with with a dominant progressive politics of advantaging minorities while dismissing majorities as ‘privileged’ if not eager practitioners of discriminatrion. Why do you think the consequences are ‘unintended’?


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