Impact case study database

Against a background of austerity and reductions in the levels of prison staff, the research was used to improve the training materials used with prison staff. Additionally, the act of undertaking and disseminating the research may very well have contributed positively to a Hawthorne effect in that the organisation increased its focus of activity on suicide prevention. Following directly from the government's response (E2) to the Harris Review, the numbers of suicides fell from 2016 to 2017 and this downward change in the numbers of suicides has been sustained (2018: 92 suicides, 2019: 84 suicides; E3). This impact was achieved in the following ways:

The Harris Review, the quantitative research for which was led by Professor Towl (E1) was published in July 2015 and the government’s response to this research informed a new programme of national training for frontline staff. This training programme was shaped not only by the report itself but also through a meeting between Professor Towl and Chris Barnett-Page of the Ministry of Justice (MoJ), the operational national lead with responsibility for reducing prisoner suicides.

The Safer Custody Group at HM Prisons Service HQ led on the design of the new programme informed by the research findings. The new prison officer training is 25% longer than previously and includes a focus on spotting factors which “ might indicate an increase in suicide risk”. (E2 p15) This training was rolled out throughout England and Wales over the second half of 2016 and into 2017. The new course was aimed primarily at new staff, but used as a refresher for those prison officers who had not attended recent training. More locally, Prof Towl himself organised and ran training at HMP Durham for prison officers and their managers, including the executive leadership team (E5).

The national and local training taught attendees to use the results of the research to perform research informed individual risk assessments allowing for an improved assessment of potential for suicide when used in their home institutions. Specifically, the training:

• Flagged the findings about gender differences in the age-related risk of suicide to raise awareness of the increased risk associated with young women [R2].

• Emphasised aspects of good practice in suicide prevention which should be continued and used more extensively in the early days of custody [R1] to reduce overall risk .

• Flagged the finding that prisoners who are imprisoned for arson offences are at an increased risk [R3].

In the year following the roll out of this training the suicide rate dropped from 122 deaths in 2016 to 70 in 2017, a decrease of 42% (E3). This was the greatest reduction in absolute numbers of prisoner suicides ever recorded (records began in 1978). Subsequent to this, in spite of our research showing turnover (i.e. prisoner movement) to increase risk due to relocation, there was a policy change to move prisoners more rapidly through the system increasing effective turnover. Despite this, the rates of suicide remained below the 2016 maximum, likely due to continued adherence to the other recommendations of the report.

The importance of Professor Towl’s research in this success was noted by Mr Alan Tallentire, the Director of HM Prisons for Tees and Wear: “ I know that you led the quantitative research for the Harris Review – a report which has been hugely influential for HMPPS, and the research you led informed the design of the national training for prison staff that rolled out in late 2016 and 2017.”(E4) Similarly, Professor Towl (along with the Chair of the Prisons and Offender Research Health team) wrote to the Chief Executive of HM Prison and Probation Service about practices identified in the quantitative research that were revealed to have the potential to contribute to a reduction in prisoner suicides. The response indicated that the ideas had been incorporated in informing national strategic policy on addressing suicide prevention (E6). For example, Mr Michael Spurr, CEO, HMPPS (dated June, 2017) wrote, “ many of your suggestions are reflected in the work that we are taking forward as part of the refreshed suicide and self-harm reduction strategy that is a key part of the prison safety and reform programme”.

As discussed above, subsequent to the highly successful ministerial and HMPPS dissemination and application of some of the key findings from the research, Professor Towl was approached to assist with staff training at HMP Durham. HMP Durham is a pilot ‘allocations’ prison which means that it has dangerously high levels of prisoner turnover rates, with many prisoners only staying for very short periods of time before being ‘allocated’ to other prisons. As noted our evidence is clear that such an environment will be associated with very high levels of suicide and indeed the policy of increasing transfers in 2018 had such an effect. In early 2020, Professor Towl therefore trained over 50 staff at the prison and is working with prison staff on using quality control approaches to improve individual support plans for those prisoners identified at being at a markedly inflated rate of risk of suicide. This has increased staff confidence in addressing this challenging area of prison work (E4, E5). Indeed the Prisons Group Director has recognised and favourably acknowledged the impact of this research dissemination: “ Your visits to the prison and engagement with staff and prisoners have been very supportive. In particular the staff training and support for the prison’s leadership team is already making a tangible difference at HMP Durham. I remain grateful to you for helping us with ensuring that our work on suicide prevention is evidence informed drawing from the most comprehensive research to date”(E4).

In sum, by sharpening our understanding of the factors associated with an increased risk of suicide, and through effective communication with both policy makers and prison staff, this highly influential research has changed national policy on prison officer education which, in turn, saved the lives of some of the most vulnerable people in society across the UK.