Imprisoned New Zealanders are facing an escalation in life-threatening self-harm attempts as the Department of Corrections grapples with a mental health epidemic, according to documents obtained through the Official Information Act. Peter McKenzie reports.

This story discusses depression, self-harm, suicide and traumatic events. 

Prison isn’t pleasant. It is a place of restraints and restrictions where your world shrinks to the size of a cell and control over your life is in the hands of someone else. The mental health of prisoners will suffer in that environment.

But documents obtained from the Department of Corrections through the Official Information Act have revealed that the degree of that suffering has rapidly increased over the past two years. The Spinoff requested the number of self-harm attempts where there was a threat to life by people in prison – in other words, information on the most serious manifestations of mental ill-health in the prison system.

The response received was stark. In the first half of the last decade, the reported number of life-threatening self-harm attempts ranged between six in 2011/12 and 17 in 2013/14 (all figures are for the 12 months to June 30). But in the five years since, the number has skyrocketed. In 2019/20, 83 incidents of life-threatening self-harm were reported. In 2018/19, 54 incidents were reported. They are the highest and second-highest reported annual numbers since at least 2007.

The average number of reported life-threatening self-harm attempts over the last two years – 68.5 – is more than triple the average number reported annually between 2007 and 2018.

These revelations come after RNZ’s Guyon Espiner’s exposure of the “punitive culture” in one of the country’s largest prisons, Auckland Region Women’s Corrections Facility (known as Auckland Women’s Prison). An internal Corrections review found that Auckland Women’s Prison “may over the years have developed a culture where many staff take a punitive approach to their work rather than a humanising approach.” Manukau District Court, in a case involving prisoners at Auckland Women’s Prison, has heard allegations of staff removing prisoners from their cells through the use of pepper spray in a process called ‘cell-buster extraction’, keeping prisoners in isolation for up to four months – many times the normal duration of 14 days – and forcing prisoners to lie face-down on the ground beside their toilets before being given food.

Auckland Women’s Prison’s punitive and dehumanising approach may be systemic throughout New Zealand’s prisons, according to a report by the University of Oxford’s Dr Sharon Shalev, which concluded that “a significant shift in the very way that [New Zealand’s] detaining agencies think about the extreme tools of seclusion and restraint, is needed. Only then will a meaningful change be possible to achieve.”

Speaking to The Spinoff, Tania Sawicki Mead, director of advocacy organisation JustSpeak, connected this punitive approach to the mental ill-health epidemic in prisons. “These are people who are unwell… once they’re [in prison], we’re exacerbating their mental ill-health and distress through traumatic and frankly inhumane treatment which only reinforces the original problem and in many cases creates additional trauma for people who are there.”

This appears to be borne out by the data. Just 10 incidents of life-threatening self-harm were reported at Auckland Women’s Prison between 2007/08 and 2017/18; over the last two years, 26 such incidents were reported at the facility.

In a letter accompanying the release of the self-harm data to The Spinoff, a Department of Corrections spokesperson emphasised that people entering the imprisoned population are disproportionately likely to meet the diagnostic criteria for mental health or substance abuse disorders. “It is estimated that 62% of people in prison would have met the diagnostic criteria for either a mental health or substance abuse disorder within the 12 months prior to imprisonment, 91% of people in prison also had a lifetime diagnosis of a mental health or substance use disorder. The disorders however often went undetected and were not treated prior to prison.”

The disproportionate rate of substance abuse and mental ill-health among those entering the incarcerated population makes them a particularly vulnerable group with highly complex needs. Corrections recognises that it needs to reform its internal culture and expand its mental health support services to address that problem, the spokesperson wrote. “Corrections’ strategy for 2019 to 2024, Hōkai Rangi… outlines the need for us to provide a humanising and respectful environment that provides people with the skills and resilience needed to safely and successfully transition back into the community on release.”

The government’s flagship investment in that expansion of mental health support is the Intervention and Support Project (ISP). According to the Corrections spokesperson, the $11.6 million over four years it plans to invest will develop and implement “a model of care to transform the way we support those who are vulnerable to self-harm or suicide”. Between 2017 and 2020, specialist mental health teams were deployed in an initial pilot programme to Auckland Men’s Prison, Auckland Women’s Prison and Christchurch Men’s Prison. The ISP pilot was a success, Corrections says, and the specialist teams are now operating as “business as usual”.

However at the same time as the ISP was being piloted, the reported number of life-threatening self-harm attempts in the three ISP facilities rapidly and disproportionately increased. The three facilities represented just 12.5% of the total number of life-threatening self-harm attempts in 2016/17, before the ISP pilot began; in 2019/20, they represented 55.4% of the total number.

To many advocates, this indicates a structural failure in Corrections’ response to concerns of mental ill-health among prisoners. Sawicki Mead believes it points to the need for systemic reform of New Zealand’s prison system. “Services available to people in prison for any form of healthcare are deeply inadequate, inaccessible and often not responsive enough to people’s individual needs. Even though there are many people doing good work wherever they can for people in prison suffering from mental distress… [that is undermined by the fact that] the government has set up a system that is trying to treat people for mental distress in an environment that is inherently distressing.

“At the most fundamental level, prisons are an inappropriate environment to provide clinical care. Given how overwhelming the number is of prisoners who have been diagnosed with mental ill-health and disorders, we are seeing that at a systemic level prisons are not set up to help people suffering from mental ill-health.”

Where to get help

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