A jury has ruled there were serious failings that contributed to the death of a Northampton man who was able to take his own life in prison.
The inquest into the self-inflicted death of 39-year-old Darren Williams - which concluded yesterday (Nov 7) - found ‘consistent failures to follow due processes and relevant protocols’ at MHP Woodhill, according to a report by the INQUEST charity.
Mr Williams - a career burglar and thief who was jailed for two years in May 2018 - was found dead in his cell on January 4, 2019, and could not be revived.
It comes after HMP Woodhill was scolded in 2019 after inspectors found the prison was "still not safe enough". Three more men have died in the prison since Mr Williams' death.
But the inquest also heard that drugs were widely available in HMP Woodhill which simultaneously entailed a culture of debts, threats and violence, a spokesperson for the charity said.
"On four separate occasions, Darren seriously self-harmed as a result of threats of violence. On each occasion suicide and self-harm procedures (known as ACCT) were started and he was moved to another wing within the prison," the spokesman added.
"However, evidence was heard that he was not offered victim support services, which was in breach of the prison’s violence reduction policy.
"Additionally, the prison heard that no action was taken when Darren named those who were threatening him.
"The jury found causative failures relating to information sharing, ACCT processes and the handling of reports made by Darren explaining the threats he was facing due to being in debt. In a detailed narrative, the jury found ‘a consistent failure’ to follow applicable processes and protocols," the spokesperson added.
The charity statement said that the jury found that:
- prison’s suicide and self-harm prevention measures (ACCTs) were inadequately followed;
- there was a significant failure to complete and allocate actions in Darren’s care maps, an integral part of the ACCT process
- Darren’s applications to move to the vulnerable prisoner’s unit were either not documented or incorrectly considered
- information about Darren’s history of self-harm and suicidal ideation was not suitably shared between relevant prison departments.
The spokesperson added: "The jury further found that the support provided to Darren was ‘inadequate and lacking’ in key areas such as violence reduction, victim support, mental health and family engagement.
"They also made clear that, in light of Darren’s long term history of drug abuse, debt accrual and mental ill-health, it was ‘vital [that] these services were offered to him in full’."
Carri Williams, Darren’s sister, said: “It’s very important to us as a family that Darren be seen as the person he was and not just a number in the system.
"He was a son, brother, grandson, uncle and a good friend to many. As a family we believe that his passing was completely preventable
"We now have to visit a cemetery on a regular basis to even feel close to him and stare at mud and ornaments. It’s just awful and unfair. He should have been kept safe.”
A Prison Service spokesperson said: “It is a tragedy whenever anyone takes their own life in prison and our thoughts remain with Darren’s family and friends.
“Since his death, HMP Woodhill has improved the support available to vulnerable prisoners, established a dedicated mental health team and put in place better processes to ensure information about prisoners at risk of self-harm is better documented and shared between the necessary prison staff.”
At the conclusion of the inquest, the coroner indicated that he would be making a report to prevent future deaths to the Governor concerning the need for members of healthcare to attend ACCT reviews and for previous ACCTs to be reopened when the same concerns recur rather than starting the process afresh.
Selen Cavcav, senior caseworker at INQUEST said: “It is chilling that the circumstances and failures of Darren’s death are so familiar. How many more people must lose their life as a result of these deplorable failures in the prison’s duty of care?
"Darren’s death is one of four self-inflicted deaths in Woodhill prison this year. As deaths in custody spiral and recommendations from inspections, investigations and inquests are ignored, a vicious cycle goes into tailspin. The current system for implementing change is not fit for purpose. A national oversight mechanism is urgently needed, to ensure official recommendations are systematically followed up and to prevent another family from experiencing this loss.”