Overcrowded prison conditions ‘a recipe for suicide’

Theoretically it goes without saying that, in maintaining a prison system, the State automatically assumes responsibility for the health, safety and wellbeing of all persons in its custody.

Yet inevitably there is a gulf between theory and practice; and while Malta's only prison can lay claim to having all the necessary safeguards down in its book of rules and regulations, the reality is that these same safeguards cannot always be implemented for logistical reasons...with results that sometimes threaten the lives of inmates.

A spotlight was cast on this situation by the recent death of an inmate in Division 6 on 5 September. Julian Genovese, 53, was found dead in an isolation cell under circumstances (later confirmed) that suggested suicide. Details that have since emerged of the circumstances leading to Genovese's death have also raised very serious questions about the standards of prison administration as a whole.

It turns out that Genovese died of asphyxiation after attempting to hang himself from a nail in the wall of his cell in Division 6, using plastic garbage bags retrieved from dustbin liners within the prison complex itself.

The nail from which he hanged himself was affixed at around four feet from the ground - considerably less than his own height - resulting in the victim slowly strangling himself to death. His lifeless body was discovered at approximately 2pm, while the last time his cell had been inspected was around three hours earlier, just after 11am.

Questions have also been raised about why Genovese was held in Division 6 in the first place - a maximum-security division designed only for violent and dangerous criminals - especially when he had already exhibited suicidal tendencies and had received psychological treatment at Mount Carmel Hospital.

Similarly, it remains a mystery why Genovese was left unmonitored for long enough to stage an elaborate and time-consuming suicide attempt (a medical doctor who spoke anonymously to MaltaToday explained that under such circumstances, the onset of death could take up to 40 minutes).

Yet Genovese was supposed to be on 'suicide watch' at the time, which theoretically means that he should have been under observation 24/7.

Administrative failures

Nor is this the only discrepancy regarding this fatality in Corradino. Officially, the reason for housing Genovese in a punitive maximum security block was that he had earlier attempted to escape while on a visit to the Mount Carmel Hospital in Attard. It is standard practice to house would-be escapees in maximum security conditions (whether or not these represent any danger to others); but while the prison authorities were adamant on enforcing one aspect of the prison regulations, they apparently stopped short of applying another rule: namely, Regulation 31(7) of the Prisons Regulations (SL.260.03), which reads as follows: '(7) The Medical Officer shall inform the Director if he suspects any prisoner of having suicidal intentions, and such prisoner shall be placed under special observation.'

The Home Affairs and Security Ministry refused to comment specifically about the case, citing the ongoing magisterial inquiry as a pretext. But the same ministry did not deny any of the above details, which were all included in questions sent by this newspaper.

"Usually inmates who are in Division 6 are those who require stricter controls. Genovese was put in Division 6 for stricter surveillance after he escaped," a ministry spokesman said, without elaborating on how 'stricter controls' could also include leaving someone unattended for three hours.

"Genovese's health was being monitored by the in-house doctor. Each time he asked for assistance he was referred to the doctor. No further comments can be made as there is a pending magisterial inquiry. However government will await the conclusions of the inquiry to assess whether there is any responsibility to be shouldered. The conclusions of the inquiry will be forwarded to the Prison Board Reform to establish whether there should be action to avoid future similar cases."

History repeats itself

On closer scrutiny it turns out that Genovese's case is not exactly unique. A very similar suicide took place in Division 6 in 2010: Barry Charles Lee, a 37-year-old Briton imprisoned on drug related charges, was likewise discovered dead in an isolation cell in Division 6. Unlike Genovese, however, Lee had been housed alone, in similar conditions, for six months before committing suicide.

This particular case had prompted stern criticism by the Council of Europe's Committee for the Prevention of Torture, which condemned the entire division as 'substandard' and recommended its closure with immediate effect.

The prison administration responded by closing it down temporarily. But Division 6 was reopened with minimal refurbishment, initially to provide 'induction' to new prisoners; only to later resume its previous role as a punitive block for troublesome or uncooperative inmates.

One former CCF inmate described Division 6 to the CPT as follows: "hygienically it's a disaster. The drainage system is a mess, there are huge rats which come swimming up the toilet through the drains, and it's almost completely dark at all times of day."

This description was upheld by a Constitutional Court ruling in the case instituted by former inmate Meinrad Calleja, who successfully pleaded that the conditions in this division breached his fundamental rights - and separately by a report issued by the CPT in 2005. Another Constitutional case, filed by British national Steven Marsden after spending two years in preventive custody at CCF, also raised similar complaints of inhuman conditions in the prison's Division Six.

Three years after Lee's suicide, Division 6 remains in use for more than just maximum security cases, despite the above recommendations by the CPT... although steps have allegedly been taken to address some of the more dire aspects of the accommodation conditions.

Population explosion

But logistical problems caused by the steadily increasing prison population, in the context of a prison administration that has not been increased to cope with the growing number of inmates, have apparently stalled attempts to overhaul the system.

Dr Ivan Mifsud, former chairman of the Prison Board of Visitors until last April, confirms that while he was still occupying that position, overcrowding was a serious problem affecting the health and safety of prison inmates.

"Division 6, until last April, was high security. But the problem of overcrowding was so acute at CCF that inmates were placed in all divisions, wherever the authorities could house them. Then, at the first opportunity, they would move them to another section of prison which was more suitable..."

Dr Mifsud is reluctant to draw any direct causal link between the conditions in Division 6 and the fact that there have been at least two suicides therein in the past three years. But he confirms that the Board, under his chairmanship, had repeatedly raised concerns about this situation with the prison management.

"The role of the Prison Board of Visitors is to oversee and review the prison, and one of the things we opposed strongly was this very fact that inmates were put in Division 6 when they were not high security inmates. We opposed (where we felt it necessary), we criticised, we tried to help the authorities find solutions, we made suggestions, we gave advice. That is all we did, because that is all we could do. I used to compare it with a sick patient going to the doctor. The doctor prescribes the medicine but it is then up to the patient to take it!"

There is evidence that this 'medicine' has still not been taken all these months later. "I cannot answer for the administration's actions or failure to act, because like I said above the Prison Board of Visitors is an independent body of professional persons whose role is to oversee, to monitor, the prison, speak to inmates, try help them resolve their difficulties, etc., but has no administrative or executive powers within the CCF."

Mifsud also confirms that Division 6 has doubled up as an alternative to a quarantine facility, despite the fact that it is not equipped to handle health problems.

"The PBV in my day had issues with the single rooms, because they were used not only to keep people from harming themselves, but even to keep persons under quarantine if the authorities were afraid that they had some contagious disease. We objected to this, because these rooms were intentionally spartan, to avoid inmates harming themselves, but this made them unsuitable and undignified for people in quarantine."

This was separately confirmed by the ministry: "Inmates can be housed in solitary confinement cells in order to quarantine them from infectious disease. Obviously they are not asked to follow the same regime used for solitary confinement purposes."

Over the 'emergency threshold'

Part of the reason for the failure to address what one inmate candidly described as a 'recipe for suicide' is the fact that while the prison inmate population has virtually exploded in the past 10 years, the administrative staff has remained more or less the same.

Crimewatch Malta, a website dedicated to statistics and information related to crime and law enforcement in Malta, claims that the prison inmate population has now surpassed the 'psychological threshold" of what is considered acceptable by international prison management standards.

The psychology threshold - also known as 'emergency capacity threshold', in the USA - is defined as the maximum number of persons the facility can hold without experiencing psychological and operational issues. For Malta the threshold is calculated as a very maximum of 600.

In February 2013, the prison population stood at 632 - up from only 281 in December 2001, and well over the 'emergency capacity threshold'. This figure has since dropped as a result of the amnesty granted by the incoming government after the last election; at the most recent count, CCF's population stood at 501.

However, a sizeable portion of this figure is accounted for by persons (mostly foreigners) who are in prison awaiting commencement of their trial, having been denied bail by the courts... whereas there are currently an estimated 14,000 criminal cases before the courts, a proportion of which will surely result in prison sentences.

Ivan Mifsud confirms that up to last March, an astounding 33% of CCF's entire population consisted in inmates who actually awaiting commencement of trial (mostly involving foreigners who were denied bail).

"Until last March about one third of the inmates were awaiting trial. I am not aware of the number of persons awaiting trial who are on bail. Yes, overcrowding was a problem, and the authorities were trying to counter this, for instance by introducing cell-sharing, and even building new divisions (I distinctly recall two small new divisions under construction)."

Mifsud, however, warns that these are only short-term solutions.

"In the long run, one must try and study prison population trends and plan accordingly - e.g., see whether it is possible to find alternative punishments to prison, try and send more foreign inmates to serve their punishments in their home countries, make the courts more efficient so sentencing is faster, maybe even build a new prison or an extension to the present prison if this is possible..."