On 13 August 2010, the Ministry of Justice published a damning report into the circumstances which led to an 18 year old prisoner hanging herself in the showers at Holloway, an incident which has left her in a persistent vegetative state.
The report by Rob Allen, Director of the International Centre for Prison Studies at King's College London, is highly critical of the poor care Ana Attia received during her time in custody and of the failure of the prison mental health team to ensure her welfare. Failures in record keeping and communication meant that the officers responsible for Ana’s care had no idea that she had a history of mental illness and self-harm.
The report also condemns the lack of mental health and suicide prevention training at the prison, which holds large numbers of women with mental health issues.
Most worryingly, the report questions whether the prison has actually improved its assessment procedures since 2004.
Despite this, the Ministry of Justice say there is no need for a public hearing of the issues and that it is sufficient merely to have published the report.
Ana Attia, then 18, was a first time prisoner at HMPYOI Holloway. She had a psychiatric history of serious mental ill-health, having been diagnosed in 2002 with paranoid schizophrenia. Her condition was reconfirmed by a psychiatrist in February 2004 and that report was in her prison records. Arguably, given her mental condition, she should never have been given a custodial sentence.
In April 2004 she was found in the showers with a ligature and was put on suicide watch. Shortly after she was taken off suicide watch, she was allowed to continue with her cleaning duties despite the fact that prison staff knew she had just broken up with her boyfriend and should have known of her vulnerable mental state. On 2 May 2004, she was found hanging in the shower from a single sheet and was cut down, but too late. She survived but has been in a presumed vegetative state ever since.
Her near death came two weeks after the suicide of Julie Hope (died HMP Holloway, 17 April 2004) and just before the suicide of Heather Wait (died HMP Holloway, 8 May 2004).
Since 2004 Ana’s mother has been campaigning for an independent inquiry into how her daughter could have been left unattended and how it was that prison staff were unaware of her psychiatric history.
The initial inquiry was carried out by the Prison Service and was wholly inadequate - important issues were not even raised with the main officers involved and the investigator appears to have prompted them in interviews.
Hickman and Rose solicitors had to threaten judicial review twice to get the Ministry of Justice to the stage where they agreed that an independent inquiry should take place and then there were very long delays in setting up the inquiry. They then had to threaten judicial review again when the Ministry of Justice appointed a former prison governor to lead the investigation, which clearly did not meet the requirements of independence.
Its key findings are that:
- There was a lack of structured assessment in Ana’s case and the prison missed opportunities to help meet her needs.
- The quality, consistency and integration of the medical care provided to Ana in Holloway was inadequate. Given her psychiatric history and the opportunities to provide a sustained programme of treatment, the failure of staff to take an interest in her case until she had been in prison for so long is hard to understand.
- The quality of care provided to Ana was adversely influenced by the limited information which staff had about her mental health problems.
- Staffing levels were too low at Holloway. In particular, on Saturdays and Sunday evenings when many women may have visits which might prove distressing for one reason or another, there is a need for women to be able to talk to staff.
- It is not clear how far the situation has improved at Holloway in respect of cases like Ana’s.
Hickman and Rose are also bringing private law proceedings for damages against the Ministry of Justice on Ana’s behalf, claiming negligence and breach of the Human Rights Act 1998.
Ms Attia's mother said: "My daughter cried for help but they left her alone in a cell and didn't give it to her. They were supposed to look after her. But there was no communication and they made a big mistake. What they don't realise is that, because of this, I lost my daughter. She'll never come home and give me a kiss, never get married. The most hurtful thing is that they won't admit it. I need them to answer my questions. I hope one day they will say 'sorry, we made mistakes'."
Anna Mazzola, the family’s solicitor said:
“We are pleased that a thorough investigation has finally been carried out and grateful that Ana’s family have had the opportunity to provide input. However, had Ana’s mother not repeatedly pushed for it to take place and known she was entitled to seek legal advice, she would never have got this far. Moreover, the investigation has clearly been limited by the fact that so much time has passed since the incident. Records have been lost, people have moved on and memories have faded.
We are very disappointed that there will be no public hearing of the issues, nor any opportunity for Ana’s family to put questions to the witnesses. This would have been the procedure had Ana actually died and an inquest been initiated. The Ministry of Justice have given Ana the minimum she is entitled to under Article 2 of the European Convention on Human Rights, which imposes a positive obligation on the state to investigate where there has been a death or near death in custody. And they have only provided that after years of wrangling. I understand that the government are concerned about the spiralling costs of these type of investigations, but it should not be left to the grieving family to have to battle for a proper investigation into how their loved one nearly died.”
For further information please contact Anna Mazzola, on firstname.lastname@example.org or at 020 7702 5331.