Independent Advisory Panel on Deaths in Custody submission to the Justice Select Committee call for evidence on Imprisonment for Public Protection (IPP) sentences – November 2021





  1. The role of the Independent Advisory Panel on Deaths in Custody (IAPDC) is to advise Ministers and officials on how they can meet their human rights obligations to prevent deaths and keep those under the care of the state safe.1 The IAPDC welcomes the opportunity to submit evidence to the Committee’s call for evidence on indeterminate sentences of Imprisonment for Public Protection (IPP). Since our sole objective is to prevent deaths in custody, this response will focus primarily on the additional mental and physical health challenges this cohort face which can lead to self-inflicted and natural deaths.
  2. As strategic principle, the IAPDC is committed to drawing on the views of those in prison and other forms of detention. This submission includes testimonies the IAPDC received from prisoners between 2017 to 2019[1]. In 2017, the IAPDC conducted the Keeping Safe consultation with prisoners on how best to prevent suicide and self-harm. A significant proportion of those who responded spoke of the hopelessness of people serving an IPP sentence and the subsequent risk of self-harm and suicide. This submission also draws from 30 detailed responses made between October 2018 to March 2019 when the IAPDC, through Inside Time, the prisoners’ newspaper, called for people to write in with their views in relation to the health and wellbeing of people serving an IPP sentence[2]. Finally, it also includes testimonies from consultations in 2020 on prison safety and COVID-19[3].



  • Robust mental and physical health support must be put in place for this vulnerable cohort who face a unique set of circumstances. This should start with a review of the mental and physical health needs of IPP prisoners, including a review of modifiable risk factors and a look at the broader range of issues relevant to the wellbeing of people still serving this sentence.
  • Further research should be conducted to examine the link between self-inflicted deaths and the IPP sentence using different research designs and methodology.
  • Family links should be maintained and facilitated as a matter of priority, whether through detention close to home, family visits, or through providing video links.
  • IPP prisoners should receive a comprehensive review of their sentence and circumstances leading to a forward plan for each individual which is updated regularly. This would provide hope for, and the real prospect of, progression and release.


  • Support on release for people who have served an IPP sentence should be increased to include sound, professional supervision and active transfer to health and social care services in the community, with social prescribing if needed.

What is the experience of people on IPP sentences in prison? What additional mental health challenges do people serving IPP sentences face because of the nature of their indeterminate sentence?



“I have seen so many IPP prisoners harming themselves unreported and taking any drugs just to end the suffering quickly because this is nothing but torture of the highest order…I myself [am an] IPP prisoner with tariff of 2 ½ years, I have now served 11 years in total and still no end. My 3 young children all have suffered anxiety because I am unable to give them a date … I have been saying ‘soon’ since they were babies.”



  1. IPP prisoners should be seen as a particularly vulnerable group. The possibility of a perpetual cycle of imprisonment exacerbates feelings of hopelessness, therefore heightening risks of self-harm and suicide. The impact on the mental and physical health of people serving an IPP sentence is a key theme which emerges from the IAPDC’s consultations.
  2. Concerns have been expressed by Coroners, the Prison and Probation Ombudsman (PPO) and HM Chief Inspector of Prisons (HMIP) about the impact of this sentence on self-harm and deaths in custody.



  1. Responses to the IAPDC’s 2017 consultation with prisoners[4], as well as further letters received via Inside Time, demonstrate how the indeterminacy of imprisonment leaves people on the IPP sentence feeling hopeless, helpless, and often afraid to seek support, which in turn could prolong their detention. IPP prisoners note that these feelings of hopelessness stem from both a frustration at serving life sentences for crimes that typically would have merited shorter determinate sentences, as well as a sense of unfairness about the disparity between their sentence and the crime[5]. 
  2. Hopelessness is thought to be a relevant factor in terms of the relationship between IPP sentences and self-harm and is one of the most prominent cognitive factors associated with suicides more generally[6]. One meta-analysis study found hopelessness has a strong link with suicidal thoughts and attempts[7]. Hopelessness is also known to be associated with repeat suicide attempts[8].
  3. Concerns about the health and wellbeing of IPP prisoners have been raised with the IAPDC by, among others, family members, senior NHS managers, Samaritan Listeners and Royal Colleges of medicine. Independent Monitoring Boards have repeatedly expressed concern for the welfare of IPP prisoners, remarking in their most recent annual report[9]:


"Several Boards, including Wakefield, Lindholme and Haverigg, continued to report the negative impact of the absence of a release date on the mental health of IPP prisoners.”

  1. The IAPDC visited HMP Humber in 2018 and spoke to prisoners and staff at the Hope Unit. A Samaritan Listener confirmed that lost hope was the most fatal thing”. The senior officer and team had built up good professional and supportive relationships with prisoners on the unit but remained concerned that continuing uncertainty, regular knockbacks and unsuccessful parole hearings mean IPP prisoners “lose complete hope and lose trust in the system[10].
  2. Although evidence suggests hopelessness increases suicidality, it is difficult to establish the independent effect of hopelessness without co-morbid depression or psychological distress. Studies have found that people given IPP sentences are disproportionately likely to have pre-existing mental health problems. Research also details the negative mental health implications of IPP imprisonment[11].



As an IPP prisoner myself there is no hope, violence drugs are the answer, we have nothing left to lose, kicking off is the only answer ‘cause we have no hope.”




  1. The psychological toll of having an unknown release date is well[12] documented[13]. The Prison Reform Trust’s 2019 report, No Life, No Freedom, No Future, which draws on government statistics, found that IPP prisoners were over two-and-a-half times more likely to harm themselves than others in the prison population[14].
  2. Rates of self-harm amongst IPP prisoners are high. Table 1 shows that even as the IPP population reduced, the number of self-harm incidents increased between 2014 to 2017. Whilst self-harm incidents have reduced over the past two years, this mirrors an overall decline in the IPP population. Last year, a total of 2,066 self-harm incidents were recorded, meaning there were more such incidents recorded than the number of IPP prisoners[15].

    Table 1: Number of self-harm incidents among IPP prisoners from 2012 2020










































Self-inflicted deaths



“I have not known for nearly 10 years if I will ever be released I was 15 when I went to prison I struggle with my mental health before going to prison  made it worse for me im now in hospital under section 47/4a of the mental Health Act when in prison I was moved around a lot I self harmed and attempted suicide it’s difficult not knowing if I will be released I’ve got nothing to aim for”




  1. IPP prisoners have repeatedly been identified as at a higher risk of suicide or self-harm than those in the general prison population. For example, the Prison and Probation Ombudsman reported in 2014:


“This [an IPP sentence] is an uncertain situation and for some could lead to hopelessness, which is associated with increased risk of suicide.” [16]


  1. As of May 2021, of the 250 IPP prisoners who have died since the sentence came into effect, 65 have taken their own lives whilst in custody[17]. Although this number is high, the figures involved are too small to draw any statistically significant conclusions and to understand whether IPP prisoners die disproportionately versus prisoners on other sentences. However, it may be that further analysis that considers the deaths of the IPP population with an appropriately comparable population, such as those serving sentences longer than four years within the wider prison population, would reveal relevant differences.


  1. Investigations into individual deaths have drawn attention to the real impact of the IPP sentence on worsening mental health which can ultimately lead to suicide. Commenting on the inquest in 2018 into the self-inflicted death of IPP prisoner Tommy Nicol, Deborah Coles, Executive Director of INQUEST and an IAPDC panel member, noted:

“The inquest heard evidence of an abhorrent lack of care concerning Tommy’s deteriorating mental health. He was left alone and distressed in an unfurnished cell, already two years over his sentence. A forensic psychiatrist said he was almost certain that the IPP sentence more than minimally contributed to his death.[18]


  1. Donna Mooney, Tommy Nicol’s sister, has spoken of the unique challenges Tommy faced being on an IPP sentence, and has worked tirelessly to highlight the plight of those still serving an IPP sentence. Donna has stressed that Tommy felt his sentence was a ‘life sentence’ and described it as “psychological torture of a person who is doing 99 years”[19] which ultimately led to him taking his own life. She told the IAPDC:

“I just want his death to count for something. He had his whole life feeling that he didn’t count for anything.

  1. The IAPDC recommends a thorough review of the mental health needs of all individuals on an IPP sentence. This review should also consider the important and specific social care and physical health needs that, if unmet, might increase the risk of suicidality inside custody and on release for this vulnerable cohort.

Women, self-harm and suicide

  1. The IAPDC’s analysis in 2019 – using an annual mean over six years – suggested that the rate of self-harm among the female population was as high as 4,520 per 1,000 prisoners[20]. Although women prisoners make up a small proportion of the IPP population (2% in 2017/18), their self-harm rate is at least double that of other women in prison and over ten times the national average within the general female population.


  1. In March 2019, the Griffins Society published The Plight of Women on IPPs[21] which outlines findings from detailed interviews with nine women in prison who, at the time, had served at least twice and as many as 11 times their tariff. Six of these nine women had tried to take their own lives multiple times during their sentence. Other findings include anger and frustration at the indeterminate element of the sentence and that every woman said simply having a ‘having a date’ would make the most difference.


Coping with the loss of loved ones


  1. The impact of losing loved ones whilst in prison compounds feelings of hopelessness and anger at the sentence, particularly when a loss occurs in the post-tariff period. Women on IPP sentences have also spoken of the impact of losing children to local authority care[22]. The loss of relationships with children have been identified as particularly traumatic for women[23].

“I never received any grief counselling following the deaths of my parents again as funding is not available for IPPs or so I was told. when I arrived here due to the self-harming I was referred to mental health who without seeing or speaking to me assessed me as unsuitable for support. I was seen by a GP around 10 weeks ago who referred me to mental health again for grief counselling and general support but still they have refused to go near me because of the IPP label.”


  1. Due to the damaging nature of the sentence, families provide an important source of support. However, relationships with families often become fractured because of the uncertainty of release[24].

    If you support and strengthen visits properly. Deaths in prison will fall. I ll say family wings and video link is key to stop death and drug taking in English prisons.”



  1. In line with Lord Farmer’s review[25], which identified the family as the “golden thread” running through the prison journey, the IAPDC recommended in its 2019 report that the Government work to maintain and facilitate family links through detention close to home, family visits or video links, and that compassion should be shown to prisoners who have lost loved ones with bereavement or grief counselling offered.



what about the pain and suffering it is laying on our families?  Just the emotional stress of having a loved one trapped in this nightmare is a form of torture.[26]



“There’s an endless amount of hoops they’ve got you jumping through. And your families out there. My nan’s 82 now. You can see why some of the lads do desperate things.”(HMP Humber)

Deteriorating physical health


  1. It is important to acknowledge the negative impact of the IPP sentence on physical health. In letters received from IPP prisoners, many speak of the impact of the sentence on both their mental and physical health, with the latter being affected by the specific issues that arise from lack of purposeful activity and chronic stress.
  2. Some letters attest to the intertwined nature of mental and physical health, highlighting that some of the effects of anxiety, depression and other mental ill-health can lead to worsening physical health, for example, from an inability to engage in physical activity. IPP prisoners can also face challenges accessing appropriate healthcare specifically because of their sentence.
  3. The IAPDC recommends a review of modifiable risk factors and physical health needs for those on IPP sentences, which should cover broader issues relevant to health and wellbeing, such as (but not limited to): physical and mental health needs; social care needs; daily/weekly activities/hours per week; work; education; library visits; gym and exercise; contact with family/friends; skills for everyday living; and sentence requirements and suitability for recategorization, release on temporary license and transfer to open conditions.

    “I have been diagnosed with epilepsy which is triggered by stress. I have never once seen a member of any Mental Health team, and it is not for want of trying. I have been told over the years a variety of reasons why from that they have no funding to cover IPP’s to the assumption that I don’t meet the criteria to access the support of Mental Health. I was told in my last prison that I could only access mental Health as an IPP if I had had “a successful suicide attempt” (didn’t make sense to me) but if I need support to call the Samaritans”




“I was in my late 30s when I entered prison and I’m now in my early 50s and my physical health could be better. I have developed a heart condition due to anxiety and taking medication. I barely sleep 5 hours a night as my neighbours are so noisy in the early hours of the morning and the night staff so noisy making their wing rounds. It is lonely in prison.”



What are the current barriers preventing release? What measures would need to be taken to overcome these barriers, and what would be the operational and resource implications for HMPPS?


  1. Some studies explore the adverse effect of the IPP sentence on an individual’s ability to engage in regime and risk reduction work that would help prepare them for release[27]. In the Griffins Society report, interviews with women prisoners illustrated widespread feelings of compounded anger that the sentence had been abolished, but they were still in custody, which led to a lack of confidence in the system and affected their willingness to engage in programmes that may enable their release[28].
  2. An IPP prisoner with learning difficulties in Wandsworth prison, noted that to be released, he had to attend specific offender behaviour courses, however, those courses were not available at his prison, and he was not able to move to a prison that did run the necessary programmes. He was essentially “stuck in a horrific limbo”[29] which severely impacted his mental health.

“Prison is MEANT to be about rehabilitation but it’s not. It’s about punishment and protecting the public. Yes, these are important, but as a prisoner, I need to see progress. I NEED to see light at the end of the tunnel. All I see right now is darkness. And THAT is why I am still a potential suicide risk.”

What options are available to reduce the size of the IPP prison population? What are the advantages and disadvantages of the different options?


  1. The IAPDC recommends that the Government reviews the cases of all individuals still serving an IPP sentence and develops a sensible forward plan for each individual that would allow for some hope and sentence progression. This solution would have the most positive impact on physical and mental health.


How is release and resettlement planned and managed for IPP prisoners given their unpredictable release date?


  1. The support that is typically in place for prisoners on release is not sufficient for IPP prisoners because of the additional risk factors and challenges they face. This is echoed by other organisations such as the Prison Reform Trust, who found that the:


support available for people serving IPPs in the community after release did not match the depth of the challenge faced when rebuilding their lives after prison.[30]


  1. One prisoner wrote to the IAPDC:



“There should be a dedicated member of staff in prisons to prepare IPPs coming up for release. No alternative duties, just prepare the person by the next parole date. This country is quick to jump on all the human rights abuses and injustices in other countries but doesn't look at its own against its own citizens. We are here we exist. Tell any IPP they are going home but that they will automatically get 3-5 years for any crime they commit and you will never see them again.”



How are people on IPP sentences managed within the community once released?


  1. One of the challenges people on IPP sentences face is the fear of being recalled, which can leave them living in a never-ending cycle of anxiety, unable to socialise with others out of fear of breaching their probation rules. This fear is even felt before they are released, and some now fear life outside of prison more than life within.
  2. People on IPP sentences need individual, tailored, and increased support as well as access to ongoing health and social care services because of the additional mental and physical challenges they face upon release. The IAPDC recommends a specific stream of social prescribing could be developed for this cohort.



“I’m in prison now for missing one night in my Approved Premises, which can cost me anything up to 3 or 4 years of my life, I understand there is always a consequence to actions and I am always willing to take responsibility for that, but to be overly punished with a consequence that doesn’t fit the action, it’s plain wrong, I need justice for me and all other IPPs up and down the country.”



What are the main reasons why people serving IPP sentences are recalled? Once recalled what support is given to prepare them for re-release?

  1. Although the IPP population is decreasing, the proportion of those who are post-tariff, and the number of IPP recalls to custody, has increased in the past five years. Reports have found that people are often recalled into indefinite custody for behaviour that appears to fall short of the tests set in official guidance[31]. This is echoed by prisoners’ fears that on release, they may be recalled for minor incidents or false allegations[32].
  2. The Prison Reform Trust’s analysis of recalled IPP prisoners highlights the impact of recall on wellbeing. One of the contributing factors is a lack of a clear plan for re-release; some participants felt unable to ask for help, many did not have a good understanding of what would be required of them, and some were not given any work that would secure their re-release[33].



During my first half of my whole sentence in prison I was continuously punished, belittled, dejected, bullied and mentally tortured for having mental health problems, as is the case for many prisoners. I have been recalled to prison now and the whole situation is recurring. I have very debilitating depression and anxiety that drags me down.”



The IAPDC is grateful for this opportunity to submit written evidence to the inquiry and would welcome the opportunity to provide further information or oral evidence if required by the Committee.

[1] Independent Advisory Panel on Deaths in Custody, ‘Keeping safe – preventing suicide and self-harm in custody.’ December 2017. Available at: [Accessed on 17/11/202]

[2] IAP in collaboration with Inside Time, Keeping Safe, September 2017.

[3] Independent Advisory Panel on Deaths in Custody, ‘Just one thing: prison safety and COVID-19’, September 2020. Available at: [Accessed on 17/11/2021]

[4] Independent Advisory Panel on Deaths in Custody, ‘Keeping safe – preventing suicide and self-harm in custody.’ December 2017. Available at: [Accessed on 17/11/202]

[5] Dr Kimmett Edgar, Dr Mia Harris and Russell Webster, 'No life, no freedom, no future', December 2020, Available at:
​​[Accessed on 11/10/2021]

[6] Independent Advisory Panel on Deaths in Custody, ‘Priorities for a prevention of deaths

strategy in Immigration Removal Centres’, October 2020. Available at: https://static1.squarespace

.com/static/5c5ae65ed86cc93b6c1e19a3/t/6058d4e6e6ba2f186a178d60/1616434407688/IAPDC+-+IRC+priorities+for+a+prevention+of+death+strategy+-+final.pdf [Accessed 12/10/2021]

[7] Jessica D Ribeiro, ‘Depression and hopelessness as risk factors for suicide ideation, attempts and death: meta-analysis of longitudinal studies’, May 2019. Available at: [Accessed 11/10/2021]

[8] Namkee Choi, Yeates Cornwall, C Nathan Marti, ‘Effect of Problem-Solving Therapy on Depressed Low-Income Homebound Older Adults' Death/Suicidal Ideation and Hopelessness’, October 2015. Available at:

Therapy_on_Depressed_Low-Income_Homebound_Older_Adults'_DeathSuicidal_Ideation_and_Hopelessness [Accessed 11/10/2021]

[9] Independent Monitoring Boards, National Annual Report 2020-21, September 2021. Available at: 2021-09-23-IMB-National-202021-Annual-Report-FINAL.pdf [Accessed 17/11/2021]

[10] Independent Advisory Panel on Deaths in Custody, ‘Indeterminate sentences for public protection (IPPs): preventing self-harm and deaths in custody’, June 2019. Available at: [Accessed on 17/11/2021]




Jamie Grierson, ‘Charlotte Nokes's father: 'They might as well have thrown the key away'’, March 2020. Available at:

father-prison-sentence [Accessed 11/10/2021

[13] May Bulman, ‘​​‘Serious failures in communication’ led to suicide of man serving ‘unjust’ indeterminate prison sentence’, January 2020. Available at: ​​

suicide-man-prison-inquest-david-dunnings-hmp-coldingley-a9309621.html [Accessed 11/10/201]

[14] Dr Kimmett Edgar, Dr Mia Harris and Russell Webster, 'No life, no freedom, no future', December 2020, Available at:
​​[Accessed on 11/10/2021]

[15] Safety in Custody Statistics, England and Wales: Deaths in Prison Custody to March 2021, Assaults and Self-harm to December 2020. Available at:

safety-in-custody-quarterly-update-to-december-2020 [Accessed on 11/10/2021]

[16] Prisons and Probations Ombudsman, ‘Learning from PPO Investigations’, April 2014. Available at: Risk_thematic_final_web.pdf ( [Accessed on 17/11/2021]

[17] Ministry of Justice, ‘Deaths in prison custody 1978 to 2020’, January 2021. Available at: [Accessed 12/10/2021] 

[18] INQUEST, ‘Inquest concludes into death of Tommy Nicol who 'lost hope' on IPP sentence’, November 2018. Available at: [Accessed 11/10/2021]

[19] Jamie Grierson, ‘Sister of IPP prisoner who took his own life calls for urgent action’, January 2019. Available at: [Accessed on 17/11/2021]

[20] Ministry of Justice, ‘Safety in custody: quarterly update to June 2019’, June 2019. Available at: [Accessed 12/10/2021]

[21] Sarah Smart, 'Too many bends in the tunnel? Women serving Indeterminate Sentences of IPP - what are the barriers to risk reduction, release and resettlement?',  2018. Available at: [Accessed on 11/10/201]

[22] Sarah Smart, 'Too many bends in the tunnel? Women serving Indeterminate Sentences of IPP - what are the barriers to risk reduction, release and resettlement?',  2018. Available at: [Accessed on 11/10/2021]

[23] Walker S., and Worrall A., ‘Life as a woman: The Gendered Pains of Indeterminate Imprisonment’,  2000. Available at: [Accessed 12/10/2021]

[24] Prison Reform Trust, ‘Unjust Deserts: Imprisonment for Public Protection’, 2010. Available at: ​​ [Accessed 12/10/2021]

[25] Lord Farmer, ‘Importance of strengthening prisoners' family ties to prevent reoffending and reduce intergenerational crime’, August 2017. Available at:

government/uploads/system/uploads/attachment_data/file/642244/farmer-review-report.pdf  [Accessed on 12/10/2021]

[26] Name Supplied – HMP Oakwood, ‘IPP Political?’, October 2020. Available at:

[27] Russell Webster, ‘The Mental Health Impact of Being An IPP’, December 2020. Available at: [Accessed 17/11/2021]

[28] Sarah Smart, 'Too many bends in the tunnel? Women serving Indeterminate Sentences of IPP - what are the barriers to risk reduction, release and resettlement?',  2018. Available at: [Accessed on 11/10/2021]

[29] Chris Atkins, ‘A Bit Of A Stretch’, February 2020.

[30] Dr Kimmett Edgar, Dr Mia Harris and Russell Webster, 'No life, no freedom, no future', December 2020, Available at:

no%20freedom_final_web.pdf  [Accessed on 11/10/2021]

[31] Dr Kimmett Edgar, Dr Mia Harris and Russell Webster, 'No life, no freedom, no future', December 2020, Available at:

no%20freedom_final_web.pdf  [Accessed on 11/10/2021]

[32] Sarah Smart, 'Too many bends in the tunnel? Women serving Indeterminate Sentences of IPP - what are the barriers to risk reduction, release and resettlement?',  2018. Available at: [Accessed on 11/10/201]

[33] Dr Kimmett Edgar, Dr Mia Harris and Russell Webster, 'No life, no freedom, no future', December 2020, Available at:

no%20freedom_final_web.pdf  [Accessed on 11/10/2021]