Decent rights, trust, and fairness all require greater economic equality. Without greater economic equality we cannot expect people to trust each other; rights to be upheld, maintained or respected; or for fairness to be preserved.

There is an un-egalitarian fantasy that it is possible to continue with great economic inequalities, but somehow for people to know their place and behave well in it. That fantasy has, unfortunately, become current government policy. So who should be held to account when official policies result in mortality rates rising: within mental health institutions most recently, prisons generally, and society more widely?

In the UK the situation has recently worsened. According to an editorial published in The Lancet on 10th March 2018:‘In 2016, the likelihood of self-inflicted death of offenders in custody was 8.6 times greater than the likelihood of suicide in the general population… It is lamentable that the UK’s prison system should have been allowed to decline to its current unsatisfactory levels, bringing with it a rise in depression and suicide as prisoners find themselves part of a system that puts containment above reform.

The editorial continued: ‘As with so much of the discussion around public services in the UK, the sense that a tipping point will soon be reached is tangible. The UK’s prison system has shed 30% of staff since austerity began in 2010. The average amount spent on suicide investigations in UK prisons has more than halved since 2012–13. Until conditions are improved, guidelines like these are a firefighting effort in a situation where the fires themselves may be preventable.

Two years ago on 23rd September 2016, Richard Garside reported that the prison population had risen from 46,000 in 1985 to 85,000. He explained that earlier that month the Prisons and Probation Ombudsman, Nigel Newcomen, had reported that prison violence was now at a ‘wholly unacceptable level’ [but we accepted it]. Six prisoners were killed in the 2015-16 year, he observed. This is up from four in 2014-15 and that was the highest number since records began in 2000. ‘Buildings are crumbling, infested with rats and cockroaches‘, The Economist noted in 2016. ‘In the year to June 2015,’ it pointed out, ‘105 prisoners killed themselves, compared with 59 in 2010‘. And that has now also worsened.

By May 2017 we learnt that ‘Deaths in state detention (excluding Deprivation of Liberty orders) increased by 19%, to 574 deaths being reported to coroners in 2016, with the largest increase seen in deaths while detained under the Mental Health Act (252 in 2016, up 34%) and deaths in prison custody (298, up 14%).’ Numbers of annual deaths of people held under the Mental Health Act are now almost as high as those in prisons and the population detained is roughly half as many people.

Today, in 2018, across the UK, twice as many detained patients die, per 1000, as prisoners die in prison in the UK, and the number dying in prisons has risen greatly. The overall situation is worsening.

A quarter of million British children currently have a parent in prison. One in seven children have had a parent in prison at some point but nobody talks about it, and nobody knows how many children, parents and siblings have a parent, child, brother or sister in a mental health institution. All of whom are now at greater risk than they were a few years ago. We only know this because  the numbers of deaths in custody have recently been rising more quickly than the number of people deprived of their liberty.

In 2017, prisons were using ‘cruel‘ punishments that restricted inmates from seeing their children. Hundreds of children had contact with fathers reduced to just two hours a month.

As David Scott explained on January 10th 2018:’We’ve been trying to reform the prison for 200 years. It’s failed. It’s time for us to think about doing something different‘.

A society that has learnt to tolerate some people being worth so much more than others, with such high income inequality, will then tolerate so many other injustices.