Executive Summary

For the first time, this report links the data published by the Scottish Prison Service (SPS) with the official records held by the National Records of Scotland (NRS) to examine cause of death in prison custody and compare deaths in prison custody with deaths occurring in the general Scottish population.

The report provides an overview of high level trends in deaths in prison custody over the period 2012-13 to 2022-23. The report presents a high level summary of deaths in prison custody, and therefore does not reflect the individual personal stories of the people involved.

The analyses presented in this report should not be taken as indicative that the risk of death changes specifically because of an individual being in prison custody. Underlying contributory or determinant factors have not been examined in the analysis here.

Data on prison population levels across 2012-13 to 2022-23 is taken from the national Prison Population statistics. The period covered by this report reflects the latest available official statistics on cause of death from NRS. The report on Deaths in Prison Custody should be viewed in the context of the prison population during the period covered by the data, and not more recent prison population figures.

Deaths in Prison Custody 2012-13 to 2022-23

From 2012-13 to 2022-23, there were 345 deaths occurring in prison custody.

The annual number of deaths occurring in prison custody fluctuated between 2012-13 and 2022-23, but there has been a general upward trend. Over the reporting period, the average number of deaths occurring per year is 31.4, with the lowest at 17 in 2012-13 and the highest at 48 in 2021-22.

Until 2018-19 deaths involving those aged 35 to 54 years comprised the highest number of deaths in prison custody in most years. Since 2019-20, the number of deaths in prison custody involving those aged 55+ years has increased and exceeded the number involving those aged 35-54 years (with the exception of 2021-22). The number of deaths in prison custody involving those aged under 34 has fluctuated over the reporting period. In 2022-23, 46% of deaths in prison custody involved those aged 55+ years, 38% involved those aged 35-54 years and 15% involved those aged under 34 years (n=39).

Just 4% (n=345) of the deaths occurring in prison custody from 2012-13 to 2022-23 involved females.

Cause of Death in Prison Custody

Over the reporting period, 105 deaths in prison custody were categorised as probable suicide (around 30%, n=345).

While there is a general upward trend in the overall number of deaths in prison custody across the period 2012-13 to 2022-23, the number of probable suicide deaths has fluctuated between years. However, the number of probable suicide deaths per year is at a slightly increased level from 2016-17 to 2022-23 when compared against the earlier years in the reporting period.

The highest annual number of probable suicide deaths in prison custody occurred in 2016-17 and 2021-22, with 15 such deaths recorded in each year. In 2022-23 there were 9 probable suicide deaths, a decrease of 6 from 2021-22. 

The second most frequent cause of death in prison custody between 2012-13 and 2022-23 was diseases of the circulatory system (71 in total over the period, 20.6% overall).  Breaking this down further, 37 of the 71 deaths caused by diseases of the circulatory system were classified as ischaemic (coronary) heart disease, while 15 were associated with cerebrovascular disease.

The number of diseases of the circulatory system deaths in prison custody per year has fluctuated over the reporting period. In the 2022-23, 10 deaths in prison custody were attributed to diseases of the circulatory system, the second highest annual figure across the time period.

Between 2012-13 and 2022-23 there were 50 drug misuse deaths in prison custody (14.5% overall). While there are fluctuations year to year, the number of drug misuse deaths in prison custody has increased over the reporting period.

In 2022-23 there were 9 drug misuse deaths in prison custody, a decrease of 3 from the peak of the previous year (12 in 2021-22). While this is a small decrease, the figure for 2022-23 is the second highest point in the time series.

The increase in drug misuse deaths in prison custody is similar to the trend observed in the general population, with the highest number of drug misuse deaths in the general population occurring in 2020.

Deaths caused by cancer (malignant neoplasms) accounted for 36 (around 10.4%) of all deaths in prison custody between 2012-13 and 2022-23. The number of cancer (malignant neoplasms) deaths in prison custody have fluctuated, but have been at a generally higher level in the second half of the reporting period (15 recorded between 2012-13 and 2017-18 compared to 21 between 2018-19 and 2022-23). The most common form of cancer in deaths in prison custody is ‘malignant neoplasms of bronchus and lung’ (14 out of 36, around 39%).

From 2020-21, there have been 16 deaths in prison custody involving COVID-19. Fifteen of these deaths in prison custody were recorded in 2020-21 and 2021-22. There was only 1 death in prison custody involving COVID-19 in 2022-23.

Comparison with the general Scottish population

Using standardised mortality ratios (SMRs) has demonstrated that the risk of death in the male prison population has been significantly lower than in the male general population of Scotland in each year between 2012-13 and 2022-23.  In 2020-21 and 2021-22 the risk is closer to that of the general population, but remains significantly lower.

The risk of male probable suicide deaths in prison custody was similar to the male general population across the rolling periods 2012-15 to 2018-21, but in the rolling periods 2019-22 and 2020-23 the risk of male probable suicide deaths in prison custody was significantly higher than the general population. 

The risk of male drug misuse deaths in prison custody was significantly lower than in the general population for the periods 2012-15 to 2019-2022. However, for the period 2020-2023 the risk of male drug misuse deaths in the prison population is similar to the general male population.  

The SMRs presented in this report should not be taken as indicative that the risk of death (by probable suicide, drug misuse or any other cause) changes specifically as a result  of an individual being in prison custody. It should be noted that underlying contributory or determinant factors have not been examined in the analysis. Patterns in both population groups impact on the calculated ratio for each time period presented. Therefore, consideration must be given to the patterns present in both the prison and general populations when interpreting the results.

If you are a journalist covering these statistics in the media, please consider following the guidelines issued by Samaritans on the reporting of suicide.

If you are struggling to cope, help is available.

NHS inform has a list of resources available to anyone, with many of these available 24 hours a day.

Samaritans can be called for free on 116 123 (UK and Republic of Ireland) or contacted via email at jo@samaritans.org. Visit the Samaritans website for more information.