Two in five prisoners who have died in segregation in the past six years were known to be at risk of self harm and suicide at the time of their deaths, figures show.

More than 50 prisoners died in prison segregation units in England and Wales due to an incident that occurred while they were in segregation in the past six years, a freedom of information request to the Ministry of Justice has revealed.

At the time of their deaths, 40% of these prisoners were being supported through ACCT (assessment, care in custody and teamwork) case management, which means they were checked on regularly because they were at risk of suicide or self-harm.

These deaths occurred despite guidelines by the Prison Service that state prisoners subject to suicide and self-harm prevention procedures should be held in segregation units only in “exceptional circumstances”.

A Guardian analysis of the annual reports by the Her Majesty’s Inspectorate of Prisons in England and Wales and figures provided by the Ministry of Justice indicate that at least 30 of the 41 deaths that occurred between 2013-14 and 2017-18 were clearly self-inflicted. Other prisoners died from drug overdoses, illness and natural causes.

A Guardian analysis of fatal incidents reports by the prisons and probation ombudsman (PPO) found some of those prisoners who died in segregation had been kept in isolation for weeks or months at a time.

The 52 deaths include:

A 21-year-old prisoner with psychosis in segregation in HMP Leicester who was found to have had nothing to occupy his time, “not even have a radio. Until he was given one, his only occupation seems to have been making models out of his food cartons.”

A 47-year-old man in Elmley. A 2014 report found that “by the time of his death, he had spent over two months segregated with a very restricted regime and would probably have remained there for at least several more weeks”.

A 18-year-old man who struggled to cope with prison life and found it hard to communicate in English had made five previous attempts to take his own life during the three months he had been in HM Prison Wandsworth. On the day of his death, the prisoner had rung a bell in his segregation cell but it took prison staff 37 minutes to respond – by which time he was found unconscious.

A 37-year-old man who took his own life at HMP The Mount in Hertfordshire in 2015 was “held in an unfurnished cell [without any furniture or sanitation, known as special accommodation] to manage his risk. No one assessed his mental health … as Prison Service instructions require”.

A 42-year-old man who had a personality disorder and schizophrenia was incorrectly recorded as not having self-harmed in custody and not on antipsychotic medication. Prison managers at HMP Birmingham authorised the man’s segregation using this incorrect information. He killed himself 72 hours after being held in segregation.

A 2015 report by the charity Prison Reform Trust stated that segregated prisoners spent an average of 23 hours a day inside their cell.

According to the PPO, segregation involves a prisoner being removed from the general prison population. A prisoner could be segregated as a form of punishment, if their presence on a standard wing would be disruptive or unsafe for others. A prisoner might also be segregated for their own protection.

The very basic design requirements for segregation units include a window, toilet and wash basin, power point, a bed or a concrete slab with a mattress, artificial light, and a call bell. Some prisoners can also placed in “special cells” – the harshest prison environment available – that do not contain basic furniture.

Donna Mooney, the sister of a prisoner who took his own life in September 2015 while in an unfurnished cell in a segregation unit, said: “People in prisons don’t have the right training to support people with mental health issues. Their approach is very much about being compliant. They don’t know where else to put these prisoners, so they just put them in segregation, which just punishes them.”

Tommy Nicol, who was serving an indeterminate sentence, was taken to a segregation unit soon after arriving at HMP The Mount and his behaviour changed rapidly. He appeared paranoiac and erratic and was moved to an unfurnished cell for 24 hours.

“There’s nothing in there. There’s a mattress on the floor and a pot. It’s horrifying. I only found this out after he died. It’s heartbreaking to think about someone you love and care about and they’re going through this mental health episode with little support. It’s traumatising to think about that,” Mooney said.

Rebecca Roberts, the head of policy at Inquest, said: “Evidence of systemic neglect and failings in the implementation of suicide and self-harm monitoring procedures are repeatedly identified in our casework and inquest conclusions.

“Prisons are damaging and dehumanising environments that exacerbate mental ill-health. Too often extreme symptoms of distress are treated as a disciplinary matter, with segregation presented as the response. This is inappropriate for people in need of urgent care and is clearly putting lives at risk.”

A Ministry of Justice spokesperson said: “Too many people self-harm and take their own lives in prison, which is why we have recruited over 4,700 new prison officers in the last two years and introduced the key worker scheme which means each prisoner has a dedicated officer for support.”

The ministry has given Samaritans £1.5m for three years to support its dedicated listeners scheme and provided training to more than 24,000 staff.

“Prisoners are only segregated in exceptional circumstances as a last resort, for example when a prisoner is behaving violently and cannot be managed in any other way,” the spokesperson added.

• In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.org or jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found atwww.befrienders.org.





