Self-Harm & Suicide Support in Prison UK

Self-harm and suicidal ideation are tragically common in UK prisons. The statistics are stark: prisoners are significantly more likely to die by suicide than people in the community, and rates of self-harm are at record levels. If you are struggling, you are not alone — and help is available. This guide explains how to access crisis support, what the prison must do to keep you safe, and how the safer custody system works.

Recognising the Signs

Prison is an environment designed to strip away autonomy, identity, and hope. It is normal to feel overwhelmed, anxious, depressed, or despairing, particularly in the first weeks. Warning signs that you or someone you know needs help include:

Talking about wanting to die or giving up

Withdrawing from people and activities

Extreme mood swings or emotional numbness

Self-harming behaviours — cutting, burning, or other injuries

Giving away possessions or saying goodbye

Increased substance use

Refusing food or medication

If you recognise these in yourself, act immediately. If you see them in someone else, tell a member of staff or a safer custody officer.

The ACCT Process

ACCT stands for Assessment, Care in Custody and Teamwork. It is the prison's formal process for supporting prisoners at risk of self-harm or suicide.

When a prisoner is identified as at risk, staff open an ACCT plan. This involves:

**Assessment**: A trained officer interviews the prisoner to understand the risk and its causes

**Care plan**: Specific steps are put in place — frequent cell checks, referral to mental health services, increased social contact

**Teamwork**: A team of staff and professionals coordinates support

**Review**: The ACCT is reviewed regularly and closed when the risk has reduced

Being on ACCT is not a punishment. It is a protective measure. If you feel at risk, you can request to be put on ACCT.

Safer Custody Teams

Every prison has a safer custody team responsible for preventing deaths, self-harm, and violence. They can:

Open and manage ACCT plans

Refer you to mental health services

Move you to a safer cell or wing if needed

Arrange peer support through the Listeners scheme

Coordinate with healthcare, chaplaincy, and psychology

You can contact the safer custody team directly, through your personal officer, or by pressing your cell bell and asking to see them.

The Listeners Scheme

The Listeners scheme, run by the Samaritans in partnership with the Prison Service, trains selected prisoners to provide confidential emotional support to other prisoners. Listeners are available on most wings and can be contacted directly or through staff.

Talking to a Listener is completely confidential. They will not report what you say unless there is an immediate risk to life. Listeners are not professionals, but they are trained to listen without judgement and to guide you toward further support.

Mental Health Services in Crisis

Every prison has mental health services, though the level of provision varies:

**Primary care**: Nurses and GPs can assess mental health and prescribe medication

**Secondary care**: Psychiatrists and psychologists provide specialist assessment and treatment

**Crisis teams**: Some prisons have dedicated mental health crisis teams for urgent intervention

**In-patient units**: A few prisons have in-patient mental health units for acute crises

If you are already under community mental health services, bring documentation to court. This helps the prison healthcare team continue your treatment without delay.

What to Do If You Feel Suicidal

If you are having thoughts of suicide, take these steps immediately:

**Tell someone**: A prison officer, a Listener, a chaplain, or a healthcare worker. Do not keep it to yourself.

**Press your cell bell**: Staff are trained to respond to crisis calls.

**Ask to be put on ACCT**: This triggers formal support and monitoring.

**Request to see mental health services**: Do not accept being told to "wait and see."

**Write to the Samaritans**: You can write to the Samaritans from any prison, and they will reply.

What to Do If Someone Else Is at Risk

If you are concerned about another prisoner:

Do not promise to keep secrets about suicide or self-harm.

Tell a member of staff or safer custody officer immediately.

Stay with the person if it is safe to do so.

Remove any obvious means if possible and safe.

Encourage them to speak to a Listener or healthcare worker.

After a Crisis

Surviving a mental health crisis in prison is not the end of the journey. Many prisoners experience recurring episodes of depression or anxiety throughout their sentence.

Request ongoing mental health support after an ACCT closes.

Consider attending counselling or therapy if available.

Build a support network — Listeners, chaplaincy, trusted prisoners, and staff.

Focus on education, work, or creative activities that give structure and purpose.

Frequently Asked Questions

Will I be punished for saying I feel suicidal?

No. Expressing suicidal thoughts is a health issue, not a disciplinary matter. Staff are trained to respond with support, not sanctions.

Can I be put on ACCT against my will?

Yes. If staff assess that you are at serious risk, they can open an ACCT even if you object. This is a safeguarding measure.

Will being on ACCT affect my parole?

Mental health struggles do not automatically harm your parole prospects. The Parole Board looks at how you have managed your difficulties and engaged with support.

What if mental health services are not available in my prison?

Submit a complaint and ask for referral to outside mental health services. In severe cases, transfer to a prison with better healthcare may be possible.

Can I get antidepressants in prison?

Yes. Prison healthcare can prescribe antidepressants and other psychiatric medication. There may be a delay while prescriptions are verified.

*Last updated: June 2026.*

Self-Harm, Suicide and Crisis Support in Prison