Report of the Inquiry into the circumstances of the Death of Bernard ...

makes clear that people with a personality disorder should not be excluded from any
health or social care.
12.23 Dr Wright commented, however, that at the last survey of prison populations
some 72 per cent of prisoners were said to have an antisocial personality disorder.
Conventional wisdom in 1998 was that little could be done to treat this condition that was
so common throughout the prisons and Sonny Lodge was assessed by the psychiatrist
at outside hospital as having a low risk of suicide. That made him low priority for
psychiatric follow-up.
Identifying risk of suicide or self-harm
12.24 Dr Wright drew a distinction between the F2052SH system, which he saw as
primarily a screening tool, and its successor, the ACCT plan, which adopts a care
planning approach. Dr Wright said that the F2052SH tended to be reduced to a
screening tool for something that was not really screenable. (Chapter 14 describes the
main features of the F2052SH system and the ACCT procedures that have now replaced
it. ACCT means Assessment, Care in Custody and Teamwork.)
12.25 Dr Wright was asked whether a doctor assessing fitness for adjudication should
be made aware of a closed F2052SH or ACCT plan. (This is considered further in
Chapter 13.) Dr Wright said that they should, in that some information was better than no
information, but the problem was that F2052SH, personality disorder, and mental illness
were so common in prison. Suicide was notoriously difficult to predict, in particular from
one-off interactions, and what a person said should not necessarily be taken at face
value.
12.26 Nonetheless, Dr Wright considered that opportunities were missed in the final
week of Sonny Lodge’s life to open an F2052SH and to plan care accordingly. In
particular, he considered the warnings from Mr Lodge’s girlfriend to be a “red warning
sign”. At the same time, certain activities by discipline staff heightened Sonny Lodge’s
sense of hopelessness.
Sonny Lodge’s sense of victimisation
12.27 Dr Wright was aware from the terms of reference of the investigation and from
seeing some of Mr Lodge’s letters that he believed he was being victimised by discipline
staff. Dr Wright considered whether this was a deluded belief caused by an underlying
mental illness with symptoms of paranoia. Dr Wright found no evidence in the papers of
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