Custodial Operations Standard Operating Procedure - Hunger Strikes

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Performance Standard
Authority
1.	Procedure Requirements
1.1	Definitions
2.	Initial Notification
3.	Initial Requirements
4.	Psychological Assessment
5.	Health Services Requirements
6.	Documenting the Hunger Strike
7.	Situation Report of the Hunger Strike
8.	Cessation of Hunger Strike

Performance Standard

A prisoner on a hunger strike is managed in accordance with this standard operating procedure and -

Safety and Security - Our Principles

Refer - Safety and Security - Our Principles (in-confidence).

Authority

Corrective Services Act 2006 ss 263, 265

1. Procedure Requirements

A hunger strike is the deliberate refusal of food or fluid and in a number of cases is used for the purpose of obtaining a desired outcome. A prisoner who chooses not to eat a meal for any other reason (feeling unwell or a dislike for what is being offered) is not classed as being on a hunger strike.

If a prisoner declares or appears to be participating in a hunger strike to a corrective services officer, an officer must -

1. immediately advise a correctional manager and/or correctional supervisor;
2. advise the prisoner that placing himself or herself on a hunger strike is not considered appropriate and that this may result in -
   
   
   1. separation on a safety order; and/or
   2. transfer from a low security facility to a high security facility (if applicable); and
   
   
3. inform the prisoner that a hunger strike will be recorded as an incident, which may be considered in future management decisions for the prisoner.

A prisoner, will be provided a period of no longer than 24 hours (but a mimimum of at leat two meal periods) to confirm whether he or she wishes to commence a hunger strike. The officer must confirm with the prisoner after the designated period of time if the prisoner intends to commence a hunger strike.

1.1 Definitions

'General Manager's nominee' means -

1. deputy general manager;
2. correctional manager; and
3. correctional supervisor.

2. Initial Notification

Following confirmation that a prisoner is on a hunger strike It must be reported immediately to -

1. the nurse unit manager or senior nurse on duty;
2. the general manager of the facility or nominee (the duty manager must be advised after hours); and
3. relevant persons by means of an incident report (refer standard operating procedure - Incident Reporting).

The general manager or deputy general manager of the facility must make the final decision in consultation with health centre staff regarding the management of a prisoner while on hunger strike.

In low security facilities, the general manager or deputy general manager of the facility must assess the need to transfer the prisoner to a high security facility, refer procedure - Transfer of Prisoners.

The general manager of the facility or nominee, or after hours the duty manager, must arrange within eight (8) hours of being advised of a confirmed hunger strike, for the prisoner to be interviewed in order to ascertain the circumstances and reasons for the prisoner refusing to eat and/or drink.

A prisoner on a hunger strike must be considered at risk of self-harm or suicide and managed in accordance with procedure - At-Risk Management (Self Harm/Suicide).

3. Initial Requirements

The general manager of the facility or nominee must provide for the management of a prisoner on a hunger strike including -

1. the nurse unit manager is notified of any concerns, including significant events or changes in the prisoner's behaviour;
2. a psychological assessment is undertaken (refer section 4 of this standard operating procedure); and
3. ensuring that -
   
   
   1. the prisoner is accommodated in an area that provides for the management of the prisoner in accordance with procedure - At-Risk Management (Self Harm/Suicide) and, where relevant, standard operating procedure - Safety Orders (refer s.53 (1)(a) CSA);
   2. access to buy-ups continues;
   3. offers of all meals are made at each scheduled meal period and the response to each offer recorded in a designated log book;
   4. significant events or changes in the prisoner's behaviour are case noted in IOMS ; and
   5. the prisoner is not permitted to engage in any physical activity, such as sport, that may impact on the physical effects of refusal to eat or drink.
   
   

4. Psychological Assessment

A psychologist must assess the prisoner as soon as practicable following confirmation of the prisoner's refusing to eat and/or drink.

The psychologist must provide the general manager of the facility with a written report outlining factors contributing to the refusal to eat and/or drink and make recommendations for intervention.

5. Health Services Requirements

A prisoner capable of making informed choices with regard to the management of his/her health issues must have those choices respected unless this results in an adverse event that places the prisoner or others at risk.

Refer Offender Health Services procedures - Consent to Treatment and Health Management of Hunger Strikes

A health practitioner will determine if a prisoner requires treatment within the corrective services facility or at an external health facility.

6. Documenting the Hunger Strike

The general manager of the facility or nominee must maintain details of actions taken subsequent to the identification that a prisoner is on a hunger strike. This must ensure all stages of the incident are fully documented by the corrective services officer's involved in the prisoner's management, including any religious or philosophical beliefs of the prisoner.

Medical assessments and reports will be filed on the prisoner's medical file.

Non-medical assessments and reports must be scanned and attached to IOMS.

7. Situation Report of the Hunger Strike

A situational report must be forwarded to the Deputy Commissioner, Statewide Operations in circumstance where a health practitioner is considering admitting a prisoner on hunger strike to an external health facility, The general manager or deputy general manager of the facility will nominate a staff member to complete the report. The report must include -

1. the prisoner's physical health provided by a health practitioner;
2. a psychologist's assessment of the prisoner's emotional/psychological state and appraisal of intervention strategies employed;
3. the prisoner's behaviour detailing any significant events; and
4. any other relevant comments.

8. Cessation of Hunger Strike

When a corrective services officer becomes aware that a prisoner has ceased a hunger strike and has commenced eating and/or drinking, the officer must notify the general manager of the facility or nominee and the nurse unit manager.

A case note must be entered into IOMS detailing the cessation of the hunger strike.

The incident report must be updated to reflect the cessation of the hunger strike and if known the reason/s the prisoner ceased the hunger strike.

Endorsed by:

PETER BOTTOMLEY

Deputy Commissioner, Statewide Operations

Approved by:

MARLENE MORISON
Commissioner

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