854
French
cancer
!R,—Jean-Michel
research Bader
funding from ARC
(July 23, p 229) repeats
baseless
allegations made in the June 25 and July 16 issues of the weekly magazine l’ Express by the director of the Gustav Roussy Institute (IGR) in Villejuif, France, criticising I’Association pour la Recherche sur le Cancer (ARC) while admitting that no other private foundation in Europe provides more money for cancer research than ARC does. Over the past ten years ARC has allocated than FFr 2000 million to cancer research and the number of subscribing members and donors exceeds 3 million. First, I would like to correct the record on ARC grants to IGR. Bader should have inquired into ARC’s special support for IGR, especially following its new director’s appointment (in October, 1988). FFr 53 million (well over k5million) have been allocated to IGR scientific research programmes and fellowships after rigorous scientific review. The second issue is the "historical grants" (as we call them) to the five institutes in Villejuif. Government-approved revision of ARC’s byelaws on June 26, 1986, entailed an acknowledgment of national needs and not just those of the Villejuif institutes, whose competence in cancer research has always been acknowledged. The scientific community in large part approved this revision, which gave an equal chance to every French cancer research team and fellowship candidate. Historical grants, such as those to IGR, have been replaced gradually and not suddenly, since the board of ARC has had the right to do since 1986. The new rules are more democratic from a geographical point of view. Replacement has been gradual so as not to jeopardise research programmes already planned to run for several years. Bader goes on to cite Professor Robert Flamant’s criticisms of how ARC funds are allocated. In France, associations such as ARC are bound by rules of procedure approved by the Minstry of the Interior in accordance with a law dating from 1901. All grant and fellowship decisions follow strict rules. All members of the eight ARC scientific regional or national commissions, and/or national and international scientific advisers (around 150 members), are professors and cancer specialists. They are also members of French public institutions, such as CNRS (National Scientific Research Centre), INSERM (National Institute for Health and Medical Research), Pasteur institutes, hospitals, cancer centres, and universities, including world renowned organisations such as the US National Cancer Institute. They independently assess and screen applications in the context of a global French research policy. Reports from scientific commissions and advisers are submitted to the ARC board, which is the only competent decision-making body. The board of directors consists of distinguished scientists and representatives of four ministries (Interior, Health, Research, and University). Some of these outstanding scientists are IGR members too. ACR’s board of directors makes all decisions on research programmes and fellowship grants. To claim that ARC’s scientific commissions control only 20% of the money is absurd and to assert that the president of ARC himself decides on the allocation of the other 80% is outrageous.
more
Association pour la Recherche sur le Cancer, 16 avenue Paul Vaillant Couturier, 94800 Villejuif, France
JACQUES CROZEMARIE, President
Suicide in prison in Auckland SIR,-Skegg and Cox’ drew attention to the extraordinary increase in prison suicides in Auckland between 1973-82 and 1983-87, which emphasises the importance of ready access to psychiatric care for prisoners. The specific prison culture, overcrowding, and psychiatric illness, as well as prison officers not familiar with handling suicidal prisoners, might have contributed to the reported results at the time. Nevertheless, our experience at the prison liaison service is that the increase in suicides in Auckland prisons between 1973-82 and 1983-87 was also due in part to the non-availability of appropriate facilities within the prison itself, and the policy of, at times, transferring more difficult inmates from other parts of New Zealand to Auckland. Since about 1985 several changes have taken place. The Department of Justice then started to address directly the concerns
in respect of inmate deaths in the 1980s. An assessment unit (for 6 inmates) and an assessment block (for 24 inmates) was established at the 550-bed medium and maximum security prison in Paremoremo near Auckland. Both these areas provide a special facility for the management of emotionally disturbed, sentenced inmates. A similar and new facility for the 170 remand prisoners at the 420-bed (general) Mount Eden Prison in Auckland itself can accommodate 14 individuals. Furthermore, every remand prisoner entering the prison system in Auckland is now screened by prison officers, nursing staff, and medical officers; if needed, a referral to the new (1987) Regional Forensic Service, Mental Health, in Auckland, is initiated. The forensic service itself provides the service suggested in the Mason report, including liaison with the police, court, prison, and general mental healthThe service encompasses a population of about 1-2 million people, and receives about 1400 referrals per year from various sources. A new medium security (15 bed) Mason clinic provides for acutely disturbed patients incorporating 5 beds for remand assessments; 30 beds are available for the rehabilitation of patients under various forms of the Criminal Justice Act. Of particular relevance to the work of the forensic service in prison is the Court Liaison Service-nursing staff placed in court liaising between court, prison, and hospital. This service covers seven courts and receives nearly 1000 referrals per year. Staff screen defendants in court for possible suicidal ideation and mental disturbances and make subsequent recommendations to court, often with respect to placement in hospital rather than in prison. In the four years (1988-91) since Skegg and Cox’s study, the total number of suicides in Auckland’s prisons has been 12, an average of 3 a year. 75 % of all male suicides were Maori people; in nearly 60% hanging was the preferred method of suicide. In this context, it is noteworthy that in New Zealand between 9 and 16% of the population are of Maori origin (depending on age group), whereas Maori individuals are represented in about 48% of all crimes committed. Maori people also make up about 50% of the prison
population (reported on television news [TVNZ] Jan 21, 1992), whereas 70% of all prison liaison referrals to the forensic service since 1989 relate to Maori.4 Since Skegg and Cox’s report, 21 prison suicides have been recorded in New Zealand between 1988 and 1991 (inclusive). At the same time the prison population in New Zealand increased from just over 3300 to well over 4300.’ This in effect means that New Zealand’s imprisonment rate of about 150 prisoners per 100 000 population is now double that of Australia, and only second to the USA.6 The decrease in suicide in prison in New Zealand, and especially in Auckland, is mirorred by reports indicating that what are termed major disorders, assaults on guards and inmates, self-mutilation, and suicides in prison have dropped strikingly in 1991-one estimation is that such incidents are 40% less than the 1990 total .6 The special facilities and new forms of case and unit management within prison in conjunction with the emerging Regional Forensic Service in both Auckland and New Zealand will, it is hoped, help to further decrease the various forms of psychiatric disturbance and especially suicides within prisons. Although the first signs are encouraging, a new difficulty has arisen over the past few years: suicides in police custody have more than doubled between 1989 and 1990, and now with 9 per year are also double the number of suicides in all prisons in New Zealand.’ Could this mean a new extended role for the Forensic Liaison Service? Regional Forensic Services, Mental Health, Auckland Area Health Board, Auckland, New Zealand 1.
HEINZ ALBRECHT DAVID CHAPLOW JANET PETERS
Skegg K, Cox B. Impact of psychiatric services on prison suicide
Lancet
1991; 338:
436-38. 2 Mason report
Report of the Committee of inquiry into procedures used in certain psychiatric hospitals in relation to admission, discharge or release on leave of certain classes of patients Wellington Government Printer, 1988 3. Inmate deaths in custody Wellington Department of Justice, 1991. 4 Albrecht H Prison liaison In Gunn J, Albrecht H, Brockman B, eds Providing psychiatric care in prisons Workshop, Progress in Forensic Psychiatry, Auckland, Feb 27, 1992 5 Murphy T Far reaching reforms let inmates see the light N Z Herald 1992; Jan 20· 9. 6 Consedine J When it pays someone to keep prisons full. N Z Herald 1991, Dec 27 8 in police cells Wellington. Department of Statistics, Headquarters, 1992.
7. Deaths
Police National
French
cancer
!R,—Jean-Michel
research Bader
funding from ARC
(July 23, p 229) repeats
baseless
allegations made in the June 25 and July 16 issues of the weekly magazine l’ Express by the director of the Gustav Roussy Institute (IGR) in Villejuif, France, criticising I’Association pour la Recherche sur le Cancer (ARC) while admitting that no other private foundation in Europe provides more money for cancer research than ARC does. Over the past ten years ARC has allocated than FFr 2000 million to cancer research and the number of subscribing members and donors exceeds 3 million. First, I would like to correct the record on ARC grants to IGR. Bader should have inquired into ARC’s special support for IGR, especially following its new director’s appointment (in October, 1988). FFr 53 million (well over k5million) have been allocated to IGR scientific research programmes and fellowships after rigorous scientific review. The second issue is the "historical grants" (as we call them) to the five institutes in Villejuif. Government-approved revision of ARC’s byelaws on June 26, 1986, entailed an acknowledgment of national needs and not just those of the Villejuif institutes, whose competence in cancer research has always been acknowledged. The scientific community in large part approved this revision, which gave an equal chance to every French cancer research team and fellowship candidate. Historical grants, such as those to IGR, have been replaced gradually and not suddenly, since the board of ARC has had the right to do since 1986. The new rules are more democratic from a geographical point of view. Replacement has been gradual so as not to jeopardise research programmes already planned to run for several years. Bader goes on to cite Professor Robert Flamant’s criticisms of how ARC funds are allocated. In France, associations such as ARC are bound by rules of procedure approved by the Minstry of the Interior in accordance with a law dating from 1901. All grant and fellowship decisions follow strict rules. All members of the eight ARC scientific regional or national commissions, and/or national and international scientific advisers (around 150 members), are professors and cancer specialists. They are also members of French public institutions, such as CNRS (National Scientific Research Centre), INSERM (National Institute for Health and Medical Research), Pasteur institutes, hospitals, cancer centres, and universities, including world renowned organisations such as the US National Cancer Institute. They independently assess and screen applications in the context of a global French research policy. Reports from scientific commissions and advisers are submitted to the ARC board, which is the only competent decision-making body. The board of directors consists of distinguished scientists and representatives of four ministries (Interior, Health, Research, and University). Some of these outstanding scientists are IGR members too. ACR’s board of directors makes all decisions on research programmes and fellowship grants. To claim that ARC’s scientific commissions control only 20% of the money is absurd and to assert that the president of ARC himself decides on the allocation of the other 80% is outrageous.
more
Association pour la Recherche sur le Cancer, 16 avenue Paul Vaillant Couturier, 94800 Villejuif, France
JACQUES CROZEMARIE, President
Suicide in prison in Auckland SIR,-Skegg and Cox’ drew attention to the extraordinary increase in prison suicides in Auckland between 1973-82 and 1983-87, which emphasises the importance of ready access to psychiatric care for prisoners. The specific prison culture, overcrowding, and psychiatric illness, as well as prison officers not familiar with handling suicidal prisoners, might have contributed to the reported results at the time. Nevertheless, our experience at the prison liaison service is that the increase in suicides in Auckland prisons between 1973-82 and 1983-87 was also due in part to the non-availability of appropriate facilities within the prison itself, and the policy of, at times, transferring more difficult inmates from other parts of New Zealand to Auckland. Since about 1985 several changes have taken place. The Department of Justice then started to address directly the concerns
in respect of inmate deaths in the 1980s. An assessment unit (for 6 inmates) and an assessment block (for 24 inmates) was established at the 550-bed medium and maximum security prison in Paremoremo near Auckland. Both these areas provide a special facility for the management of emotionally disturbed, sentenced inmates. A similar and new facility for the 170 remand prisoners at the 420-bed (general) Mount Eden Prison in Auckland itself can accommodate 14 individuals. Furthermore, every remand prisoner entering the prison system in Auckland is now screened by prison officers, nursing staff, and medical officers; if needed, a referral to the new (1987) Regional Forensic Service, Mental Health, in Auckland, is initiated. The forensic service itself provides the service suggested in the Mason report, including liaison with the police, court, prison, and general mental healthThe service encompasses a population of about 1-2 million people, and receives about 1400 referrals per year from various sources. A new medium security (15 bed) Mason clinic provides for acutely disturbed patients incorporating 5 beds for remand assessments; 30 beds are available for the rehabilitation of patients under various forms of the Criminal Justice Act. Of particular relevance to the work of the forensic service in prison is the Court Liaison Service-nursing staff placed in court liaising between court, prison, and hospital. This service covers seven courts and receives nearly 1000 referrals per year. Staff screen defendants in court for possible suicidal ideation and mental disturbances and make subsequent recommendations to court, often with respect to placement in hospital rather than in prison. In the four years (1988-91) since Skegg and Cox’s study, the total number of suicides in Auckland’s prisons has been 12, an average of 3 a year. 75 % of all male suicides were Maori people; in nearly 60% hanging was the preferred method of suicide. In this context, it is noteworthy that in New Zealand between 9 and 16% of the population are of Maori origin (depending on age group), whereas Maori individuals are represented in about 48% of all crimes committed. Maori people also make up about 50% of the prison
population (reported on television news [TVNZ] Jan 21, 1992), whereas 70% of all prison liaison referrals to the forensic service since 1989 relate to Maori.4 Since Skegg and Cox’s report, 21 prison suicides have been recorded in New Zealand between 1988 and 1991 (inclusive). At the same time the prison population in New Zealand increased from just over 3300 to well over 4300.’ This in effect means that New Zealand’s imprisonment rate of about 150 prisoners per 100 000 population is now double that of Australia, and only second to the USA.6 The decrease in suicide in prison in New Zealand, and especially in Auckland, is mirorred by reports indicating that what are termed major disorders, assaults on guards and inmates, self-mutilation, and suicides in prison have dropped strikingly in 1991-one estimation is that such incidents are 40% less than the 1990 total .6 The special facilities and new forms of case and unit management within prison in conjunction with the emerging Regional Forensic Service in both Auckland and New Zealand will, it is hoped, help to further decrease the various forms of psychiatric disturbance and especially suicides within prisons. Although the first signs are encouraging, a new difficulty has arisen over the past few years: suicides in police custody have more than doubled between 1989 and 1990, and now with 9 per year are also double the number of suicides in all prisons in New Zealand.’ Could this mean a new extended role for the Forensic Liaison Service? Regional Forensic Services, Mental Health, Auckland Area Health Board, Auckland, New Zealand 1.
HEINZ ALBRECHT DAVID CHAPLOW JANET PETERS
Skegg K, Cox B. Impact of psychiatric services on prison suicide
Lancet
1991; 338:
436-38. 2 Mason report
Report of the Committee of inquiry into procedures used in certain psychiatric hospitals in relation to admission, discharge or release on leave of certain classes of patients Wellington Government Printer, 1988 3. Inmate deaths in custody Wellington Department of Justice, 1991. 4 Albrecht H Prison liaison In Gunn J, Albrecht H, Brockman B, eds Providing psychiatric care in prisons Workshop, Progress in Forensic Psychiatry, Auckland, Feb 27, 1992 5 Murphy T Far reaching reforms let inmates see the light N Z Herald 1992; Jan 20· 9. 6 Consedine J When it pays someone to keep prisons full. N Z Herald 1991, Dec 27 8 in police cells Wellington. Department of Statistics, Headquarters, 1992.
7. Deaths
Police National
