If someone in prison is at risk of self-harm or suicide, prison and healthcare staff should work together to help keep them safe. This support is provided through a process called ACCT, which stands for Assessment, Care in Custody and Teamwork.
You may hear staff say that someone is "on an ACCT". This means concerns have been raised about their safety, and a team of prison and healthcare professionals is working together to provide additional support and monitoring.
To learn more about how ACCTs work in prison, you can read the HM Prison and Probation Service guide. If your loved one is currently being supported through the ACCT process, you may also find our safety toolkit for families and carers helpful.
An ACCT is designed to help protect people who may be at risk of self-harm or suicide.
If a member of prison staff or the healthcare team becomes concerned about someone's safety, they can open an ACCT. This is the formal process used to record concerns and put extra support in place.
Mental health teams are responsible for assessing and treating mental health conditions. If concerns about a person's wellbeing become more serious, the ACCT process will usually run alongside any existing treatment they are receiving.
This means that a wider group of staff, including prison officers, healthcare staff and safer custody teams, may become involved in supporting that person and checking on their welfare.
Once an ACCT has been opened, a meeting called an ACCT review will take place.
An ACCT review brings together the professionals involved in supporting the person, including prison staff, healthcare staff and members of the safer custody team. Together, they create a plan to help keep the person safe and support their wellbeing.
The plan may include:
- Reducing immediate risks of harm
- Putting additional safety measures in place
- Arranging regular welfare checks
- Providing mental health support and treatment
- Identifying any additional needs or concerns
- Agreeing practical steps that may help the person cope
Depending on the level of risk, support might include frequent check-ins, increased observation, or, in some cases, having a member of staff remain with the person for extended periods.
People on an ACCT should continue to receive any healthcare or mental health treatment they need. This may include therapy, support from mental health professionals, medication where appropriate, and activities designed to help them manage difficult feelings and stay occupied.
If someone has not previously been seen by healthcare or mental health services, staff may use the ACCT process as an opportunity to assess what support they need.
ACCT reviews take place regularly while concerns remain about the person's safety. Once the team believes the risk has reduced and appropriate support is in place, the ACCT can be closed.
More information on the part that families and carers can play
What families and carers can expect
Families and carers can play an important role in helping prison staff understand and support a person who is struggling.
ACCT review meetings are usually organised by the prison's Safer Custody team. They will invite the professionals involved in the person's care and support.
Where appropriate, family members and carers may also be invited to contribute. This could involve attending a meeting, joining by telephone, or sharing information with staff beforehand.
However, involvement can vary between prisons. Factors such as security requirements, staffing levels and local procedures may affect how families are included.