IPRT Statement on publication of Five Deaths in Custody Reports

20th February 2026

20th February 2026

IPRT Response to Five Deaths in Custody Investigation Reports 

Reports published by the Department of Justice, Home Affairs and Migration:  18, 19, and 20 February 2026 

IPRT welcomes the publication of five Deaths in Custody investigation reports, published on 18, 19 and 20 February by the Minister for Justice, Home Affairs and Migration. 

The reports concern the following deaths in custody: 

• Mr M, who died by suicide in Mountjoy Prison in 2023. 
• Mr Q, who died as a result of a drug overdose in Mountjoy Prison in 2024. 
• Mr H who died by suicide in Midlands Prison on 8 March 2024. 
• Mr N, aged 79, who became acutely unwell while detained in Cloverhill Prison and died in Tallaght Hospital on 6 May 2024. 
• Mr D, who died in Cloverhill Prison following acute health deterioration and complex mental health needs on 4 February 2022. 

While IPRT welcomes the publication of these reports, we reiterate that death in custody investigations should be prompt, the Irish Prison Service (IPS) action plan developed urgently, the subsequent report submitted to the Minister for Justice in a timely fashion and the reports published as soon as possible to avoid further distress to family members and to ensure that lessons are learned and implemented as a matter of priority.  

The reports into the deaths of Mr M, Mr Q, Mr H and Mr D each highlight serious systemic failures, particularly in the State’s response to known and escalating risk in custody and in the ongoing use of prisons to detain people with serious mental health needs in inappropriate environments. 

Commenting, Saoirse Brady, Executive Director of IPRT, said: 

“Timely publication of Deaths in Custody reports is essential to ensuring accountability, transparency, and learning. Delays of this magnitude undermine confidence in oversight mechanisms and deny families answers for far too long. These reports lay bare cracks in the system that continue to widen, with devastating consequences. In too many cases, risks were known but not acted upon in a timely way and ultimately resulted in tragedy. From IPRT’s perspective, many of these deaths could have been preventable.” 

 She added: 

“The Chief Inspector of Prisons has been clear that the sharp increase in deaths in custody in 2024 — rising from 24 the previous year to 31 — is linked to unprecedented levels of prison overcrowding. Combined with chronic gaps in mental health and addiction services, this creates a pressurised system which is failing people when they are in state care and at their most vulnerable.” 

Ms Brady continued: 

“What these reports show, together with the report on Ivan Rosney’s death and the RTÉ Investigates programme is that there are clearly people in our prisons who should not be there. We understand the pressures facing the mental health system more broadly, but these issues have been repeatedly identified for years — as have deficiencies within the prison system itself. The question now is: at what point will meaningful government action follow?” 

“With the prison population continuing to rise, this issue will not resolve itself. Unless the Government acts urgently and decisively, we will continue to see avoidable loss of life. The systems must start talking to one another — and they must do so now.” 

The following summaries represent IPRT’s initial analysis of the Death in Custody reports published:  

Mr. M – Death in Custody report: The report into Mr M’s death highlights a profound failure to respond to acute mental health deterioration. His family and prison staff had identified significant changes in his mental state, including paranoia and distress. His brother contacted the prison to express concern, and Mr M had refused temporary release because he wished to access addiction treatment. IPRT notes that despite these warning signs, long waiting lists for mental health supports and a failure to escalate concerns as a matter of urgency meant that no effective or timely action was taken as his mental health deteriorated. 

Mr. Q – Death in Custody report: The report into Mr Q’s death also points to systemic failure in the management of drug-related risk in custody. While it is unrealistic to expect prison staff to intercept all illicit drug use, where drug use and associated risk are clearly identified, protective measures must be put in place. In the week prior to Mr Q’s death there were four overdoses in the prison, including one the day before his death. Although officers acknowledged that Mr Q was “under the influence”, this did not trigger heightened monitoring, escalation or additional safeguards. The rates of high levels of illicit drug use in prisons, and the absence of a meaningful response when the prison management was already aware of a heightened risk with previous incidents of similar overdoses n, is deeply concerning. 

Following Mr Q’s death, hundreds of yellow tablets, similar to those taken by Mr Q, were surrendered by people in custody. IPRT notes that had action been taken earlier, following one of the preceding overdoses, there is a possibility that his death could have been prevented. While the IPS did take effective measures a month later in August 2024 in response to a similar drug-related risk in Portlaoise Prison, this highlights the importance of acting promptly when such risks are identified. 

Mr. H – Death in Custody report: The report into Mr H’s death similarly exposes systemic weaknesses in the identification and management of suicide risk. Mr H had sought psychological support and was experiencing acute personal distress linked to relationship breakdown, housing uncertainty and concerns about access to his child. While prison staff and chaplaincy services engaged with him, a breakdown in referral processes meant that the prison psychology team never received his request for support. Although the emergency response following his collapse was prompt and professional, IPRT considers that the failure to ensure that identified psychological need translated into timely intervention represents a critical missed opportunity for prevention. 

Mr. N – Death in Custody report: The report into the death of Mr N presents a different picture. Mr N, who was 79 years old, became acutely unwell shortly after committal and was transferred to hospital, where he later died. While the investigation identified shortcomings in documentation and transport procedures, it found that prison staff acted appropriately and treated Mr N with dignity and respect. There is no indication that known risk was ignored or that earlier intervention would likely have altered the outcome. 

Mr D - Death in Custody report: Mr D was detained in Cloverhill Prison, primarily on the D2 landing, and was under regular review by the Prison In-Reach Court Liaison Service (PICLS team) and prison medical staff following his relocation on 21 December 2021.  

In the short period before his death, the report notes that Mr D showed clear symptoms of psychiatric disturbance and neglect of personal hygiene. On 4 February 2022, he was found unresponsive in his cell during the morning unlock, there was no indication that staff acted inappropriately. 

The investigation highlighted that, although staff were dedicated and responded professionally, D2 did not provide the therapeutic environment that Mr D required, given his mental health needs. The report reinforced long-standing concerns about the care of people in prison with mental illness, noting that previous recommendations for appropriate mental health provision in therapeutic settings and secure hospital transfers had not been fully implemented. 

Ms Brady concluded:  

“IPRT extends its deepest sympathies to the families of Mr M, Mr Q, Mr H, Mr D and Mr N. Each of these deaths represents a profound human loss. Families deserve timely answers and the assurance that lessons will be learned — yet too often, systemic failures persist, and preventable tragedies continue to occur.” 

Failure to take effective, timely action 

Taken together, these reports reveal a consistent pattern as in three of the four deaths: where there was an identified risk , it was not met with timely, preventative action. Mental health deterioration, drug-related risk and acute distress were identified but not effectively escalated or addressed. In contrast, Mr N’s case demonstrates that when health needs are recognised and existing protocols are followed, appropriate care can be delivered in custody. 

What is clear is the urgent need for systemic reform to ensure that mental health deterioration and drug-related risks in custody are consistently met with timely, preventative and protective responses, so that tragic loss of life is prevented. 

IPRT has written to the Minister for Justice, Jim O’Callaghan, the Minister for Health, Jennifer Carroll MacNeill and the Minister of State with responsibility for mental health, Mary Butler, calling for the urgent convening of a high-level, cross-government roundtable involving relevant ministers, agencies and advocates to address the crisis in psychiatric care in prisons and to end the inappropriate use of prisons for people with serious mental health needs.  

ENDS

NOTES FOR EDITORS:   

1. Irish Penal Reform Trust (IPRT)  www.iprt.ie    
2. IPRT is Ireland's leading non-governmental organisation campaigning for the rights of everyone in prison and the progressive reform of Irish penal policy, with prison as a last resort.   
3. Prison figures: As of Friday 20 February 2026, Irish prisons were operating at 123 percent capacity, with 5,800   in prison custody with 542 people sleeping on mattresses on the floor.   
4. Death in Custody Investigation Report: Mr M, Mountjoy Prison, 2023 – found here . 
5. Death in Custody Investigation Report: Mr Q, Mountjoy Prison, 2024 – found here . 
6. Death in Custody Investigation Report: Mr H, Midlands Prison, 8 March 2024 – found here . 
7. Death in Custody Investigation Report: Mr N, Cloverhill Prison / Tallaght Hospital, 6 May 2024 – found here .  
8. Death in Custody Investigation Report: Mr D, Cloverhill Prison, 4 February 2022 – found here .