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SINGAPORE: A man sentenced to life in prison in 2004 for kidnapping climbed on a railing in the psychiatric housing unit of Changi Prison during time in the courtyard and released himself, falling one floor lower and dying of a wound on the head.
The coroner ruled his death a deliberate act of suicide on Tuesday (December 22), noting that the prison has taken steps to prevent recurrences and is reviewing other possible security measures, including a sensor system to detect any person near the bars.
An internal review by the Singapore Prison Service (SPS) found no negligence on the part of any prison official, and SPS is reviewing its infrastructure design, the court heard.
Mr. Chua Ser Lien was pronounced dead on the morning of July 8 this year after being seen climbing a railing from the second floor to the fourth floor.
He released his hold and fell backward, hitting the back of his neck. He received immediate attention from officers on the scene and paramedics who arrived 20 minutes later, but he could not be resuscitated.
The court heard that Mr. Chua, who has two children with his ex-wife, has been incarcerated in Group A of Changi Prison since 2004, where he was placed in pre-trial detention after being charged with kidnapping for ransom.
He was transferred to the psychiatric housing unit in 2018 after his pre-existing bipolar symptoms worsened.
The prison officers of this unit, the only housing unit that cares for inmates with psychiatric problems or mental disorders, have attended courses to help them deal with inmates.
Mr. Chua was evaluated as non-suicidal.
On the morning of his death, officers distributed medication to inmates through metal doors before allowing them to leave their cells during the scheduled television hour in the television room.
However, Mr. Chua, who was noted for being a loner, had never joined them to watch television and would be allowed to leave his cell to roam the living room. He had done it for months with no problem.
Closed-circuit television footage showed Mr. Chua climbing the stairs from the third floor to the fourth floor, where he began to climb over the railings that had crossed bars.
He climbed sideways on the bars, using them as steps, until he reached the fourth level. At that moment, the officers saw him and ran to the scene and called him, but Mr. Chua released him and he fell backwards.
He landed on his back at the foot of the third-floor stairs. Rescue efforts failed and he was pronounced dead at 10.15 a.m. that day.
YOUR MENTAL HEALTH RECORDS
His only available medical history was from the Institute of Mental Health, where he was held in custody in early 2004. He was diagnosed with bipolar disorder.
Prior to this, he had been a managing director at a cleaning company, but his erratic behavior began to manifest itself when he visited a university for a meeting and offered to donate a million dollars, before racking up S $ 600,000 in gambling debt.
He later reported that he was depressed and began drinking heavily. After his conviction and sentencing, his wife filed for divorce to request a rental apartment, but she still considered him her husband and visited him with their two children.
She had been concerned that she had a mental illness since 2002, when she began to show hallucinations, telling her that the kitchen was hell and the living room was heaven.
She referred him to a private hospital for treatment and suspected he had schizophrenia, bipolar disorder, and depression.
In the months leading up to his death, his ex-wife noticed that Mr. Chua had become more aggressive towards her during his visits and felt that his medication was not helping him much. She last visited him in November 2019, before speaking with him on the phone in June of this year.
However, she saw no signs of suicidal inclinations in her ex-husband. The other prison officials and Mr. Chua’s cellmate also did not notice such signs, the court heard.
POST-INCIDENT
After Mr. Chua’s death, SPS ordered that no inmate be allowed to remain alone outside their cells. High-risk prisoners will now be guarded in the complex’s medical center.
The prison is also reviewing the design of its infrastructure and is considering a sensor system that will activate whenever someone tries to approach the bars.
The coroner noted that the railings were originally intended to prevent prisoners from falling from the second floor, but unfortunately they facilitated Mr. Chua’s ascent.
The railings are likely to be replaced with ones that cannot be grasped or held, the court heard.
The coroner noted that Mr. Chua had been receiving appropriate medical treatment during his incarceration and that prison guards and medical staff had responded promptly.
He conveyed his condolences to Mr. Chua’s family.
Where to get help: Samaritans of Singapore operates a 24-hour hotline at 1800 221 4444, or you can email [email protected]. If someone you know is at immediate risk, call 24-hour emergency medical services.
