Places of Long-Term Deprivation of Liberty 342. Regarding inmate fatalities in prison, it should be noted that over the 2003­ The Ombudsman conducts 2009 period, the annual number of deaths in prisons run by the SGIP ranged a corresponding between 160 in 2003 and the 225 recorded in 2008. In percentage terms, the mortality rate has fluctuated between 0.34% in 2003 and 0.40% in 2006. The official data published by the SGIP indicate that in 2009 there were 224 deaths in investigation whenever it is informed of the death of an inmate in a prison prison (216 men and 8 women) specifying that 57% were due to natural causes without including the complications associated with HIV, 21% related to drug overdoses, 12.10% to suicides, 7.60% to complications associated with HIV, 1.30% (3 cases, the same as in 2008) to aggression, which despite being a low overall number is a significantly higher rate than in the population at large, and 0.90% to accidents. The mortality rate in prisons in 2009 was 0.34%, whereas in the population at large that rate is exceeded only after the age of 53 (0.36%), according to figures provided by the INE; the average age of the deceased in prison, however, was 44,5 years. For that average age, the mortality rate in prisons easily doubles the rate in the general population (0.15% at 44 and 0.18% at 45 for both sexes). Whenever a death is reported, a corresponding investigation is conducted by the Ombudsman’s Security and Justice Department. 343. Official data for 2010 indicate that Spanish prisons were the scene of 56 According to official data, suicide attempts and 23 deaths recorded as suicides. All the deaths by suicide in 2010 there were 56 involved hanging, which accounted for 64.28% of the total attempts, followed by self-inflicted cuts (23.21%) and swallowing harmful products (7.14%). A suicide attempts plus 23 deaths recorded as suicides third of the deaths by suicide and a fifth of all attempts took place while inmates were in solitary confinement. Seven of the deaths by suicide involved inmates who were remanded in custody. Although the suicide rate in Spain is significantly lower than in other European countries, it cannot be ignored that the rate in prisons, based on data for 2009, is six times higher than the rate amongst the general population; specifically, in 2009 there were 3,429 deaths recorded as suicides amongst both sexes in the general population (0.0075%), whereas the prisons run by the SGIP recorded 27 cases, which is 0.0453%. Whenever the Ombudsman’s office hears of a case, it proceeds to open an ex-officio investigation to monitor the scope of the confidential information that is gathered in all cases by the prison authorities, as well as the legal proceedings that, as appropriate, are instigated. In addition, the inspection visits to prisons are used to monitor the implementation The inspection visits are of the suicide prevention programme, whose purpose is the early detection of used to monitor the individual risk in order to take measures, which can even involve 24-hour accompaniment in order to prevent any suicide attempt. Specifically, according to SGIP sources, none of the inmates who died in 2010 and whose death was implementation of the suicide prevention programme recorded as suicide was following this programme, yet this was the case for 18 of the people who attempted but failed to commit suicide. THE OMBUDSMAN OF SPAIN 143