Attitude, Communication Can Prevent Suicides
By Matthew Crawford (12/09/2005)

Suicides have become synonymous with correctional facilities. Reports of apparent suicides and attempted suicides populate the pages of newspapers and other media outlets almost daily. But despite the abundance of such reports, suicide rates have dropped at state prisons and local jails during the last 20 years, according the U.S. Department of Justice's Bureau of Justice Statistics.

A recent report revealed that jail suicide rates have declined from 129 per 100,000 inmates in 1983 to 47 per 100,000 inmates in 2002. State prison suicide rates dropped from 54 per 100,000 in 1980 to 14 per 100,000 in 2002.

Lindsay M. Hayes, project director of the National Center on Institutions and Alternatives, who has researched suicide at correctional facilities for nearly 25 years, says the drop in suicide rates can be attributed to several different factors, including increased awareness of the issue through reports and the development of more responsive policies and procedures, more training, new intake screening forms, and more mental health and medical staff.

"Although jails still complain they don't have enough mental health staff and enough medical staff, they clearly have more of those personnel today than they did back in the '80s and '90s," says Hayes, who oversees the publication Jail Suicide/Mental Health Update. "There is still not enough of them because there has been a fairly dramatic increase in the number of mentally ill inmates coming into jails."

Hayes says an increase in litigation following inmate suicides has also prompted changes.

"Whether the lawsuit is successful or not is secondary to what happens in the jail system," he says. "Officials will become concerned with not only the death that occurred but the subsequent lawsuit that follows, and will try to take remedial measures to correct the problem that might have caused it."

Overall, Hayes says there are two key factors that greatly contribute to the success or failure of suicide prevention programs at correctional facilities: attitude and communication.

Attitude

Hayes says jail administrators or sheriffs who take a proactive approach and a "whatever it takes" attitude toward suicide prevention will have far fewer suicides than facilities that have administrators who believe suicides are unavoidable.

"That's what separates the good programs from everybody else," Hayes says.

However, that attitude must also be substantiated by action and program components that will reduce suicides:

  • Staff must receive training each year to remain updated on methods of suicide prevention and detecting potentially suicidal inmates.
  • Intake screening questions should be asked when inmates are booked into the facility and recorded on intake forms to help determine any mental health issues and factors that might predispose them to suicide.
  • A safe housing environment should be provided to inmates.
  • Inmates that show signs of suicidal behavior should be put on suicide watch. Observation should be constant or guards should check on a potentially suicidal inmate at least every 15 minutes.
  • Policies and procedures for suicides should be clearly stated.

Although there is no guaranteed way to eliminate inmate suicides, Hayes says having safeguards in place before suicides occur is an effective approach to reducing them.

"You're not going to prevent every single suicide, but you can dramatically reduce the opportunity," Hayes says. "When that inmate falls through the cracks and commits suicide, go back and review that death with a lot of scrutiny."

FACILITIES STILL STRUGGLE TO LOWER NUMBER OF SUICIDES

Despite a Bureau of Justice Statistics report that states suicide rates in jails and state prisons have dropped over the last 20 years, the number of suicides has increased at jails and prisons because of an increase in the number of inmates throughout the country, according to Lindsey Hayes, who has researched inmate suicides for nearly 25 years. Several jurisdictions are struggling to prevent inmate suicides:

  • There were 29 self-inflicted inmate deaths in California during the first nine months of the year. Lawyers who represent nearly 26,000 mentally ill inmates say classification flaws that put mentally ill inmates in more secure facilities with violent inmates could lead to suicides because inmates spend more time in their cells and have less human interaction.
  • With five inmate suicides in Ohio as of press time this year and a record 11 suicides in 2004, officials are working to curb self-inflicted deaths. A new policy requires all inmates held in segregation cells be screened for suicide risk. Previously, only inmates with mental illness or inmates who appeared to be at risk were screened.
  • Since April 2004 at least 13 inmates have committed suicide in Connecticut. Officials are asking police officers and prosecutors to provide more information on inmates' mental health when they are incarcerated to help avoid more deaths.
  • A new unit designed to improve living conditions for mentally ill inmates in Iowa has been the site of four inmate suicides during the last two years. Correctional officers have stepped up patrols of the unit and now check suicidal inmates every five minutes instead of every 15 minutes.
  • The Utah County Jail in Provo, has experienced a record number of suicides this year, with four inmates killing themselves as of press time. In order to curb the number of suicides at the facility a committee has been formed to re-evaluate jail protocol and personnel training. Additional screening procedures have also been implemented during the booking process.

If there were mistakes, change the suicide prevention program so they do not occur again, Hayes says.

"The opposite view is what I call the obstacles to prevention, that is the opposing view that suicides cannot be prevented," even with staff training and intake screening questions, Hayes says.

Communication

Suicides can be avoided through effective communication from the time of an arrest until an inmate is released from the facility, Hayes says.

Because arrests are often emotional experiences, police officers have a good opportunity to gauge an arrestee's mental health. If an arrestee is crying or acting despondent while being arrested or transported, that information should be reported to jail personnel during the booking process. Tips from family members or other people at the scene of an arrest can also help determine if an arrestee is suicidal.

Once an inmate is housed within the jail, any unusual activity or signs that he is potentially suicidal should be relayed during shift changes. A shift supervisor should also be aware of any signs of suicidal behavior.

"Once the inmate displays signs of suicidal behavior, that information needs to be communicated effectively throughout the entire jail," Hayes says.

There should also be a clear channel of communication between facility personnel and a suicidal inmate. Correctional staff should use active listening and make eye contact, and if the inmate is in immediate danger stay with him.

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