Suicide in Jails and Prisons

Suicide in Jails and Prisons

Suicide

Incidence of suicide in prisons

According to the World Health Organization, suicide is the most common cause of death in jails and prisons. The rate of suicide in penitentiaries is also high. These correctional facilities also have a role to play in ensuring their inmates are healthy and safe. This is the reason why a plan for prevention of suicide in correctional facilities is essential. Characteristics available from various sources suggest that certain populations have higher risk of committing suicide. These are young males at the age of about 15 to 49 years. Elderly inmates, specifically elderly males also have higher-than-average risk of committing suicide. The other groups are indigenous people, persons with issues relating to abuse of alcohol, drugs or other substances, and persons with mental illnesses. A report by the State of Montana Department of Corrections also suggests that having previously attempted to commit suicide is a predisposing risk for suicide Weir, 1998()

A different report suggests that all inmates are basically high-risk persons. By the fact that they are inmates and their freedom is limited, they suffer stress that often predisposes them to risk of suicide. Some evidence suggests that the rates of suicide are increasing even in places where there are fewer prisoners. This is not associated with suicidal behaviors but rather more generally is associated with being in these institutions. It is suggested that many inmates often have suicidal thoughts and behaviors at some point of their prison sentences Warren, 2001()

Pre-trial inmates also have higher suicide rates. It is estimated that those detained during the pre-trial period are 7.5 times more likely to commit suicide than sentenced prisoners who also are also 6 times more likely to commit suicide compared to those released and in the general population. These statistics, worrying as they are, suggest that there is need to look into the causes of suicide for inmates.

Suicide rates for inmates who are released and break the law a second time are also a lot higher. They are said to have higher suicide rates because after their release from prison they found it harder to survive among the general population. Suicide rates of U.S. state prisons are much higher than federal prisons with men in both state prisons and federal prisons being more likely to commit suicide. Suicide rates as a percentage of all prisoners have decreased over the years. In 1986, this stood at close to 110 suicides per 100,000 inmates and this is now under 40 per 100,000. Though this represents a significant change over the years, there is need to reduce the rates even further.

Data from the Bureau of Justice Statistics suggests that the suicide rates in the 1980s has declined steadily. This has since stabilized. Suicide rates in federal prisons is lower than the overall average for the country.

Smaller jails, especially local jails, often have higher suicide rates compared to larger facilities such as state and federal jails and prisons. This is associated with the smaller jails being gateways into the justice system for majority of the inmates. This means that often this is the first time that these individuals have been arrested. This creates intensive stress and pressure in the individuals, most of who had otherwise lived their lives in the right side of the law. Often, these inmates lose hope of their efforts to stay on the right side of the law and have a tough time trying to deal with the guilt arising from their crime. They also face humiliation from their families, friends, and the general public as a result of having being incarcerated Topp & Welldon, 1991.

Another reason why smaller jails have higher rates of suicide or suicide attempts is because they often lack mental health professionals to deal with mental health issues facing the inmates. They are often understaffed and even where there are sufficient staff, they have other duties, especially, consistent observation of prisoners Smith, 1991()

Predisposing factors of suicide

The inmate environment is extremely conducive for suicide and suicidal behaviors. This is because it provides inmates with isolation and privacy that are predisposing factors for suicide. Correctional facilities also often do not have mental health facilities for inmates. Therefore, they endure their mental illnesses without any formal assistance. Correctional facilities also separate inmates and do not allow them to congregate in social support networks. Correctional facilities also hold groups that have statistically higher risk of committing suicide. These include young persons, those who abuse alcohol, drugs, and other substances, and the mentally ill. This is because of issues such as alcohol or drug dependency and having to withdraw from this once they are in prison Joan Petersilia, 2008()

More risk factors of suicide that are identified include being released from prison, either on parole or after serving a full sentence, overcrowding in prisons, being put in isolation, having to serve long sentences for committing violent offences, and psychiatric disorders or mental illness Ilangaratne, 1992.

Another report suggests other stressors of inmates being denial of appeal or parole, being close to release and loss of hope at this point, transfer to a different prison facility, threat of assault that may arise from the period of their stay, physical illness, and disciplinary actions taken by the warden Fussell & Louie, 2008()

All in all, the reasons for suicide are all related to the different stressors that inmates face during their incarceration. Therefore, any efforts to prevent suicides should aim at reducing the stressors and helping the inmates cope with the situation. Despite the difficulty in meeting these objectives, there is need to strive to achieve these because they lead to improved quality of life of prisoners while in these correctional facilities. The ability to resolve stress has also been shown to help inmates lead a better life when they are released from prison, either on parole or after serving their full sentence.

Characteristics and histories of victims of prisoner suicide

Correctional facilities have a large number of inmates with different kinds of mental health problems. In a study conducted by the Bureau of Justice Statistics, it was shown that more than 50% of all inmates had mental health issues. Approximately 75% of inmates with mental health issues had a concurrent substance abuse disorder. This suggests that majority of mental health issues in inmates are as a result of substance abuse Cox & Skegg, 1993()

The study also revealed that a large number of inmates have major depressive orders. Approximately 30 per cent of those in local prisons had major depressive orders compared to 23 per cent in state prisons and 16 per cent in Federal correctional facilities. Another study conducted by the Bureau of Justice Statistics suggested that one in every ten inmates in any correctional facility had spent at least one night in a mental health institution prior to their incarceration Conacher, 1996.

The American Psychiatric Association also conducted a review of these studies and other literature and concluded that one in every five inmates needs psychiatric care as a result of their mental health disorders F. Alison, 2008()

Suicidal inmates also have a history that generates a set of warning signs that if someone was keen enough would be important in identifying their risk of suicide. One of the most effective warning signs generated by these inmates is talking to other inmates about their willingness to die or commit suicide. While this is often not taken seriously, several studies have shown it is the single most important warning sign for suicidal inmates. Other warning signs are talk about their feeling of hopelessness or lack of reason to live, feelings of being trapped in the correctional institution, anxiety, anxiousness, agitation, previous suicidal attempts or extreme mood swings L. Alison, 1999()

Though these warning signs are often generalized to all correctional facilities, research has shown that they are often more specific to jails and prisons. It is important for the correctional facility staff to monitor the inmates' reaction to their sentence or incarceration. A study has shown that majority of inmates who commit suicide do it within the first 24 hours of their detention Timmermans, 2005()

Young adults who are arrested for offences that are nonviolent such as abuse of alcohol, drugs and other substances have been found to be at greater risk of committing suicide. This is associated with their greater fear of being in prison, and being afraid of how their parents, family and friends will react to the news of their arrest. Often, their substance abuse issues are hidden to the family members and some friends until they are arrested when this becomes known to many Schulman, 1968.

Therefore, it is important to understand the situation in which the inmate was when they were arrested to assess risk of committing suicide.

Under what circumstances is prisoner suicide likely to occur

From the literature, prisoner suicide is most likely to occur when an inmate is faced with one or more risk factor of suicide. Often, when a prisoner is predisposed to two or more risk factors, they have higher risks of committing suicide. Prisoners are often more likely to commit suicide if they show the warning signs of suicide earlier discussed. Other situations that may lead them to commit suicide include receiving bad news about their family, friends or relatives, marital problems, conflict with inmates they are together with, or tension about their sentences or court hearings and sexual coercion Gunn, Maden, & Swinton, 1991.

Under these circumstances, inmates have often been known to cause suicide.

Why are prison officials obligated to address the problem of prisoner suicide?

Despite prisoners or inmates being stripped off their freedom, they are still entitled to other fundamental rights. They have the right to adequate medical care. It is the role of the prison officers to provide all inmates with adequate medical care despite their reason for incarceration duration of incarceration, or behavior during incarceration. This is dictated in the Eighth Amendment Adams, 1992()

Prison officials may also find themselves on the wrong side of the law as a result of deliberate indifference. This is defined as when a prison officer disregards risks to the inmate either deliberately or due to recklessness. However, provided the negligence can be attributed to an action that the prison official should have done, the prison official can be found guilty of deliberate indifference. It is important for the prison official to understand and identify any risks to the health and safety of the inmates Adams, 1992()

Circumstantial evidence can be used to prove the prison officer's knowledge of a certain risk even though they are not expected to know specific risks from specific sources. This inference can be made from the obvious nature of the risk, or other inferences such as direct evidence. Direct evidence is the situation where the prisoner requests a medical checkup or makes formal grievances that their request for medical assistance was denied.

Access to mental health care is also covered in the prisoners' rights. Prisoners or inmates have the same constitutional right of access of mental care and prison officials can be found guilty of deliberate indifference when they deny a prisoner access to this. For a prison to provide adequate mental health care, there is need for the prison to have a way of identifying inmates that require mental care, provide appropriate care, and ensure confidentiality of receiving mental care. The prison must also be able to provide prescriptions and administer medications for the mental health disorders that the inmates are facing.

Policy for prevention of inmate suicide

Policy

The Department of Corrections has stepped up their efforts in reducing suicide and suicide attempts in prisons. The Department requires all prison officials to respond to warning signs or suicide attempts appropriately with mental health and psychiatric care to prevent suicide. All inmates should also be assessed and any found having at least one warning sign for suicide or other predisposing factors should be referred for appropriate professional help immediately.

Applicability

All prison officials have a duty to play in preventing suicides in the prison.

Definitions

Assessment:

any official or unofficial judgments conducted by the chief, warden, supervisor, or other prison staff to determine risk of suicide for a particular inmate.

Staff:

any person paid or voluntary, working in the prison under specific terms of service.

Directives

Staff responsibilities

1. All prison officials must:

a. Conduct a person assessment of each prisoner's risk of suicide by identifying early warning signs. They must exhibit fairness, objectivity, and professionalism in dealing with the assessment.

b. Report immediately, through the official forms provided, any information they receive, assessment of warning signs, or through other knowledge, any issues that may cause prisoner suicide.

c. Ensure that any information about these reports and assessments made to determine the risk of prisoner suicide is kept confidential.

d. Cooperate with the medical staff in the prison to ensure the prisoner receives the appropriate psychological care and that information they provide to these staff is free of errors or malicious information.

e. Complete special training regarding to assessment of warning signs of prisoner suicide or other factors that may lead to prisoner suicide.

f. Follow up any deliberately false or malicious reports of suicide and ensure the appropriate disciplinary action is undertaken.

These rules apply to all members of staff within the correctional facility regardless of their rank, reason, or shifts. Any information that they receive, regardless of the source, should be evaluated with diligence to ensure that appropriate measures are taken before the inmate commits suicide.

2. No personnel within the correctional facility should exude fear towards inmates who have warning signs of suicide.

a. The personnel should ask the inmate if they have or are considering suicide.

b. They should assess the prisoner's acts to establish whether they are self-destructive.

c. They should be as direct as possible in asking about the prisoner's thoughts and try to assess the honesty in the answer they receive.

3. The prison administration should:

a. Ensure the availability of appropriate and quality-checked first aid and safety equipment. These include resuscitation masks, latex gloves, defibrillators, and tools that can be used to open cell doors that are jammed or for cutting a hanging inmate.

b. Ensure all prison staff are trained in recognition, assessment, and response to early warning and risks of suicide and first aid.

c. Ensure that isolation cells are used appropriately. Placing prisoners in isolation is often a risk factor for suicide. Therefore, isolation should also be used when the inmate reaches a point where all other available options have failed.

d. Ensure isolation cells are suicide protected. This means the cells should not have any items that the inmates could use to cause harm. Items that could be used for hanging such as bed sheets, rope, and furniture should also be removed.

e. Attempt to find professional associations and organizations that aim at suicide prevention in correctional facilities to work with to develop tools for assessing suicide risk in jails and prisons. These organizations should also be supported to provide training to prison staff and be involved in retraining staff members towards the success of the suicide prevention strategies.

Prisoner orientation and education

Prisoners should be educated and orientated on identifying early warning signs of suicide. The prisoners should also be educated on the confidentiality and anonymity in the process towards resolution of mental health issues and other issues causing suicidal behavior. Information provided to prisoners should include:

Methods for self-protection

Prevention strategies within the organization, and interventions available

Ways of reporting suicide attempt in a discrete manner including the locked box provided for such reports.

Protection against any form of retaliation by the inmate being reported,

Consequences of providing false or misleading information

That prisoners are not required to file written reports but prison officers receiving these reports have to file written reports to assess the risk of suicide.

Prevention

1. All prison staff and inmates should be alert to the signs of potential situations in which prisoner suicide may occur. Warning signs include: