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| Anticipate and prevent |
| By Sarah Etter, News Reporter |
| Published: 06/25/2007 |
The morose repercussions of an offender suicide can reverberate through a facility for days, weeks or months. As staff, offenders and family come to grips with an in-custody death, procedures and processes are usually revisited to prevent an even like this from happening again.The suicide rate in corrections can fluctuate depending on agency procedures. As the mentally ill prison population skyrockets, suicides and suicide attempts could as well. In fact, some health experts believe the influx of mentally ill inmates will prompt departments to reevaluate their suicide prevention strategies and adopt more practices from the public mental health sector. “We really need to look at the epidemiology of suicide in a high risk community,” says Dr. Bruce Sieleni, Director of mental health services the Iowa DOC. “If you look at those in the community who are at the highest risk for committing suicide, it tends to be the population who is incarcerated. It’s very significant that we’re locking up people with more mental illnesses, depression and substance abuse problems, and that they are also more likely to commit suicide.” Sieleni points to research from the World Health Organization, which reports men are more likely to commit suicide than women. Men are also more likely to be incarcerated. Additionally, those suffering from mental illness, such as schizophrenia, or addiction, like alcoholism, also are at a higher risk. “In corrections, it’s tough,” Sieleni says. “By default, we’re dealing with a population much more likely to commit suicide to begin with. Then you add the stresses of incarceration, deteriorating relationships, and being removed from loved ones and it just gets worse.” Most departments do offer training for staff, mental health screenings for inmates, observations for at-risk inmates, and counseling. Those steps aren’t always enough to keep suicide rates consistent with the national average, however, leaving officials to stew over what went wrong. According to Dr. Scott Chavez, National Commission on Correctional Health Care Vice President too little training is one big problem. “An agency can have the best policies in the world. An agency can have zero tolerance for suicide. But if you don’t have the strongest staff training program possible, it’s just not going to work. It’s not enough to simply train on a quarterly basis. You must be vigilant for suicide prevention. You cannot let this slide, or take your eye off of the problem for even a moment.” Lindsay M. Hayes, suicide prevention consultant and project manager for the National Center on Institutions and Alternatives says that many agencies face training troubles. “After an inmate suicide, agencies will call me and say that they’ve done their training and they’ve been on top of the issue,” she explains. “But when I go in to assess them, I inevitably find a problem with.” Hayes says a comprehensive suicide prevention plan should include thorough training, multiple mental health screenings, communication between all department areas, housing and supervision for suicidal offenders, and emergency response plans. Thorough incident reporting and a morbidity/mortality review are also important. “The mortality/morbidity review must be comprehensive and cross-disciplinary,” says Hayes. “Everyone from security, medical and mental health staffs must come to the table, not to point fingers, but to really review the procedures in place and see what went wrong and where the agency can improve.” According to Sieleni following procedures that were once standard protocol may not help a suicidal inmate. “In a regular mental health setting, you let someone at risk for committing suicide continue on a regular schedule, surrounded by the people they would usually see. In corrections, we immediately isolate them. But that isolation will intensify their feelings of depression and suicidal tendencies. It seems counterintuitive from a security perspective to let someone stay in the general population of a facility, but we need to look at the least restrictive environment to observe these offenders,” he explains. Hayes adds that many might disagree with that idea, but research has consistently shown that segregation may increase the risk for suicide. “There are currently class action lawsuits in California and New York about the use of isolation for suicidal inmates. It’s a big issue,” says Hayes. “Segregation has typically been thought of as the best place for these inmates because it is the most secure location in the building. But research has shown for years that segregation equals lockdown for 23 hours a day and it is counterproductive for someone in that situation. They need to interact with other inmates and correctional staff rather than dwelling on their problems.” Monitoring times inmates are most likely to attempt suicide, like after a court date, especially if they receive a lengthy sentence they didn’t expect is also a key strategy. To offset that, Hayes recommends screening offenders when they return from court. She also recommends those observing suicidal inmates conduct their rounds at erratic intervals rather than at every fifteen minutes, to prevent the inmate from anticipating when they will be checked on. Even if all of these plans are in place, if an inmate is determined, is unlikely that every suicide will be prevented. Following protocol and remaining vigilant in keeping current with proper procedures should create a safe, positive environment for both staff and inmates. Related resources: World Health Organization report Preventing Suicide. A Resource for Prison Officers |
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