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Report Suggests Ways of Reducing Jail Suicides

With jail inmates committing suicide at a high rate, the Vera Institute of Justice has made recommendations on how local authorities might reduce the toll.

In a report entitled “Preventing Suicide and Self-Harm in Jail,” the institute studied four county jails around the U.S. to compare the systems they use to prevent inmates from taking their own lives.

Suicide has long been the leading cause of death in U.S. jails, but no national data have been issued since 2014.

At that point, the total had reached a high of 372 deaths, or 50 for every 100,000 inmates, which is two and one-half times times the rate of suicides in state prisons and about three and one-half times that of the general population, the Associated Press and Capital News Service of the University of Maryland reported last month.

The 18-month Vera study focused on jail systems in Middlesex County, N.J., Middlesex County, Ma., Pinellas County, Fl., and Spokane County, Wa.

All of the jails studied do “clinical mortality reviews” after suicides, which almost two-thirds of U.S. jails do not, Vera said.

The new study follows up a 2016 Vera report that discussed the potential for using “sentinel event reviews” to address the problem of suicide and other forms of self-harm.

The Sentinel Event approach, traditionally used in medicine and aviation, has begun to be applied to the field of criminal justice in order to examine the underlying factors that lead to wrongful convictions and other examples of judicial or police misconduct. In the case of jail suicides, the approach is aimed at exploring whether such incidents reflect “underlying system weaknesses.”

The results “may provide… important keys to strengthening the system and preventing future harm,” Vera says.

The new report discusses barriers to using sentinel event reviews in jails and recommends ways that jailers can adopt them.

(See also Andrew Guthrie Ferguson and James Doyle, “In Criminal Justice, the ‘Simple’ Solutions Are Usually Wrong,The Crime Report, January 31, 2017.)

It concludes that “it is possible to forestall suicides in custody with a comprehensive suicide prevention program.”

The plan should include regular training of all staff, screening and assessment of inmates for suicide risk, good communication procedures, housing prisoners commensurate with their risk level, and multidisciplinary review processes, among other factors,

Vera offers three primary recommendations for officials who run jails:

      • Develop suicide prevention plans that are consistent with national standards. Guidance is available from the National Commission on Correctional Health Care and the American Correctional Association on what Vera calls the “11 key components of robust
        suicide prevention programs.”
      • Get guidance on “how to implement an all-stakeholder, non-blaming review process” after a suicide.
      • Don’t limit internal reviews to completed suicides cases but include all cases of suicide attempts and other self-harm incidents. There are no national data on self-harm in jails, but one survey found that two percent of inmates in prisons are involved in “self-injurious behavior” each year.

The study discusses various issues that Vera says jail administrators must take into account, including whether health care is provided by private vendors and the necessity of collaboration between corrections and health care workers.

Another major factor in preventing jail suicides is the facility’s “organizational culture,” Vera says.

The institute says that sentinel event reviews “require a culture that is committed to addressing system weaknesses in order to prevent future adverse outcomes, instead of a culture of blame that is fixated on identifying bad apples.”

As things stand, the report said, many jail staff members “described a culture of… placing blame on individual people.” This was summarized colloquially as a “cover your ass mentality.”

Despite some advances in dealing with common mental health problems of inmates, the report said that some corrections officers remain pessimistic about the idea of preventing suicides, believing that, “If somebody wants to kill themselves, they’re going to find a way to do it.”

Jail systems must also deal with the “complex legal landscape in each jurisdiction,” Vera says. This includes considerations of legal liability, employee fear of lawsuits, and the fact that internal jail records may be sent to courts or disclosed through public record requests.

The full report can be downloaded here.

Ted Gest is president of Criminal Justice Journalists and Washington Bureau Chief of The Crime Report.