Health Care Reform

Jail Suicide

Suicide continues to be a leading cause of death within jails, prisons and juvenile facilities throughout the country. NCIA Jail Suicide Prevention and Liability Reduction Services have found that the suicide rate in county jails is several times greater than that of the general population, while the suicide rate in prisons remains slightly higher than in the community.

As unfortunate as it may sound, prisoners must employ a certain degree of creativity when contemplating suicide. Without easy or legal access to drugs, weapons, or willing assistants, inmates often use painful, even tortuous, methods of shuffling off the mortal coil. Correctional agencies attempt to moderate inmate opportunity to commit suicide by designing cells with high security window grills, moving-plate safe ventilators, rectangular, floor-mounted safe-skirting heater pipes, and fixed resin-clad storage units (Burrows, Brock, Hulley 2003). At many prisons, suicide assessments are conducted at intake, and if suicidal tendencies are discovered, the inmate is placed in a specially-supervised ward that is periodically checked by staff no fewer than every 15 minutes. According to NCIA the initial intake assessment is not enough to determine if the inmate should be held on suicidal watch. The assessment should be an on-going process. Although the intake screening form remains a valuable prevention tool, the more important determination of suicide risk is the current behavior expressed and/or displayed by the inmate.

It is unclear whether many of these developments work or not. Many of the risk-factors for suicidal behavior in prisoners resemble those for non-prisoners, such as substance-abuse, mental health facility-admittance, acute psychoses, and psychiatric morbidity (Shaw, Appleby, Baker 2003); it may be more efficient and cost-effective to assess and monitor these indications on a regular basis than attempt to redesign the living environments of potentially millions of inmates....