Inmate suicide prevention is central to correctional training and day-to-day prison operations. And for good reason: suicide represents 1.7% of all deaths in the United States, but 30% of all deaths in prison. Nearly 10% of prisons experienced a suicide in 2019 – a figure that does not include suicide attempts.
It’s no surprise, then, that the issue of inmate suicide was the focus of this year’s American Jail Association Conference & Jail Expo. Even in sessions focusing on other topics, inmate suicide prevention kept coming up.
“Even when you’re doing everything you’re supposed to, people are still dying,” says prison and juvenile justice suicide expert Dr. Lisa Boesky, who presented at the conference. “And if you were lucky and didn’t have a suicide, that doesn’t mean you’re doing everything right.” Dr. Boesky and other presenters discussed many new ways to look at suicide prevention. Here are four related themes.
1. Take care of your staff
Wait, this is an article on detained suicide prevention, right? Yes. But many of the suicide prevention measures in prisons depend on prison staff. We can build soft cells and place inmates in suicide gowns and use medical monitoring to reduce the risk of suicide. But these things cannot substitute for a caring and observant correctional officer.
Unfortunately, many correctional officers find it difficult to care because they suffer from burnout. “Burnout directly affects what you see and how you react when you see it,” says Krista Chick, counselor for Quality Correctional Health Care in Alabama. “You might not notice something and if you do, you might be less likely to do something about it.”
Strategies to combat burnout include developing hobbies and interests outside of work, spending time in nature, practicing mindfulness, and developing gratitude. But it’s also possible for leaders to help staff by creating staff-centric spaces in the facility. This is an approach used in the new jail in Franklin County, Ohio. Leaders set out to create an environment focused on inmate rehabilitation, but quickly realized that the changes were also having a positive effect on staff.
Consider, for example, a staff dining room. In many correctional facilities, staff eat the same food as inmates, often bringing a tray back to their post. But Franklin County built an indoor/outdoor area inside the secure perimeter but completely separate from the rest of the jail. Staff feel a sense of relief and escape. They can see and smell the outdoors and return to work rested and invigorated.
Other staff-centric areas include wellness centers, locker rooms and parking lots. Even adding small touches of light, color and art to these areas can create a tacit recognition that staff are different from inmates. And that in turn can reduce burnout and increase the chances that they’ll stay alert to signs of suicide risk – and have the emotional energy to intervene.
2. Focus on interaction and time outside the cell
Correctional officers have long understood the irony of suicide prevention in prisons – many inmate suicide prevention measures appear designed to increase someone’s desire to commit suicide. Top of that list is isolation. Suicidal inmates often live with mental illness. They exhibit abnormal behavior and do not respect the rules of the prison. This, in turn, leads to their reduced access to programs, and often to their isolation, which in turn can increase suicidal ideation.
The Ventura County (CA) Sheriff’s Office created a special Therapeutic Inmate Management Unit to break this cycle. The objective of the unit is to improve the socialization and compliance with treatment of psychiatric inmates, by giving them better access to programs – to, quite simply, get them out of their cells.
Deputies are assigned specifically to the unit and leverage numerous resources to learn as much as possible about inmates. They create inmate profiles and detail what works and what doesn’t in daily reports. Art and music appreciation classes, film screenings, a “coffee shop” atmosphere, and moral reconvocation therapy are just a few of the programs offered to inmates, as long as they follow general rules and medications. assigned to them.
Developing a special unit like the one in Ventura County takes time, planning, and funding. But the basic idea – maximizing social interaction rather than reducing it – can be applied to any establishment. “99% of suicides happen when people are alone,” says Dr. Boesky. “They may look angry, aggressive and needy, but inside they are desperate. They think, “My family would be really better off without me” or “I’m just a number, I don’t matter. Social interaction shows them they matter. Correctional officials, she said, should encourage officers to talk to residents, to get them out of the cell. For example, if the inmate is on continuous suicide watch, you may be able to remove him from the cell from time to time and have him watch television with a staff member present.
3. Incorporate biophilic design concepts
The average prison is not an inviting place. They are designed to contain and hold. “Think about what the architecture of your establishment communicates,” says David Bostwick, legal consultant at architecture and engineering firm HDR. “There is not a lot of modesty, they are overcrowded. It’s a hardened environment where tables and chairs can’t move, there’s no natural light.
That’s because most prisons were built before 1980, when societal attitudes toward incarceration focused on punishment. Today things are different. So many inmates are in prison in part because of mental health and addiction issues. And, Bostwick notes, about 70% were not convicted.
That’s why the Franklin County facility mentioned above is built on a very different model. The facility incorporates biophilic design concepts to reduce anxiety and stress. This approach recognizes that 80-90% of inmates have experienced some sort of trauma – emotional, physical or sexual abuse – before coming to the facility.
While some biophilic design concepts require the construction of new facilities, others can be done in existing facilities. Some ideas to consider:
- Install the artwork. Franklin County installs huge murals attached to walls with strong adhesive. They are mostly out of reach of inmates to reduce damage, but are visible from cells and create the effect of looking outside through a window.
- Provide creative outlet spaces for inmates. In Ventura County, the Therapy Unit has blackboards in cells where inmates can draw to resolve tensions. In Franklin County, large portions of the common room walls present a similar surface for inmate artwork.
- Repaint and add color. Consider a color scheme for your installation, using colors and textures that evoke nature.
- Install skylights or other means to let in natural light, or select lighting patterns that mimic the natural light cycle.
- Reduce noise with acoustic tiles or use FM transmitters for TVs and provide headphones to inmates, eliminating the cycle of turning on the TV to be heard during inmate conversations.
- Install chairs that can move and tables and chairs that feature woodgrain surfaces. When everything is stainless steel and immobile, inmates lack confidence and control over their surroundings.
- Identify basic needs – for example, what do people hoard and why? Many inmates wash their underwear themselves rather than handing them over to the laundry exchange. Can you give them access to a laundromat to do their own laundry? This can reduce clutter and demonstrate confidence.
“The environment shapes behavior. Everything in design elicits an emotional response,” says Bostwick. Evoking a positive emotional response can in turn reduce depression and suicidal ideation in inmates.
4. Give prisoners a “livable life”
Across all of these approaches to inmate suicide prevention, Dr. Boesky summed it up best: “The best suicide prevention is to make life livable.”
She also pointed to the potential impact of the design changes: “What Franklin County does is prevent suicide.” But there are plenty of other ways to make prisoners’ lives more enjoyable. Consider the reading materials provided by your institution. Are books and periodicals of interest to inmates or are they publications such as romance novels or discarded magazines that no one wants? Many facilities have converted to video visits — for good reason — but for those monitoring suicide, in-person visits can save lives. Suicide watch shouldn’t mean limiting showers or cutting programming. This should involve medication when needed, but not overmedication.
More recreation, a cellmate, programs that help inmates learn to read, graduate from high school, or better understand why they use illegal drugs – all of these are important ways to give life. hope to detainees and to prevent them from having to put themselves under surveillance.
“Don’t think of suicide prevention as a smock and a security cell,” says Dr. Boesky. “Your goal should be to keep them less likely to become suicidal in the first place. We should ask ourselves, what can we do in our prison that doesn’t cost a lot of money and can make a difference?”
NEXT: Suicide Prevention in Prison: Best Practices and Policy Considerations