Suicide Underscores Need for Mental Health Care in Correctional Facilities

Written by: Beth Boone, Esq.

Death by suicide behind bars is a serious challenge in correctional health care, and there is a greater focus on expanding mental health services and prevention programs to reduce fatalities.

Corrections officers, facility administrators, community health care agencies and other stakeholders also play important roles in watching for suicide risk, and understanding their role in making referrals or getting treatment for people who exhibit risk signs.

An important first step is training all health care providers, not just mental health care professionals, on the warning signs of suicide among an incarcerated population. Educating your staff about what to look for can help reduce the risk of suicides happening in the first place, and minimize the risk that family members or survivors will file lawsuits.

Health care providers must understand how to assess potentially suicidal patients, how to monitor them, and how to get them into treatment as quickly as possible, according to the National Commission on Correctional Health Care.

Providers and administrators should also be mindful to avoid making suicide prevention and precaution actions seem punitive or too restrictive. For example, suicide prevention at some facilities involves removing a mattress, taking away personal belongings, halting out-of-cell activities, withholding reading materials, TV privileges, and other comforts.

Those conditions can seem as bad as isolation units or solitary confinement that is used as a deterrent and protective measure when a person is violent or presents a danger to others, and can discourage inmates from being honest about whether they are having suicidal thoughts.

According to NCCHC, here are a few suicide prevention protocols that should be considered during an inquiry:

• Was the inmate a medical, mental health, or suicide risk during any prior contact or confinement at this facility?
• Does the arresting or transporting officer have any information (e.g., from observed behavior, documentation from sending agency or facility, conversation with family member) that indicates the inmate is a medical, mental health, or suicide risk now?
• Has the inmate ever attempted suicide, or been known to consider suicide?
• Is the inmate now being treated or has ever been treated for mental health or emotional problems?
• Has the inmate recently experienced a significant loss (e.g., relationship, death of family member or close friend, job)?
• Has a family member or close friend of the inmate ever attempted or committed suicide?
• Does the inmate feel there is nothing to look forward to in the immediate future (expressing helplessness or hopelessness)?
• Has the inmate expressed that they are thinking of hurting or killing himself/herself?

Consider including attorneys who are experienced in correctional health care litigation defense as you create staff training programs, and establish policies and protocols for suicide prevention and monitoring. Better education for all stakeholders is the best way to reduce loss of life and litigation risk.