National Study of Jail Suicide: 20 Years Later

 
Mansfield, Mass., May 18, 2010. The National Center on Institutions and Alternatives (NCIA) released a major study on jail suicide on May 18, 2010. The study, commissioned by the U.S. Justice Department’s National Institute of Corrections, found a dramatic decrease in the rate of suicide in county jails during the past 20 years. The suicide rate in county jails was calculated to be 38 deaths per 100,000 inmates, which was approximately 3 times greater than that in the general population of the United States (at 11 deaths 100,000 citizens), but nearly a threefold decrease from 107 suicides per 100,000 inmates reported by NCIA in similar Justice Department commissioned-study released in 1986.

According to Lindsay M. Hayes, NCIA Project Director and author of the National Study of Jail Suicide: 20 Years Later, “the recent decrease is extraordinary.” He said there may be several explanations for the reduced suicide rate. “During the past several years, national studies of jail suicide have given a face to this longstanding and often ignored public health issue in the nation’s jails,” Hayes stated. He then added, “The increased awareness of inmate suicide, coupled with the threat of liability, is also reflected in national correctional standards that now recommend comprehensive suicide prevention programming, better training of jail staff, and more in-depth inquiry of suicide risk factors during the intake process.” With strong data to indicate that suicides can be prevented, Hayes emphasized that “the antiquated mindset that ‘inmate suicides cannot be prevented’ should forever be put to rest.”

Despite this encouraging data, Hayes stressed that suicide continues to be a leading cause of death in jails across the country. The current study, a follow-up to a similar national survey that NCIA conducted for the Justice Department in 1986, resulted in a 68-page report of the findings that Hayes said “can be used as a resource tool for both jail personnel in expanding their knowledge base and administrators in creating and/or revising policies and training curricula on suicide prevention.”

The study identified 696 jail suicides in 2005 and 2006 combined, with 612 deaths occurring in detention facilities (housing individuals for more than 72 hours) and 84 in holding facilities (housing individuals for less than 72 hours). To ensure confidentiality and increase cooperation with surveyed agencies, individual states and jail facilities were not identified in the report. The findings are shown below. Significant findings are in bold and italics.
Suicide Victims:

  • 67% were white.
  • 93% were male.
  • The average age was 35.
  • 42% were single.
  • 43% were held on a personal and/or violent charge.
  • 47% had a history of substance abuse.
  • 28% had a history of medical problems.
  • 38% had a history of mental illness.
  • 20% had a history of taking psychotropic medication.
  • 34% had a history of suicidal behavior.

Characteristics of Suicides:

  • Deaths were evenly distributed throughout the year; certain seasons and/or holidays did not account for more suicides.
  • 32% occurred between 3:00pm and 9:00pm.
  • 24% occurred within the first 24 hours, 27% between 2 and 14 days, and 20% between 1 and 4 months.
  • 20% of the victims were intoxicated at the time of death.
  • 93% of the victims used hanging as the method.
  • 66% of the victims used bedding as the instrument.
  • 30% of the victims used a bed or bunk as the anchoring device.
  • 31% of the victims were found dead more than 1 hour after the last observation.
  • CPR was not administered in 37% of incidents.
  • 38% of the victims were held in isolation.
  • 8% of the victims were on suicide watch at the time of death.
  • No-harm contracts were used in 13% of cases.
  • 35% of deaths occurred close to the date of a court hearing, with 69% occurring in less than 2 days.
  • 22% occurred close to the date of a telephone call or visit, with 67% occurring in less than 1 day.

Characteristics of the Jail Facilities:

  • 84% percent were administered by county, 13% by municipal, 2% by private, and less than 2% by state or regional agencies.
  • 77% provided intake screening to identify suicide risk, but only 27% verified the victim’s suicide risk during prior confinement, and only 31% verified whether the arresting officer believed the victim was a suicide risk.
  • 62% provided suicide prevention training, but 63% either did not provide training or did not provide it on an annual basis.
  • 93% provided a protocol for suicide watch, but less than 2% had the option for constant observation; most (87%) used 15-minute observation periods.
  • 32% maintained safe housing for suicidal inmates.
  • 35% maintained a mortality review process.
  • 85% maintained a written suicide prevention policy, but as shown above, suicide prevention programming was not comprehensive.

The Changing Face of Suicide Victims. Twenty years after a similar survey was conducted in 1986, this National Study of Jail Suicide: 20 Years Later found substantial changes in the demographic characteristics of inmates who commit suicide. As shown in the table below, some of these changes were stark. For example, suicide victims once characterized as being confined on “minor other” offenses were found in the 2005-06 data to be held on “personal and/or violent” charges. Intoxication was previously viewed as a leading precursor to inmate suicide, yet recent data indicate that it is now found in only a minority of cases. Whereas more than half of all jail suicide victims were dead within the first 24 hours of confinement according to 1986 data, current data suggest that less than a quarter of all victims commit suicide during this time period, with an equal number of deaths occurring between 2 and 14 days of confinement.

 

Changing Face of Jail Suicide Victims
Variables 1985-1986 2005-2006
Facility Type 70% Detention 88% Detention
Race 72% White 67% White
Sex 94% Male 93% Male
Age 30 35
Marital Status 52% Single 42% Single
Most Serious Charge 29% Minor Other 43% Violent/Personal
Jail Status 89% Detained 91% Detained
Intoxication at Death 60% 20%
Time of Suicide 30% between 12:00am and 6:00am 32% between 3:01pm and 9:00pm
Length of Confinement 51% within 1st 24 hours 23% within 1st 24 hours
Method 94% Hanging 93% Hanging
Instrument 48% Bedding 66% Bedding
Time Span (between last observation and finding victim) 42% found within 15 minutes 21% found within 15 minutes
Isolation 67% 38%
Known History of Suicidal Behavior 16% 34%
Known History of Mental Illness 19% 38%
Intake Screening for Suicide Risk 30% 77%
Written Suicide Prevention Policy 51% 85%

 

 

In addition, inmates who committed suicide appeared to be far less likely to be housed in isolation than previously reported and, for unknown reasons, were less likely to be found within 15 minutes of the last observation by staff. Finally, more jail facilities that experienced inmate suicides had both written suicide prevention policies and an intake screening process to identify suicide risk than in years past, although the comprehensiveness of programming remains questionable.

According to author Hayes, findings from this study create a formidable challenge for both correctional and healthcare officials as well as their respective staff. “Although our knowledge base continues to increase, which has seemingly corresponded to a dramatic reduction in the rate of inmate suicide in detention facilities, much work lies ahead,” he said. The data indicate that inmate suicide is no longer centralized to the first 24 hours of confinement and can occur at any time during an inmate’s confinement. According to Hayes, “because roughly the same number of deaths occurred within the first several hours of custody as occurred during more than a few months of confinement, intake screening for the identification of suicide risk upon entry into a facility should be viewed as time limited.” He stressed that “because inmates can be at risk for suicide at any point during confinement, the biggest challenge for those who work in the corrections system is to view the issue as requiring a continuum of comprehensive suicide prevention services aimed at the collaborative identification, continued assessment, and safe management of inmates at risk for self-harm.”

The National Center on Institutions and Alternatives (NCIA) is a private, non-profit organization that is headquartered in Baltimore, Maryland, with an office in Mansfield, Massachusetts. The National Institute of Corrections (NIC), a division of the U.S. Justice Department, provides training, technical assistance, information services, and policy/program development assistance to federal, state, and local corrections agencies. NCIA entered into a cooperative agreement with the Justice Department to conduct this national study of jail suicide. NCIA has conducted four other national studies of jail, prison, and juvenile suicide for the U.S. Justice Department. Lindsay M. Hayes is a nationally-recognized expert in the area of suicide prevention in correctional facilities. He has directed all five national studies, acts as a consultant to correctional facilities, and is a federal court monitor.

The full 68-page National Study of Jail Suicide: 20 Years Later can be viewed at either:

National Study of Jail Suicide: 20 Years Later (PDF)

or

http://nicic.gov/Library/024308.pdf

Please note that the documents are large and may take several minutes to download.

 

For further information about our Suicide Prevention in Custody services contact Lindsay M. Hayes at lhayesta@msn.com or 508.337.8806