From New Mexico Counties Newsletter
- What are common misperceptions about jail suicide? RESPONSE: The most common misconception is that suicides are not preventable, i.e., if an inmate chooses to kill themselves, there is generally nothing we can do about it. As reduced suicide rates in county jails throughout the country clearly demonstrate, this is simply not true. While all suicides are not preventable, many of them are and jurisdictions that remain vigilant in prevention efforts avoid bad outcomes.
- What are challenges you see to reducing jail suicide? RESPONSE: The two main impediments to suicide prevention are negative attitudes and complacency. Negative attitudes, particularly from decision makers within a correctional agency, can corrupt prevention efforts. Complacency can be just as dangerous and usually occurs when an agency, without exerting much effort in prevention, goes through a period of time without any inmate suicides or serious suicide attempts, thus falsely believing they are immune from the problem.
- Is treatment of suicidal inmates possible in a jail setting or is it the jail setting that makes some inmates suicidal? RESPONSE: We have no choice. Jails have become the de facto treatment setting because, given the shrinking number of in-patient beds, it is very difficult to hospitalize a suicidal inmate. While it is true that an inmate’s confinement often creates and/or exacerbates their suicidal thoughts, and the best treatment is often their release from incarceration, while they remain in our custody, the most realistic treatment is identification, management, stabilization, and periodic follow-up.
- Do you think educating detention staff in mental health subjects should be a part of their training? RESPONSE: Yes, basic training in mental health issues is extremely important to the management of inmate behavior. The training need not concentrate on differing DSM-IV diagnoses, rather it should provide instruction on good communication skills, crisis intervention techniques, and other intervention skills meant to deescalate behavior.
- What accounts for the decline in jail suicide? RESPONSE: There are many reasons why the suicide rate in county jails has decreased, including a more consistent offering of suicide prevention training to staff, more in-depth probing of suicide risk factors during intake screening, better suicide prevention practices, and the continuing threat of liability. Most importantly, however, the general awareness that inmate suicides can be prevented is much greater today than 20 years ago.
- What are the signs of a suicidal inmate, and how should staff respond?RESPONSE: There is no short answer to that question. There are many signs and symptoms to suicidal behavior, including the most obvious one of talking about/or threatening suicide or making statements that are death-related (e.g., “I’ve had it. I can’t take it anymore”). Other signs and symptoms include current depression, severe agitation and/or anxiety; helplessness and/or hopelessness; paranoid delusions or hallucinations; strong guilt and/or shame over offense; intoxication and/or withdrawal; previous history of suicidal and/or self-injurious behavior; and history of mental illness.
It is also extremely important to remember that we should not rely exclusively on the direct statements of an inmate who denies that they are suicidal and/or have a prior history of suicidal behavior, particularly when their behavior, actions and/or history suggest otherwise. Often, despite an inmate’s denial of suicidal ideation, their behavior, actions, and/or history speak louder than their words.
- What are some of the trends and patterns across the country on jail and prison suicide, as well as suicide attempts? RESPONSE: The National Study of Jail Suicide: 20 Years Later report that our agency developed for the U.S. Justice Department’s National Institute of Corrections in May 2010 found several changing dynamics to jail suicides, including the fact that suicides no longer are more likely to occur within the first 24 hours of confinement and, therefore, victims are not necessarily intoxicated upon their deaths. In addition, many suicides occur in close proximity to court hearings, as well as telephone calls and/or visits from family members. Finally, although most jails self-reported having a written suicide prevention policy at the time of the inmate suicide, most of the policies were found to be inadequate and not reflective of comprehensive procedures in the identification, management, and stabilization of suicidal inmates.
- How does New Mexico rank within these trends and patterns? RESPONSE: That is a difficult question to answer because our most recent research study did not focus on state-by-state trends. I will say, however, having spent time in your state, and consulted with the New Mexico Association of Counties (NMAOC) on a few occasions, I do not know of another county association whose risk management entity is more devoted to the issue of jail suicide prevention than the NMAOC. I hope that your member counties continue to take advantage of your training resources and technical assistance.
- What are the top 5 suicide prevention measures that a jail system should take in addressing the problem? RESPONSE: In no particular order of importance because they are all critical to prevention, 1) pro-active administration that maintains a zero-tolerance for inmate suicides; 2) professional, well trained, and caring staff; 3) adequate practices that mirror a reasonable suicide prevention policy; 4) adequate medical/mental health staffing resources; and 5) an adequate number of “suicide-resistant” cells designated to house suicidal inmates.
- How effective is suicide prevention training in a jail or prison setting? RESPONSE: Having conducted suicide prevention training for over 30 years, I am a bit biased, but I truly believe it is the backbone of any prevention program. An agency really cannot prevent a problem if its staff have not received sufficient on-going training. In addition, training cannot be limited to correctional staff, but also should be mandated for both medical and mental health personnel. A significant explanation for the reduction in the rate of jail suicide throughout the country has been the dedication to suicide prevention training.