My experience has been that negative attitudes impede meaningful suicide prevention efforts. Such attitudes form obstacles to prevention, and can be seen on both a local and universal basis. Simply stated, obstacles to prevention are empty excuses that inmate suicides can not be prevented. For example, a Local Obstacle might sound something like this:

• “We did everything we could to prevent this death, but he showed no signs of suicidal behavior;”

• “There’s no way you can prevent suicides unless you have someone sitting watching the prisoner all the time, and no one can afford to be a baby sitter;”

• “We didn’t consider him suicidal, he was simply being manipulative and I guess it just went too far;”

• “We aren’t mind readers nor trained to be psychiatrists;”

• “If someone really wants to kill themselves, there’s generally nothing you can do about it;”

• “Suicide prevention is a medical problem...it’s a mental health problem...it’s not our problem.”

Following a recent inmate suicide, a jail commander and police chief made the following comments:

• “I suppose that with fewer prisoners in the jail, the jailer on duty could make his rounds more frequently. However, the current policy we follow states that the jailers make routine inspections every 20 to 30 minutes. Generally, that is not enough time for prisoners to hurt themselves.” (Jail Commander)

• “There was nothing unusual about the arrest. I was very satisfied with the way the officers involved handled the situation. The only real unanswered question is why the inmate chose to do what he did. Personally, I do not believe it is any of the police department’s business nor is it in the scope of our employment to determine why.” (Police Chief)

Following two inmate suicides in the same housing unit within a three-day period, the warden appeared disinterested as to whether the suicides were related:

• “Our concern is more if we suspect foul play...we always go back and review our policies and procedures to see if there’s anything we could do to prevent it...I have no idea why they do it. If I ever did, I could probably do a better job of preventing it.”

Then there are Universal Obstacles to prevention—regressive attitudes that are far more dangerous because of their far-reaching ability to negatively influence correctional policy on a larger scale. We often find the roots of this attitude in both the academic or psychiatric communities:

• “Statistically speaking, suicide in custody is a rare phenomenon, and rare phenomena are notoriously difficult to forecast due to their low base rate. We cannot predict suicide because social scientists are not fully aware of the casual variables involving suicide;”

• “Demographic profiles of custodial suicide victims are of little value for prediction because they often mirror the characteristics of typical jail inmates;”

• “Even those skilled mental health professionals, who have the time for extensive personal interaction with troubled individuals, either cannot forecast suicide or are unable to prevent patient suicide even if it had been somewhat anticipated;”

• “Jail suicides are extremely difficult to predict due to their spontaneous nature;” and

• “To speak bluntly, custodial suicide may constitute less a readily solvable problem than a situation which, in view of our present knowledge and our financial limitations, may be expected to continue.”

There are various ways to defuse these local and universal obstacles, the most appropriate of which is to demonstrate successful interventions.

As described in our Jail Suicide/Mental Health Update (Volume 8, Number 1, 1998) newsletter, I had the opportunity to visit the Orange County Jail System in Santa Ana, California. With over 5,000 inmates, it is the 12th largest jail system in the country, and 3rd largest in California. During the past 10 years, over 831,040 have been processed through the system and only 5 inmates have successfully committed suicide. The suicide rate in the Orange County Jail System (9.4 deaths per 100,000 inmates) among the lowest I have seen. Why? Because there are no obstacles to prevention. As bluntly stated by the jail commander:

“When you begin to use excuses to justify a bad outcome, whether it be low staffing levels, inadequate funding, physical plant concerns, etc. – issues we struggle with each day – you lack the philosophy...that even one death is not acceptable. If you are going to tolerate a few deaths in your jail system, then you’ve already lost the battle.” (Jail Commander, Orange County, California)