Correctional facilities and staff have a legal responsibility and ethical obligation to protect individuals in their custody and care from self-harm, including suicide. Numerous myths surround the issue of suicide, such as “You can’t stop individuals in custody from killing themselves if they want to do it,” or “Suicides usually occur suddenly without warning.” Post-reviews of situations involving individuals who die by suicide demonstrate that detainees/inmates almost always display risk factors and warning signs of suicidal ideation.
Suicide is often considered to be an issue to be handled by mental health professionals. However, most suicides occur in facility housing units during nonprogrammatic hours. Therefore, front-line correctional staff often carry the heaviest burden to identify, monitor and respond to suicidal behaviors in correctional facilities.
What to look for
Having a thorough understanding of risk factors, stressors and warning signs will help correctional officers identify individuals at risk for suicide during direct observation of and communication with detainees/inmates.
Risk factors are characteristics or situations that could increase an individual’s likelihood of suicide. Some risk factors include:
- Gender: Increased risk for males
- Sexual orientation and gender identity: 40% increase of suicide in those who do not identify as heterosexual or cis gender
- Military service: 21% increase of suicide
- Mental health disorders, particularly mood disorders (depression, bipolar disorder)
- Limited social support
- Family or personal history of suicide
- History of trauma
- First-time arrest or conviction for a violent offense
- Lengthy sentence
Warning signs are “red flag” behaviors that alert correctional officers that an individual may be at risk for suicide. Some warning signs include:
- Making statements or threats to harm/kill themselves
- Talking, writing or drawing about wanting to die
- Looking to secure means to complete suicide
- Dramatic mood changes
- Inability to sleep or sleeping all the time
- Uncontrolled anger or aggression
- Withdrawing from family, friends, activities
- Giving away personal possessions
- Engaging in behavior to get put in isolation or segregated housing
Stressors are feelings or situations unique to being in a correctional environment that could heighten an individual’s likelihood of suicide. Some stressors include:
- Guilt or shame over incarceration
- Loss of family/friends
- Loss of personal choice, privacy and control over their lives
- Callous treatment by correctional staff
- Fear for personal safety
- Problems with other detainees/inmates or staff
Detainees/inmates can also experience stress or anxiety during critical times (after experiencing a personal loss such as death of partner or family member, before or after significant dates in their lives, before or after hearing dates, immediately after intake or during holidays) and after critical incidents (threat or act of violence or sexual assault, emotional or stressful visit with family or legal representative, or receiving bad news from home).
When to look for it
Intake: The American Correctional Association recommends that jails and prisons screen all detainees/inmates during intake to identify risk factors for suicide and immediate risk of self-harm. This information is used to inform housing and security decisions. Correctional staff who are not responsible for conducting receiving screenings still need to be aware of the process their facility uses and follow any recommendations provided to them based on the outcomes of the screening (e.g., suicide precautions).
Daily Observations: Detainees/inmates may not disclose suicidal ideation at intake or they may become at risk post-intake. Risk for suicide is fluid, meaning it can fluctuate throughout their period of incarceration. Correctional officers’ high level of contact with detainees/inmates puts them in a unique position to know when stressful events occur and notice behavior changes that may be indicative of possible suicidal ideation. They should always be alert for risk factors, stressors, and warning signs for suicide and follow their agency’s policies and procedures for responding immediately.
This is probably the most important role correctional officers assume in suicide prevention and response. This involves monitoring detainees/inmates in the general population to identify stressors and warning signs as well as observing those placed on suicide precautions.
Correctional officers must be vigilant in adhering to the suicide precautions or special conditions prescribed for individuals who are identified to be at risk for suicide. These are often determined by the facility’s mental health providers or facility administrators and communicated to staff. Precautions could include special considerations related to:
- Housing assignments
- Observation intervals
- Clothing, bedding and hygiene products
This includes the immediate response to a suicidal situation and the provision of life-saving measures.
The three most common types of suicide in correctional facilities are:
- Hanging and strangulation
- Drug overdose
- Self-inflicted wounds (cutting major arteries, swallowing foreign objects, inflicting head trauma)
Responding to any of these or other types of suicidal situations requires quick thinking and immediate action. No matter the type of suicidal situation correctional officers are responding to, priority must be given to the safety and security of detainees/inmates and staff in the facility.
When correctional officers directly observe or are made aware of a suicidal situation, they should follow these basic rules:
- Call for backup immediately and notify the control center and shift supervisor via radio.
- Respond to suicidal situations in pairs. In most facilities, protocols dictate that backup must be present before entering the cell. While one officer is providing medical attention, the second officer should be contacting and communicating with the emergency medical providers, mental health staff and shift supervisors.
- Follow the facility’s protocols regarding securing or locking down cells, units and other areas of a facility during a suicidal situation.
- Always practice standard precautions to protect against potential infectious disease.
Correctional facilities should have a suicide prevention program, which details the protocols for identifying, monitoring and responding to suicidal situations. Correctional officers should be familiar with their facility’s specific suicide prevention program and protocols and what is expected of them as a correctional officer. Failure to follow their facility’s suicide prevention program could result in civil and criminal liabilities for the facility as well as themselves.