U.S. Department of Justice National Institute of Corrections Prison Suicide: An Overview and Guide to Prevention National Institute of Corrections Morris L. Thigpen, Director Susan M. Hunter, Chief Prisons Division John E. Moore, Project Manager Prison Suicide: An Overview and Guide to Prevention By Lindsay M. Hayes Project Director National Center on Institutions and Alternatives Mansfield, Massachusetts June 1995 This document was prepared under grant number 93P01GHU1 from the National Institute of Corrections, U.S. Department of Justice. Points of view or opinions stated in this document are those of the author(s) and do not necessarily represent the official position or policies of the U.S. Department of Justice. Copyright © 1995 by the National Center on Institutions and Alternatives The National Institute of Corrections reserves the right to reproduce, publish, translate, or otherwise use, and to authorize others to publish and use all or any part of the copyrighted material contained in this publication. ii TABLE OF CONTENTS FOREWORD .......................................................................................................................................v PREFACE AND ACKNOWLEDGMENTS ..................................................................................vi 1. INTRODUCTION AND LITERATURE REVIEW ..............................................................1 2. NATIONAL AND STATE STANDARDS FOR PRISON SUICIDE PREVENTION ...........................................................................................................8 Reviewing the National Standards ................................................................................................9 Reviewing State Standards...........................................................................................................15 Conclusion ....................................................................................................................................26 3. PRISON SUICIDE RATES: A 10-YEAR REVIEW.............................................................27 NCIA Survey Findings..................................................................................................................27 Conclusion ....................................................................................................................................31 4. EFFECTIVE SUICIDE PREVENTION PROGRAMS IN STATE PRISONS.................33 Elayn Hunt Correctional Center..................................................................................................33 State Correctional Institution at Retreat.....................................................................................40 5. SUICIDE PREVENTION IN FEDERAL PRISONS: A SUCCESSFUL FIVE-STEP PROGRAM............................................................................................................46 Program Description.....................................................................................................................47 Demographic Data........................................................................................................................51 Survey of Chief Psychologists — Overview.................................................................................56 Summary........................................................................................................................................56 6. THE COURTS’ ROLE IN SHAPING PRISON SUICIDE POLICY.................................58 Jail and Prison Suicide Lawsuits...................................................................................................58 Two Roads to the Courthouse .....................................................................................................59 Courts as Agents of Reform..........................................................................................................59 Suicide Claims and Section 1983 Actions ..................................................................................60 So Much for Theory — What About the Facts? ........................................................................63 Summary........................................................................................................................................67 7. SUMMARY AND CONCLUSIONS.......................................................................................68 REFERENCES ...................................................................................................................................70 APPENDICES A. Sample Suicide Precaution Protocols ..........................................................................................78 B. Total Prison Suicides and Rates by State: 1984-1992 ................................................................80 C. Suicide Prevention Protocols of the Elayn Hunt Correctional Center......................................83 D. Selected Procedures of the Pennsylvania Department of Corrections ......................................95 iii TABLES Table 2-1. Suicide Prevention Protocols Within Departments of Corrections...........................18 Table 3-1. Total Prison Suicides and Rates by State, 1993 ..........................................................29 Table 3-2. Total Prison Suicides and Rates by State, 1984 through 1993...................................29 Table 3-3. Total Prison Suicides and Rates in the Seven Smallest State Prison Systems, 1984 through 1993.......................................................................................30 Table 3-4. Total Prison Suicides and Rates, 1984 through 1993 .................................................30 Table 3-5. States with Declining Prison Suicide Rates of 50% or More......................................31 Table 4-1. Total Annual Admissions versus Total Annual Suicides, 1983 through 1994 ...............................................................................................................34 Table 4-2. Annual Prison Suicide Rates in Louisiana, 1984 through 1994.................................40 Table 4-3. Annual Prison Suicide Rates in Pennsylvania, 1984 through 1993...........................42 Table 4-4. Suicide Potential Checklist at SCI-Retreat .................................................................43 iv FOREWORD While suicide is recognized as a critical problem within the jail environment, the issue of prison suicide has not received comparable attention. Until recently, it has been assumed that suicide, although a problem for jail inmates as they face the initial crisis of incarceration, is not a significant problem for inmates who advance to prison to serve out their sentences. This assumption, however, has not been supported in the literature. Although the rate of suicide in prisons is far lower than in jails, it remains disproportionately higher than in the general population. To date, little research has been done or prevention resources offered in this critical area. This monograph was produced by the National Center on Institutions and Alternatives in an effort to fill a critical void in the knowledge base about prison suicide. In addition to a thorough review of the literature and of national and state standards for prevention, the document offers the most recent national data on the incidence and rate of prison suicide, effective prison suicide prevention programs, and discussion of liability issues. The National Institute of Corrections hopes that this document will encourage continued research, training, and development of comprehensive prevention policies that are imperative to the continued reduction of prison suicides throughout the country. Morris L. Thigpen, Director National Institute of Corrections June 1995 v PREFACE AND ACKNOWLEDGMENTS In April 1993, I embarked on the task of developing a comprehensive monograph on prison suicide. Having devoted more than 15 years to the study and prevention of jail suicide, I was not only well aware of the problem of suicide in custody, but also had developed the strong bias that we should be directing much more energy toward the issue. My feeling then and now is that while the number of suicides in jails far exceeds the number in prison, that fact certainly should not lessen our responsibility to identify and prevent as many of these prison deaths as we can. It is always difficult, however, to preach prevention without first identifying the parameters of the problem. The intent of this document is not only to detail what is now known about prison suicide, but also to describe how far we have come in our prevention efforts and the work that still lies ahead. Only by continuing to examine the problem of prison suicide and transmitting what is learned to those entrusted with the custody and care of inmates will we be in the best possible position to reduce the likelihood of prison suicide. It is my hope that this monograph provides the appropriate vehicle for disseminating such information. Many individuals are involved in a project of this scope. First, I would like to thank Susan M. Hunter, chief, NIC Prisons Division, and John E. Moore, program monitor, for their positive response to my initial concept proposal and support in the project, as well as Nancy Sabanosh for her diligence in pushing the document through the publication process. Second, the assistance from each department of correction throughout the country, resulting in a 100 percent survey response, is greatly appreciated and thanks are also due to those jurisdictions