Prisons are long-term correctional facilities operated by the states and the federal government. Jails are short-term holding and detention facilities operated by county and municipal governments. Suicide is a serious problem among inmates in both settings.

What is the problem?

Suicide is the third leading cause of death in prisons and the leading cause of death in jails. For 1984-1993 the national prison suicide rate was 20.6/100,000, 1.5 times higher than that of the general population. In the Pennsylvania state prison system there were 82 suicides from 1989-1999, a rate of 25.6/100,000. A study of jail suicides in 1986 found that holding facilities accounted for 30% of the deaths and detention facilities accounted for 70%. The suicide rate in detention facilities is reported to be 9 times higher than in the community.

Who completes suicide in prison?

Nationally, in 1997, 153 male inmates at state facilities completed suicide compared to only 6 female inmates. In the PA state prison system, all 8 suicide deaths in 1997 involved male inmates, and 50% of the suicide fatalities in 1999 were whites (who made up 34% of the overall inmate population). Approximately 64% of the PA prison suicides in 1998 involved inmates known to have mental health or mental retardation problems. Among 1990 prison suicides in California, 60% of the victims had been diagnosed with a serious mental disorder and 53% had a history of substance abuse. A NY State Department of Corrections study of 1986-1994 suicides reported that inmates convicted of a violent felony comprised 80% of the suicides, but made up only 56% of the state prison population. In PA those serving life sentences made up 17% of the state prison population, but accounted for 37% and 44% of the suicides in 1998 and 1999 respectively.

Who completes suicide in jails?

A national study of jail suicides in 1986 found that 72% were white, 94% were male, the average age was 30, 60% were intoxicated at the time of incarceration, 75% of the victims were being held on non-violent charges, 27% were detained on alcohol/drug-related charges. This same study reports that among 1986 suicides in holding facilities 46% of the victims faced alcohol/drug-related charges and 82% were intoxicated on admission.

What are the causes of prison suicides?

Suicidality is rooted in the severe stress and pain generated by a serious life crisis. The stress and pain increase as the crisis, or the individual's perception of it, worsens. As this happens, feelings of control and self-esteem deteriorate. Suicide occurs when the stress induces a level of psychological pain so unbearable that death is seen as the only means of relief. Prisons represent a concentration of high-risk individuals in high stress circumstances. Imprisonment and the events leading to it are highly stressful. Isolation from family and a highly controlled, dehumanizing environment are factors. A study of suicide in federal prisons identified the following precipitating situations: additional legal problems in 28% of the cases, marital or relationship problems in 23%, and inmate conflict problems in 28% of the cases.

Why do suicides happen in jails?

Jail suicides involve young, highly traumatized, alcohol-compromised individuals, often first offenders, detained in settings with little screening for suicide risk, insufficient training of staff, and limited supervision of the detainees. The national study of 1986 jail suicides found that 89% were not screened for suicidal behavior at booking, 51% of the deaths occurred in the first 24 hours of incarceration, and that 48% of those who were intoxicated died within the first three hours of their stays.

What are high-risk periods for inmate suicides?

Lindsay Hayes, of the National Center on Institutions and Alternatives (NCIA), cites: waiting for trial or sentencing, immediately after sentencing, impending release, "special days" (e.g., holidays, birthdays, and the anniversaries of weddings, divorces, deaths, the offense, sentencing, imprisonment, etc.), and following the receipt of "bad news" of any kind (e.g., a death, divorce proceedings, further legal difficulties, etc.). The first 24 hours are of detention in jails are the most dangerous in regard to suicide. In all facilities, inmates in isolation, seclusion, administrative segregation account for a disproportionate number of suicides. Risk also rises when an inmate is bereaved by the suicide of another inmate with whom he/she had a close relationship, or if there has been a recent suicide attempt in the facility. Periods of decreased staffing (i.e., weekends, nights, holidays) and darkness are times when many inmate suicides take place. Inter-facility transfers may also amplify risk as may the loss of a valued job in the prison.

What are the warning signs of inmate suicidality?

The leading indicators of inmate risk are severe depression, diminished self-esteem, complaints of emotional or psychological pain, talking about or threatening suicide, and non-lethal self-injury. A preoccupation with death is never "normal." In all settings, extreme sadness or crying, expressions of inability to cope or go on, extreme physical and psychological agitation, and excessive self-blaming should raise concern. A history of mental illness or suspected mental illness, and previous attempts or other suicidal behaviors are potential indicators. Intoxication constitutes extremely high risk. Behaviors such as writing a will, giving away or packing up possessions, dropping individuals from visitors lists, and unrealistic remarks about "getting out" may indicate that an inmate is suicidal. Inmates with serious physical illnesses such as cancer or HIV/AIDS (20 time higher risk of suicide) and those who have been raped or intimated to grant sexual favors are at risk of becoming suicidal.

What are some of the myths of jail and prison suicide?

• "Those that talk about suicide don't do it." Not true - while not every victim openly or verbally expresses their intentions, many do, and should be heeded.
• "Suicide victims want to die." Not true - suicidal individuals are typically ambivalent about dying and most only seek to die because they feel that there are no other options.
• "Suicidal individuals don't want to be helped." Not true - suicidal individuals have often sought help from physicians, counselors, ERs, and other sources.
• "Asking about suicide may only give people ideas." Not true - talking about suicide is the most effective way of determining if an individual is thinking about suicide.
• "Only those who are chronic substance abusers or long-term mentally ill attempt suicide." Not true - while these groups are at very high risk, inmate suicides involve many individuals who are intoxicated but not alcoholics or addicts as well as those with short-term transient or situational depressions that were undiagnosed and untreated.
• "Calling their bluff can snap them out of it." Not true - this may be the single worst thing that could be done.

Sources

Bureau of Justice (1997), National Prisoner Statistics, 1997. "Correctional populations in the US" Washington, DC: US Department of Justice.

Couturier, L. and F. Maue (2000), "Suicide prevention in a large statewide department of corrections: A full-court press to save lives" Jail Suicide/Mental Health Update 9:4:1-8.

California Department of Corrections (1991), Suicide Prevention in the California Department of Corrections: Annual Report, 1990. Sacramento, CA.

Hayes, L. (2000), "Suicide risk despite denial (or when actions speak louder than words)" Jail Suicide/Mental Health Update 10:1:1-6.

Hayes, L. and J. Rowan (1988), National Study of Jail Suicides: 7 Years Later. Alexandria, VA: National Center on Institutions and Alternatives

National Institute of Corrections (1995), Prison Suicide: An Overview and Guide to Prevention. Washington, DC: US Department of Justice.

New York State Department of Correctional Services (1994), Characteristics of Suicide Victims in NYDOCS Between 1986-1994. Albany, NY.

Prepared by: Tony Salvatore, 06.06.01