National Study of Jail Suicides – Seven Years Later, Hayes and Rowan Jail Suicide Prevention Information Task Force, 1988
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NATIONAL STUDY OF JAIL SUICIDES:
SEVEN YEARS LATER
BY
Lindsay M. Hayes
National Center on Institutions and Alternatives
Joseph R. Rowan
Juvenile and criminal Justice International, Inc.
Developed by Jail Suicide Prevention Information Task Force:
National Center on Institutions and Alternatives,
in cooperation with
Juvenile and Criminal Justice International, Inc.
with assistance from the
National Sheriffs’ Association
FEBRUARY, 1988
National Center on Institutions and Alternatives
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635 Slates Lane, Suite G-100
l
Alexandria, Virginia 22314
l
(703) 684-0373
ABSTRACT
This report comprises findings from a national study of jail suicides. Reject staff from
the National Center on Institutions and Alternatives (NCIA) gathered information from all
jails (county and city) and police department lockups throughout the country regarding the
incidence of jail suicides during 1985 and 1986. The study resulted in the identification of 854
jail suicides during 1985-86, with 453 occurring in 1985 and 401 in 1986. Project staff analyzed
demographic data on 339 of the 1986 suicides. Subsequent comparison with NCIA’s prior
national research revealed that, absent minor variations, there were not any appreciable
differences in jail suicide characteristics from 1979 and 1986. Most of the key characteristics of
jail suicide -offense, intoxication, method/instrument, isolation, and length of incarceration
- have remained virtually unchanged over time. The consistency of such findings could
impact the ability to deter suicidal behavior. The authors discuss utilization of these findings
in the prevention of jail suicides.
TABLE OF CONTENTS
ABSTRACT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ii
TABLE OF CONTENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iii
LIST OF TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
v
PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
vii
ACKNOWLEDGEMENTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
viii
EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ix
I.
INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
II.
PRIOR JAIL SUICIDE RESEARCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
And Darkness closes In. . .A National Study of Jail Suicides. . . .
Other Significant Research 1981 to the Present . . . . . . . . . . . . . . .
A Word About Suicide Victim Profiles . . . . . . . . . . . . . . . . . . . . . . .
1
2
5
NATIONAL STUDY OF JAIL SUICIDES: SEVEN YEARS LATER . . .
9
Methodology: Phase I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Under-Reporting of Jail Suicides . . . . . . . . . . . . . . . . . . . . . . . . . . .
Methodology: Phase II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9
15
19
DEMOGRAPHIC FINDINGS OF 1986 JAIL SUICIDE DATA . . . . . . . .
21
Personal Characteristics of the Victim . . . . . . . . . . . . . . . . . . . . . .
21
A)
B)
C)
III.
A)
B)
C)
IV.
A)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Race . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Most Serious Charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Additional Charges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Jail Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
DWI Statute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Most Serious Prior Charge. . . . . . . . . . . . . . . . . . . . . . . . . . .
Intoxication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
iii
21
22
22
23
24
25
25
26
27
28
.....................
29
Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Method and Instrument. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Time Span Between Suicide and Finding Victim. . . . . . . . .
Isolation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Mental Health/Medical History. . . . . . . . . . . . . . . . . . . . . . .
Suicide Screening Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Length of Incarceration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Possible Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29
30
31
32
32
33
35
36
37
Length of Incarceration By Most Serious Charge. .
Length of Incarceration By Isolation. . . . . . . . . . . . .
Length of Incarceration By Intoxication. . . . . . . . . .
37
38
39
SPECIAL CONSIDERATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
41
Intake Screening and Suicide Prevention. . . . . . . . . . . . . . . . . . . . .
41
Screening Forms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Suicide Prevention Program . . . . . . . . . . . . . . . . . . . . . . . . . .
42
47
NCIA’s National Studies of Jail Suicides: Comparison of
1979 and 1986 Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Jail Suicide Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
48
52
VI.
SUMMARY/CONCLUSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
55
VII.
APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
58
B)
Characteristics of the Suicide Act.. . . . . .
1.
2
3.
4.
5.
6.
7.
8.
9.
a)
b)
c)
V.
A)
1.
2
B)
C)
A)
B)
C)
D)
E)
Summary of And Darkness Closes In. . .A National Study of
Jail Suicides (1981)
Survey Instruments from Current Study
Frequency Distributions of Additional Charges and
Prior Charges
Intake Screening Forms
Bibliography: Jail Suicide Literature Review
LIST OF TABLES
TABLE
1
Comparison Profile of Jail Inmate and NCIA
1981 Jail Suicide Victim . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
2
Jail Suicides By State, 19851-986. . . . . . . . . . . . . . . . . . . .
11
3
Phase I: Sources for Identifying 1986 Jail Suicides . . .
12
4
Other Jail Deaths By State, 1985-1986. . . . . . . . . . . . . . .
13
5
State-Reported 1986 Jail Suicides By Total
Identified . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
6
Phase II: Survey Responses for 1986 Jail Suicides. . . . .
20
7
Race. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
8
Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
22
9
Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
10
Marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
23
11
Most Serious Charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
Jail Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
DWI Statute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
27
Most Serious Prior Charge. . . . . . . . . . . . . . . . . . . . . . . . .
28
Intoxication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Time of Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17
Day of Week . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18
Month. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
30
19
Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31
20
Instrument . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21
TimeSpan.....................................
32
22
Isolation........................................
33
23
Prior Suicide Attempts . . . . . . . . . . . . . . . . . . . . . . . . . . .
34
24
Mental Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
34
25
MedicalProblems................................
34
26
Suicide Screening Forms. . . . . . . . . . . . . . . . . . . . . . . .
35
27
Length of Incarceration . . . . . . . . . . . . . . . . . . . . . . . . . . .
36
28
Length of Incarceration By Most Serious Charge.. . . .
38
29
Length of Incarceration By Isolation. . . . . . . . . . . . . . . .
39
30
Length of Incarceration By Intoxication. . . . . . . . . . . . .
40
31
Screening Forms Received From Survey
Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
46
32
Suicide Prevention Program. . . . . . . . . . . . . . . . . . . . . . .
47
33
NCIA’s National Studies of Jail Suicide:
Demographic Characteristics of Jail Suicides
From 1979 and 1986 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
49
vi
PREFACE
In September, 1986, the National Center on Institutions and Alternatives (NCIA)
received a one-year grant from the National Institute of Corrections, U.S. Department of
Justice, to act as National Coordinabx of the Jail Suicide Prevention Information Task Force.
In cooperation with Juvenile and Criminal Justice International, Inc., and with assistance from
the National Sheriffs’ Association, the Project: 1) Conducted 12 regional jail suicide prevention
seminars throughout the country, training over 750 participants; 2) Acted as a clearinghouse
by providing technical assistance materials to state officials and individual correctional
facilities, and interested others regarding jail suicide prevention, including the dissemination
of a quarterly newsletter, Jail Suicide Update; 3) Developed a model training manual on
suicide detection and prevention for use in jails and lockups; and 4) Gathered information
from county jails, city jails, and police department lockups on the incidence of jail suicides
during 1985 and 1986, including a replication of NCIA’s 1981 National Study of Jail Suicides.
The following report presents the findings from this study.
vii
ACKNOWLEDGEMENTS
The authors gratefully acknowledge the assistance provided by the following
individuals in the development of this report:
Michael A. O'Toole, Chief, Jails Division, and Stuart Readio,
Program Manager, National Instiute of Corrections, Boulder, Colorado.
Cary Bittick, Executive Director; AN. Moser, Jr., Director Jail Project; and Anna T. Laszlo, Director - Research and
Development, National Sheriffs’ Association, Alexandria,
Virginia.
Linda Van Den Bossche, Research Associate, National Center
on Institutions and Alternatives, Alexandria, Virginia.
Richard Bennett, Ph.D., Professor, School of
Justice, The American University, Washington, D.C.
Andy Hall and staff & the Pretrial Services Resource Center,
Washington, D.C
Alice Boring and Sandy McWilliams, Editorial and Report
Development Consultants; Chris Cormier Hayes, Research
Consultant, National Center on Institutions and Alternatives,
Alexandria, Virginia; and Barbara C Rowan, Editorial and
Report Development Consultant, Juvenile and Criminal
Justice International, Roseville, Minnesota.
Jail officials, state department of correction administrators, and
medical examiners for supplying essential data.
viii
EXECUTIVE SUMMARY
Suicide is the leading cause of death in our nation’s jails. Experts have projected that the
rate of suicide in jail is several times greater than that of the general population. These suicides
have created publicity, increased public awareness, and ultimately, litigation against jail
facilities, city governments, county commissioners, etc. Local jailers have also felt the pressure
and have increasingly asked for technical assistance in suicide prevention, often from the
National Institute of Corrections (NIC), within the U.S. Department of Justice. In response, the
NIC formed a National Jail Suicide Task Force in 1984, an advisory board whose mandate was
to design strategies for reducing jail suicides nationwide. One strategy of the advisory board
was to establish a national coordinator for jail suicide prevention and information.
In September, 1986, the National Center on Institutions and Alternatives (NCIA)
received a one-year grant from the NIC to act as National Coordinator of the Jail Suicide
Prevention Task Force. In cooperation with Juvenile and Criminal Justice International, Inc.,
and with assistance from the National Sheriffs’ Association, the Project: 1) Conducted 12
regional jail suicide prevention seminars throughout the country, training over 750 jail
personnel; 2) Acted as a clearinghouse by providing technical assistance materials to state
officials and individual jail facilities, and others interested in jail suicide prevention, including
the dissemination of a quarterly newsletter (Jail Suicide Update); 3) Developed a model
training manual on suicide detection and prevention for use in jails and lockups; and 4)
Gathered information from county jails, city jails, and police department lockups on the
incidence of suicides during 1985 and 1986, including a replication of NCIA’s 1981 National
Study of Jail Suicides.
The present study was divided into two phases. During Phase I, surveys were sent to
16,483 jail facilities in the United States. For purposes of this analysis, two facility types were
identified: Holding Facility (which normally detains persons for less than 48 hours) and
Detention Facility (which normally detains persons or houses committed/sentenced
offenders for more than 48 hours, but less than two years). Each jail was asked to complete a
one-page survey if it had a suicide(s) or other death(s) during 1985 and/or 1986. Further, in
ix
order to supplement the verification of data, survey forms were also sent to state and county
medical examiners; state jail inspection offices (within departments of correction) and other jail
liaison agencies; state attorney general offices; and state police/bureau of investigation offices.
Finally, a newspaper clipping service was utilized to verify jail suicides not identified through
other sources. Phase I resulted in the identification of 854 jail suicides during 1985-1986, with
453 suicides occurring in 1985 and 401 in 1986.
During Phase II, in-depth survey questionnaires were sent to jails which experienced a
suicide(s) in 1986. Project staff subsequently received or gathered demographic data on 339
suicides. Holding facilities comprised 30% of the suicides, while detention facilities comprised
70% of such deaths. Highlights of the data included overall findings that:
l
72% of victims were white.
l
94% of victims were-male.
l
Average (mean) age of the victim was 30.
l
52% of victims were single.
l
l
l
l
l
75% of victims were detained on non-violent charges,
with 27% detained on alcohol/drug related charges.
89% of victims were confined as detainees.
78% of victims had prior charges, yet only 10% were
previously held on personal/violent offenses.
60% of victims were intoxicated at the time of
incarceration.
30% of suicides occurred during a six-hour period
between midnight and 6:00 a.m.
94% of suicides were by hanging; 48% of victims
used theirbedding.
Two out of three victims were in isolation.
51% of suicides occurred within the first 24 hours
of incarceration; 29% occurred within the first
three hours.
X
l
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l
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89% of victims were not screened for potentially
suicidal behavior at booking.
52% of all victims charged with alcohol/drug-related
offenses died within the first three hours of confinement.
78% of victims who were intoxicated died within the
first 24 hours of incarceration; 48% died within
the first three hours.
The suicide rate in detention facilities is projected to be
approximately nine times greater than that of the general
population.
In addition, holding facility data included findings that:
l
46% of victims were held on alcohol/drug-related charges.
l
82% of victims were-intoxicated at the time of their incarceration.
l
64% of victims died within the first three hours.
l
97% of victims were not screened for potentially suicidal
behavior at booking.
Experts generally agree that certain signs and symptoms exhibited by the detainee often
foretell a possible suicide and, if detected, could prevent such an incident. What an individual
says and how he/she behaves while being arrested, transported to the jail, and at booking, are
vital in detecting suicidal. behavior.
Properly trained personnel, who have a basic
understanding of jail suicide research and victim profile construction, can assess suicide
potential both at the booking stage and during subsequent phases of aninmate’s incarceration.
During the booking stage, intake screening is imperative for suicide prevention. Findings from
the present study showed that 89% of all suicidevictims were not afforded any intakescreening
at the time of their booking. Data from holding facility suicides showed that 97% of the victims
were not screened.
In regard to suicide prevention programs within jail facilities experiencing a suicide in
1986, the study showed that such programs werefound in 58% of detention facilities and 32%
of holding facilities. The quality of such programming is not analyzed in the present study.
Despite minor variations, findings from the present study are consistent with NCIA’s
1981 National Study of Jail Suicides (utilizing 1979 data). Allowing for slight differences in jail
suicide characteristics, most of the key indicators (offense, intoxication, method/instrument,
isolation, and length of incarceration) evidenced the same value over time.
While we know more about jail suicide prevention than ever before, the need for
additional research has never been greater. Future research efforts should focus on control
group (non-suicidal) comparisons, psychological autopsies, and evaluation of jail suicide
prevention programs. By continuing to learn more about the problem and transmitting that
knowledge to those entrusted with the custody and care of inmates, we will be in the best
possible position to prevent the tragedy of jail suicide.
On an individual basis, experience has clearly demonstrated that almost all jail suicides
can be averted with implementation of a prevention program that includes written rules and
procedures, staff training, intake screening, communication between staff, and human
interaction. The key to prevention remains a capable and properly trained staff, the backbone
ingredient of a facility. Such a system, however, will not come to fruition without pro-active
jail administrators who not only maintain an awareness of suicide as a-national problem, but
take the initiative to prevent such an occurrence in their own facility.
xii
I.
INTRODUCTION
Suicide is the leading cause of death in our nation’s jails. Experts have indicated that the
rate of suicide in these facilities is several times greater than that of the general population.
While jail suicide remains a serious problem, efforts toward prevention continue to show
steady progress. Chief among these efforts are training and research. In recent years, jail
suicide prevention training has gained wide popularity, chiefly a result of litigation and
correctional standards which call for increased understanding and awareness of jail suicide.
Research efforts have also increased in recent years, and havebecome an important ingredient
in suicide prevention training.
A)
In October 1981, the National Center on Institutions and Alternatives (NCIA)
completed the study - And Darkness Closes In.. A National Study of Jail Suicides for the
National Institute of Corrections (NIC), U.S. Department of Justice. That study, the first
national view at the problem, documented 419 suicides occurring in county and local jails
during 1979, the year selected for analysis. From demographic data collected on 344 of these
suicides, a profile of the “typical” victim was constructed.
The victim was most likely to be a 22-year-old White, single male. He would have been
arrested for public intoxication, the only offense leading to his arrest, and would thereby be
under the influence of alcohol and/or drugs upon incarceration. Further, the victim would not
have had a significant history of prior arrests. He would have been taken to an urban county
jail and immediately placed in isolation for his own protection and/or surveillance. However,
less than three hours after incarceration, he would be dead. He would have hanged himself
with material from his bed (i.e., sheet or pillowcase). The incident would have taken place on
a Saturday night in September, between the hours of midnight and 1:00 a.m. Jail staff would
have found the victim, they say, within 15 minutes of the suicide. Later, jail records would
indicate that the victim did not have a history of mental illness or previous suicide attempts.
(Caution should be exercised, however, because a significant percentage of jails have
inadequate screening procedures from which to derive this information. Research and
psychological autopsies reveal a high correlation between these variables and jail suicide, see
Section V.)
The scenario described above, according to the study, reflected a “hypothetical.
construct” based on those characteristics appearing most often in jail suicide victims.
Data also showed that 73.6% of the suicide victims were charged with crimes that fell
within the non-violent category. Alcohol/drug related charges accounted for over 30% of
these charges. In regard to the presence of intoxication upon arrest and confinement, almost
60% of the suicide victims were under the influence of alcohol and /or drugs at the time of arrest
and incarceration. Two out of every three inmates who committed suicide were being held in
isolation. Over 50% of all suicide victims in the study were dead within the first 24 hours of
incarceration, with 27% of the suicides occurring within the first three hours.
In addition, over 88% of victims under the influence of alcohol and/or drugs at the time
of incarceration committed suicide within the first 48 hours of confinement, with over half of
these victims being found dead within the first three hours of confinement. In addition, the
majority (63%) of the victims placed in isolation committed suicide within the first 48 hours of
incarceration, with over 30% of these victims dying within the first three hours of confinement.
Of 419 suicides, 73% occurred in county facilities, while 27% of the victims died in local jails and
lockups.
A complete summary of And Darkness Closes In. . A National Study of Jail Suicides
can be found in Appendix A.
B)
As our general awareness of the jail suicide problem increases, so do the number of
research efforts. In addition to NCIA’s 1981 study, subsequent research has reported
increasingly consistent findings and generated feasible policy implications.
2
One example of the utility of research in suicide prevention can be found in Hamilton
County, Ohio.* Jn 1982, a year-long study at the county jail was designed to identify factors that
distinguished suicide attempters from nonattempters, and to use the most cost-effective of
these factors in an early identification and prevention program based on improved screening,
referral, and surveillance of those at risk. Data analysis yielded the following factors in
predicting potentially suicidal behavior: self-report of alcohol/drug abuse, self-report of
suicidal thoughts, feelings of hopelessness, history of multiple suicide attempts, intoxication
upon admission, and suicide impulse disorder.
As a direct result of this research, changes were made in the county jails’ screening/
referral procedures. The predictors were used as screening criteria for reasons of objectivity,
economy, and attempter/nonattempter discriminability. Specific procedures were developed
and taught to jail health screening staff for use during a six-month trial period. After Hamilton
County officials instituted the procedures, data were collected on the number of suicide
attempts and the number of suicide watches for a six-month period. Only 45 suicide watches
(applied for prescribed periods of time) were initiated, as compared with 70 during the
previous 4-l/2 months. This was a decrease from 15 suicide watches per month to 7.5 per
month of shorter duration. The suicide attempt rate also decreased from about 2.5 per month
to only two in six months.
In 1984, the Commonwealth of Massachusetts completed a study of suicides in police
department lockups2 In regard to age, race, marital status, and other demographic variables,
findings in Massachusetts parallel those of NCIA’s 1981 study. More dramatic are the study’s
findings concerning the victims’ reason for detention and appearance of intoxication upon
1
2
Bobbie Hopes and Ruth Shaull, “Jail Suicide Prevention: Effective Programs Can Save Lives,” Corrections
Today, December, 1986, pp. 64-70.
specialcommission to Investigate Suicide in Municipal Detention Centers, Final Report - Suicides in
Massachusetts Lockup, 1973-1984. Boston, Massachusetts, 1984. Unfortunately, the study’s data
base was distorted by the lumping of completed suicides with attempts holding simple gestures).
Despite this flaw, the Massachusetts study provided interesting data on lockup suicides.
3
arrest. Almost 60% of the detainees were being confined on alcohol-related charges,
including protective custody and drunk driving. In addition, 74% of the victims were
intoxicated at the time of their arrival at the lockup. Finally, 85% of the completed suicides
occurred within four hours of incarceration. Perhaps most importantly, the Massachusetts
study found that 75% of the lockups in the sample did not provide suicide prevention training
to its staff, and 89% of the lockups did not ask detainees any questions regarding suicidal
behavior.
A South Carolina study, also completed in 1984, again provided data that paralleled
3
NCIA’s 1981 study. Further, the researchers found that the suicide rate of inmates in police
department lockups was approximately 250 times greater than the rate for the state’s general
population. In addition, the suicide rate for city and county jails (including county prisons)
was approximately 14 times greater than the rate for the state’s general population.
A two-year evaluation of 46 jail suicides in Ohio, completed in 1983; also rendered
similar results4 The researchers found that: 1) suicides were found to be most prevalent in
city/municipal detention facilities; 2) an overwhelming majority of victims chose hanging as
the mode of death; 3) over two-thirds of the suicides occurred within the first 24 hours of
incarceration; 4) the most serious crime of the victim tended to be either a misdemeanor
property offense or alcohol/drug-related; and 5) the victims tended to be young, single,
unskilled males. The researchers concluded: “In short, the findings from. the study of the
suicide rate, victims and circumstances in Ohio’s jails and temporary detention facilities were
very similar to the results of the previous studies of suicide in jails. . . .The fact that there were
very few differences in the data obtained on the suicides in Ohio for 1980 and 1981 or between
the findings of this study and the earlier studies suggested that the phenomena is not changing
3
4
John M. Memory, Jail Suicides in South Carolina: 1978-1984. Unpublished Paper. Columbia,
South Carolina: Office of the Governor, Division of Public Safety Programs, 1984.
Patricia L Hardyman, The Ultimate Escape: Suicide in Ohio’s Jails and Temporary Detention Facilities,
1980-1981. Columbus, Ohio: Ohio Bureau of Adult Detention Facilities and
services, March, 1983.
4
rapidly. The increase in the number of reported suicides appears to be partially due to an
increase in publicity. Yet, this trend should not alleviate the jail administrators’ concern or
5
need to develop adequate policies and operations to cope with the problem.“
Finally, the medical examiner’s office in Los Angeles County, California, completed a
10-year study of jail suicides in 1987: Through the examination of 103 suicides, the researchers
reported interesting findings concerning length of incarceration prior to suicide, method of
suicide, and time span between cell checks and suicide: Similar to NCIA’s 1981 study, 59% of
the Los Angeles County jail suicides occurred during the first 24 hours of incarceration, with
35% taking place within the first six hours. In regard to the method of suicide, all the suicides
were by hanging. More interesting, however, were findings concerning the position in which
the victim was found. Contrary to popular belief, although 41% of the victims were found in
the suspended position, 59% were found either slumped, sitting, or kneeling. Finally, only 2%
of the suicide victims were found within 10 minutes of the last cell check, 52% were found
between 20 and 60 minutes, and an astounding 37% were found between 2 and 4 hours.
C)
A Word about Suicide Victim Profiles
As we attempt to come to grips with the problem of jail suicide, prevention efforts are
sometimes geared toward quick-fix solutions. Such band-aid approaches as television
monitors, tearaway blankets, and other “prevention tools” are usually mere attempts to treat
only the symptom. Although these tools can be a necessary part of jail suicide prevention,
experts agree that their use should never be utilized to overshadow staff training, intervention
and supervision.
5
Ibid, p. 20.
6
Karl B. Harris, Jail Suicide in Los Angeles County: July 1, 1977 Through June 30, 1987. Los Angeles, California:
Department of Chief Medical Examiner-Coroner, 1987.
5
Suicide profiles have also fallen victim to the quick-fix, superficial prevention
techniques. At times, these profiles are simply a mirror of a jail’s inmate population. Other
times they can be seemingly contradictory. Used without an awareness of potentially suicidal
behavior, they are misleading.
The victim was most likely to be a 22-year-old White, single male. He would
have been arrested for public intoxication, the only offense leading to his arrest,
and would thereby be under the influence of alcohol and/or drugs upon
incarceration. Further, the victim would not have had a significant history of
prior arrests. He would have been taken to an urban county jail and
immediately placed in isolation for his own protection and/or surveillance.
However, less than three hours after incarceration, he would be dead. He would
have hanged himself with material from his bed (i.e., sheet or pillowcase). The
incident would have taken place on a Saturday night in September, between the
hours of midnight and 1:00 a.m. Jail staff would have found the victim, they say,
within 15 minutes of the suicide. Later, jail records would indicate that the
victim did not have a history of mental illness or previous suicide attempts.
When NCIA constructed and released the above victim profile from resulting 1979 jail
suicide data, it was as equally praised as it was criticized. While appearing in many training
manuals throughout the country, the profile was maligned for misleading jail personnel into
believing that profiles can predict and thus, prevent suicides. Further, critics charged that
many of the characteristics appearing in the suicide profile fit those of a typical jail inmate, and,
therefore, such a profile was useless as a predictive tool. NCIA’s primary objective, that of
“sensitizing” jail personnel to those characteristics or variables appearing most often in jail
suicide victims, became lost in the controversy. Quick-fix advocates embraced NCIA’s profile,
while foes argued that not all jail suicides occur on Saturday nights in September. Both camps
missed the point.
NCIA’s suicide victim profile was not meant to be a death certificate of all inmates that
commit suicide in our nation’s jails. Nor was it intended for jail personnel to ignore those
inmates that, while exhibiting suicidal tendencies, did not fit the profile’s various demographic
variables. The profile’s intent was, and remains, simple - to sensitize jail personnel to those
characteristics appearing most often in jail suicide victims, while acting as a supplement to
the warning signs and behavior that are observed in the defection of suicidal behavior. In
6
essence, to ignore more revealing signs of potentially suicidal behavior because the individual
did not fit the profile would not only be foolish, but negligent.
Further, while some of the profile’s variables mirror the typical jail inmate (i.e., sex, age,
marital status, etc.), there were appreciable differences with other variables. As can be seen in
Table 1, while Black inmates comprise 41% of the jail population, they accounted for only 22%
of the jail suicides. Approximately 53% of jail inmates are confined as detainees, yet 91% of
all suicide victims were detainees. While 31% of jail inmates are under the influence of alcohol
upon arrest, over 60% of jail suicide victims were intoxicated upon arrest. Although the
average length of stay in jail is approximately 6 to 11 days, 50% of all jail suicide victims were
dead within the first 24 hours of incarceration, and 27% commited suicide within the first three
hours. Finally, while alcohol/drug related charges account for 20% of offenses for which jail
inmates are confined, they represented 30% of all suicide victims.
As such, when utilized in conjunction with staff training/awareness and intake
screening, and adapted to reflect a facility’s demographic characteristics, a victim profile can
be a valuable supplementary tool in jail suicide prevention.
7
-
TABLE 1
-
JAIL INMATE
PRomE"
CHARACTERISTICS
NOA1981
SUIODE VICI'IM
PRomE·"
SEX
Male
Female
92%
8
97%
3
White
Black
Other
58%
41
1
67%
22
18-24
~
25-34
39
21
RACE
•
11
-.
AGE
Other
MARITAL STATUS
Single
Married
Separated/Divorced
Widowed
(18-27)
(28-37)
(Other)
54%
27
19
54%
21
2S
54%
30
16
Detained
Sentenced
53%
47
91%
9
INTOXICAnON
31%
60%
-
JAIL STATUS
LENGTH OF
INCARCERAnON (AVERAGE>
6--11 Days-
OFFENSE
Violent
30%
33
20
17
Property
Alcohol/Drug Related
Minor Other'
24 Hours (SO%)
3 Hours (27%)
27%
22
30
21
-see Bureau of Justice Statistics, Jail Inmates 1986 and Jail Inmates 1983.
*'See And Dtzrlcnt:ss ClostS In . • •A National Study of Jail Suicides, 1981. Based on 1979 jail
suidde data.
-see Bureau of Justice Statistics, Jail 11I1fIIlUs 1982; B. Jaye Anno, Analysis of JlliI Pre-Profile
Dtzta. Washington, D.C., Blackstone Associates, June, 1917; and I<imme Planning
and Architecture, The Nature of NftD 571U1ll Jails: Report and AMlysi9. OIampaign,
Dlinois, October, 1985. Estimate for average length of incarceration in holding
facilities not available.
8
III.
NATIONAL STUDY OF JAIL SUICIDES: SEVEN YEARS LATER
As previously stated, suicide is the leading cause of death in our nation’s jails. These
suicides have created publicity, increased public awareness, and ultimately, litigationagainst
jail facilities, city governments, county commissioners, etc. Local jailers have also felt the
pressure and have increasingly asked for technical assistance in suicide prevention, often from
the National Institute of Corrections (NIC), within the U.S. Department of Justice, in
preventing jail suicides. In response, the NIC formed a National Jail Suicide Task Force in 1984,
an advisory board developed to design strategies for reducing jail suicides nationwide. One
strategy of the advisory board was to establish a national coordinator for jail suicide prevention
and information.
In September, 1986, the National Center on Institutions and Alternatives (NCIA)
received a one-year grant from the NIC to act as National Coordinator of the Jail Suicide
Prevention Information Task Force. In addition to conducting various training seminars and
providing technical assistance in jail suicide prevention, the reject gathered information
from county jails, city jails, and police department lockups on the incidence of jail suicides
during 1985 and 1986. The following report presents the findings from this study.
This second national study of jail suicides was divided into two phases. During Phase
I, surveys were sent to 16,483 jail facilities in the United States. Each jail was asked to complete
a one-page survey if it had a suicide(s) or other death(s) during 1985 and/or 1986 (see
Appendix B). A jail was defined as any facility operated by a local jurisdiction (e.g., county,
municipality, etc.), whose purpose was the confinement of inmates apprehended by law
enforcement personnel. Jails, as defined here, include temporary holding and pre-trial
detention facilities, lockups, “drunk tanks,” etc., which normally detain persons for less than
48 hours, and facilities which normally detain persons or house committed/sentenced
offenders for more than 48 hours. In addition, all state police lockups were included within this
definition, as well as local jails operated by state correctional agencies, i.e., Alaska, Connecticut,
Delaware, Hawaii, Rhode Island, and Vermont. By definition, therefore, state and federal
prisons were excluded from this study.
Surveys were mailed to 13,458 city jails and police department lockups, and 3,025
county facilities.’ Further, in order to supplement the verification of data, survey forms were
also sent to 517 state and county medical examiners; 60 state jail inspection offices (within
departments of correction) and other local jail liaison agencies; 50 state attorney general offices;
and 70 state police/bureau of investigation offices. Finally, a newspaper clipping service was
utilized to verify jail suicides not identified through other sources.
Phase I resulted in the identification of 854 jail suicides during 1985-86, with 453 suicides
occurring in 1985 and 401 in 1986. As can be seen by Table 2, each state, with the exception of
Rhode Island and Vermont, experienced at least one jail suicide during 1985 and/or 1986.
Texas led all states in jail suicides by a wide margin during 1985 and 1986. In addition,
the states of Texas, California, New York and Illinois comprised 32% of all jail suicides in the
country.
As previously discussed, data collected during Phase I was attributed to various
sources, including self-reports, state departments of correction (jail inspection units), state/
county medical examiners, and newspaper articles. Table 3 provides a breakdown of data
collection sources for 1986 jail suicides. As can be seen, 180 (45%) of the 401 jail suicides were
identified through jail self-reporting. Data obtained from state departments of correction and
medical examiners yielded an additional 175 (44%) suicides not identified through selfreporting. Project staff were able to identify an additional 46 (12%) suicides from other
sources, principally through newspaper articles.
The reader is warned that self-reports were given primary recognition for jail suicide
identification. For example, if a jail suicide was identified by more than one source, including
7
Mailing lists were utilized from NCIA’s 1981 National Directory of County and Local Jails, and the most
current (1987) National Sheriffs’ Association mailing list. Business reply envelopes were also utilized
to assure a higher rate of return.
10
TABLE 1
JAIL SUIOOES BY STATE, 1985-1986
I
11'15
1!J86
TOTAL
T....
48
Califomia
New York
lWDois
Ohio
Florida
37
31
26
20
20
24
15
10
13
16
14
15
15
12
11
6
6
11
3
10
7
3
2
4
6
2
7
5
4
4
2
4
3
5
3
5
3
4
3
3
3
46
32
2S
2S
19
15
9
18
18
14
10
10
9
7
8
5
10
9
3
11
4
5
9
10
8
6
8
3
4
4
4
5
3
4
1
94
69
STATE
Mkbipn
Pemwylvania
VargirUa
.
NewJeney
adahoma
Georgia
M....chusetts
North Cuolina
Indiana
Oregon
T......
-.
AJabuna
Ketuc:ky
Maryland
MiIIouri
Arizona
ArbJwu
Colorado
Louisiana
South Cuolina
ICuIas
McmIana
Minnaota
W_hington
Wllcanain
Cmmecti:ut
Milaileippi
South Dakota
AJMb
Idaho
Utah
New HampslWe
NewMecico
District of Columbia
Iowa
~
2
W_VirgiDia
WyaniDg
2
1
1
1
1
2
2
2
39
35
33
33
28
27
26
24
24
22
20
16
16
15
14
14
14
12
12
12
12
12
10
10
9
8
8
7
7
7
6
6
6
5
5
4
4
4
4
4
3
2
1
1
1
1
0
0
0
1
1
1
1
0
0
2
1
0
0
4S3
401
8S4
NIbn,kI
DlJaware
Hawaii
MaiM
North Dakota
Rhode bland
Vermont
TOTAL
3
1
56
51
11
2
2
a self-report from the facility in which the suicide occurred, the source would be attributed to
a self-report. Table 3, therefore, is meant to be more a reflection of the self-report accuracy,
than data collection efforts of state reporting systems. (For a further discussion of statereporting and the under-reporting of jail suicides, see pages 15 thru 19.)
In addition to jail suicide data, jail facilities and other agencies were requested to
complete a survey on “other” jail deaths during 1985-86. As can be seen by Table 4, a total of
409 other jail deaths were identified during 1985-86. Caution, however, should be utilized with
respect to all data concerning other jail deaths. Based upon correspondence with responding
facilities, project staff believe that because the project was referred to as a national study of
jail suicides, a sizeable number of jail facilities only supplied data on other deaths if they also
had had a jail suicide. The same hypothesis holds true for other agencies supplying data.
Further, in returning the survey forms, jail facilities provided differing interpretations or
definitions of other deaths! It is felt, therefore, that due to problems of under-reporting, data
listed in Table 4 should be considered the minimum number of jail deaths in those states.
8
For purposes of this study, the following definitions were offered. HOMICIDE: Any death of an individual
while in the custody of any law enforcement agency resulting from or leading directly from any nonself-inflicted act perpetuated against that individual by a second party. ACCIDENT: Any death of
an individual while in the custody of any law enforcement agency resulting from or leading directly
from any non-intentional, identifiable act. UNDETERMINED CAUSES: Any death of an
individual while in the custody of any law enforcement agency resulting from or leading directly
from any unknown or unspecifiable act or agent. NATURAL/OTHER CAUSES: Any death of an
individual while in the custody of any law enforcement agency resulting from or leading directly
from any natural or other act.
12
13
TABLE 4 (Continued)
OTHER JAIL DEATHS BY STATE, 1985-1986
1985
STATE
HOMICIDB ACClDBNT
UNDETER.
1986
NATURAU
OrnBR
Montana
Nebraska
1
2
2
2
New Hampshire
0
New Jersey
New Mexico
1
4
2
3
2
North Carolina
5
3
33
1
North Dakota
Ohio
Oklahoma
1
Oregon
Pennsylvania
Rhode Island
1
South Carolina
1
South Dakota
Tennessee
7
10
Texas
Utah
3
1
Virginia
Washington
West Virginia
Wyoming
8
50
,
1
8
4
1
0
1
0
1
0
0
1
0
0
1
17
5
1
1
0
1
23
103
184
NATURAU
ornER
1
2
2
35
1
Wisconsin
UNDETBR.
1
1
3
5
44
2
1
2
3
2
1
TOTAL
1
1
4
0
3
7
48
3
1
4
4
2
2
1
5
'4
0
3
1
1
5
0
2
2
0
0
3
1
Vermont
TOTAL
HOMICIDB ACCIDBNT
0
1
Nevada
New York
TOTAL
5
8
0
0
3
3
1
1
19
61
18
1
1
1
0
2
1
,"
123
225
,
B)
A common frustration in the area of jail suicide research surrounds under-reporting of
the data. NCIA’s 1981 study found that there are various reasons for the discrepancy in
reporting suicides, including sensitivity of the subject matter and the reluctancy of jail
administrators to participate in the face of litigation regarding the suicide; the lack of mandate
on localities to report data; and the difference of opinion on where the suicide occurs (e.g., jail,
ambulance, hospital, etc.).
Ten years ago, it was unusual for a jail to be sued for negligence following a suicide.
Today, it is unusual if a suit is not filed. Although there are no statistics available on jail suicide
litigation, the Bureau of Justice Statistics estimated that 27% of our nation’s jails were under
court order to improve one or more conditions of confinement, with 41% of such facilities
cited for deficient medical services9 Thus, due to liability concerns, issues of confidentiality
and/or a natural distrust of research inquiries from outside agencies, there is a reluctancy on
the part of jails to accurately self-report suicide data.10
In response to mounting criticism of conditions within local jails, most states adopted
jail standards in the late 1960’s. Coupled with these standards was the advent of inspection
programs, which graded jail facilities based upon such standards. In addition, there was the
expectation that these inspection programs (housed within state departments of correction)
would annually collect various data, e.g., suicides, from these facilities. According to a 1984
report by the Advisory Commission on Intergovernmental Relations, ". . .states still have a
distance to travel to fulfill their standards/enforcement responsibility. A substantial number
either have not established standards or have made them only voluntary. Many states do not
have inspection programs, and even in those that do, the effectiveness of enforcement
9
US. Department of Justice, Bureau of Justice Statistics Bulletin, Jail Inmates 1986, Washington, D.C.: Bureau of
Justice Statistics, October, 1987.
l0
All survey respondents were assured that data provided would be coded and held in the strictest
confidence. Results of the study are presented in summary fashion, thus preventing the direct linkage
of specific data to the particular facility from which the information originated.
15
11
frequently is not assured.“
Yet, most experts agreethat state jail standards/inspection
programs have made progress, however modest.
In NCIA’s 1981 study, only 31% of the jail suicides were identified by jail inspection
programs within state departments of correction. As can be seen from Table 5, states have
made steady, yet uneven progress in collecting data on jail suicides. Only 25 states, plus the
District of Columbia, have jail inspection units which collect such data. Together they account
for 54% of all identified jail suicides in 1986, a steady improvement from the 31% in NCIA’s
1981 study, yet still far below expectations. Table 5 also reveals that state medical examiner
offices in -nine states collect jail suicide data not available from state departments of
correction, and 15 states have no central repository for such data.
Texas and Michigan provide clear, yet contrasting, examples of two states going in
opposite directions regarding jailsuicide reporting efforts. In NCIA’s 1981 study, Texas was
identified as having 25 jail suicides during 1979. At that time, Texas did not have a central
repository for jail suicide data. In September, 1983, legislation was enacted which mandated
that all jail deaths be reported to the state’s Attorney General Office. As previously shown in
Table 2, the state of Texas reported having 46 jail suicides during 1986. This substantial
increase, approximately 100% from the 1979 data, can perhaps more legitimately be attributed
to mandatory reporting than a dramatic increase in jail suicides throughout that state.
The state of Michigan provides a different picture. The state’s jail inspection unit (Office
of Facility Services) has always had an aggressive reputation for collecting accurate jail suicide
data. In NCIA’s 1981 study, Michigan was identified as having 22 jail suicides during 1979,
most of which were reported from the Office of Facility services (OFS). Further, according to
statistics from the OFS, the state averaged 17 jail suicides a year from 1980 through 1983. In
May, 1984, however, the state legislature removed local lockups from the jurisdiction of the
OFS after the state Association of Chiefs of Police argued that it was too costly to comply with
state jail standards. As previously shown in Table 5, the state of Michigan reported only five
11
Advisory Commission on Intergovernmental Relations, Jails: Intergovernmental Dimensions of a Local Problem..
Washington, D.C.: May, 1984, p. 103.
16
-
TABLES
-
STATE-REPORTED 1986 JAIL SUICIDES BY TOTAL IDENTll'IED
I
STATE
"
AIat.ma.
AJMka
1
0
6
AriJIInaAIbNu
2S
CaJiIDmia
. CoIorado-
0
2
0
1
13
2
1
0
18
DIIa_-
c:aan.cticu~
Diltlict oi Coluznbia
Florida
c..p.
.
.
Haw.ii
IdahoIWnoia
Jndima
Iowa~
~
LouiIiana
M.irw
Maryland-
TOTAL
REPORTED
-
MMuc:huIettI.
MidUpn
MiaII..ota
~~MaataNe
NebnsQ-
NftIIdaN_ Hazrphire-
N.wJeoMy
N.w MtIXicD·
N.wYork
North Carolina
North Dakota-
8
1
8
3
3
0
1
11
7
5
8
1
11
9
9
0
0
"
3
3
3
2
UtM
VIIIIIDnt
Vilpliae
W........
W_Vlrpla-
1
2
1"
1
2S
25
5
0
7
1
19
10
5
18
0
10
"
0
"
"
25Z
.at
0
TOTAL
,
"
5
46
1
0
13
3
WiIaINift
~
"
"
0
0
0
8
1
0
7
0
5
0
T_
T_
3
2S
"
"
CIdIhama
ClrIpar.-ytYUlla
Rhode Island
Sauth Carolina
South DUota-
9
1
5
9
32
10
5
1
1
15
10
1
0
7
1
QIiD
TOTAL
IDENTIFIED
46
1
0
18
2
2
·Data obtained through state medical examiners office, not available from departments
of correction.
"Data not available through any state agency.
17
jail suicides during 1986, with an additional four being-identified by NCIA project staff. In
contrast, 24 jail suicides were identified in Michigan during 1985, presumably before the full
force of the new law was felt.
A third determinant of jail suicide under-reporting concerns the difference of-opinion
on where the suicide occurred (e.g., jail, ambulance, or hospital). There are incidents, the
number of which are unknown, where a detainee attempts suicide in his jail cell, is
immediately removed from the facility and transported by ambulance to a hospital, and
subsequently dies. The jail facility might list the case as an attempted suicide, or have no
record at all of the incident. Thus for reliability purposes, jail suicides are at times
inappropriately listed as hospital suicides.
As previously discussed, the state of Ohio completed a statewide study on jail suicides
in 1983. The researchers hypothesized that “the number of suicides indicated on the reports as
occurring in jails and temporary detention facilities was understated. This hypothesis was
based on the fact that jails often transport suicide victims to a hospital as part of the jails’
standard emergency procedure. Unfortunately, on the computerized files, the ‘transported’
prisoners could not be differentiated from any others who attempted suicide in a hospital or
nonprisoners taken to a hospital as an emergency procedure. Therefore, the total number of
suicides reported on the computerized files as occurring in a jail or temporarydetention facility
was believed unreliable.“12
To test their hypothesis, the researchers obtained annual computerized suicide reports
from the state Department of Health - Data Section. The reports highlighted persons who
“reportedly” committed suicide and died within a hospital or jail facility. Staff then reviewed
the death certificates of all persons listed in the suicide report as having died in a jail facility
or hospital. These death certificates were obtained by the state’s Division of Vital Statistics.
Collected from the death certificates were locations of death (name of city) and location of
injury (name of facility). The suicide victims who had been jail inmates were identified by
12
Patricia L. Hardyman, p. 2.
18
carefully checking a variety of entries on the death certificate, i.e., location of injury, date of
death, how the injury occurred, and immediate cause. Their findings revealed that although
jails reported 22 suicides occurring between 1980 and 1981, a further analysis of death
certificates from hospital suicides found that there were, in fact, 46 suicides that should have
been identified as jail suicides. Thus, an additional 24 jail suicides were uncovered.
The researchers concluded: ‘The suicide rate in Ohio’s jails and temporary detention
facilities indicated that the number of reported suicides occurring in Ohio facilities was understated by about half on the official suicide reports.“
13
C) Methodology: Phase II
During Phase II of the present study, project staff developed a four-page, in-depth
survey questionnaire aimed at identifying characteristics of the 1986 suicide victim and
suicide act. Information sought regarding the victim included race; sex; age; marital status;
current offense(s); custody status; relationship, if any, of victim’s confinement to state’s drunk
driving law; prior arrests; and presence of intoxication (alcohol and/or drugs) at the time of
incarceration. In regard to the suicide act itself, information was sought concerning date and
time of suicide; method; instrument used; time span between suicide and finding of the victim;
use of isolation; previous suicide attempts; indications of mental illness and/or medical
problems; use of suicide screening forms; length of incarceration prior to suicide; and facility
capacity/population at the time of the suicide.
In addition, data was also sought on the type and location of the facility; year of
original construction and last renovation; incidence of suicide in 1984 and 1985; presence of a
suicide prevention program; and procedures of external reporting requirements utilized
following a suicide.
13
Ibid, p. 18. Further, the national scope and size of the data base in this NCIA study precluded the same
death certificate analysis as was done in Ohio. As previously stated in NCIA’s 1981 National Study of
Jail Suicides - “. . after au exhaustive search for existing data, Project staff identified 419 suicides
in jails during 1979. However, because of the problems in suicide reporting, as discussed, care
must be taken in considering this number of suicides the final one. The number could be, and
probably is, greater.” See Lindsay M. Hayes and Barbara Kajdan, And Darkness Closes In. . .A
National Study of Jail Suicides. Washington, DC.: National Center on Institutions and Alternatives,
October, 1981, p. 15.
19
The four-page survey was modeled after NCIA’s1981 survey instrument to allow for
appropriate data comparison, see Section V. (A copy of the survey instrument can be found
in Appendix B.)
The four-page survey was distributed by mail to those 349 jails accounting for the 401
suicides during 1986. This process was initiated in June, 1987. As can be seen by Table 6, the
initial mailing resulted in 233 (58%) completed surveys being returned. A second mailing was
done in late July, 1987, yielding 58 (15%) additional completed surveys. Subsequent telephone
contact to those facilities not responding to previous survey requests, culminated in 15 (4%)
more completed surveys. Finally, data on 33 (8%) suicides were obtained from medical
examiner reports and newspaper articles. The total demographic data base became 339
suicides, or an 85% response/collection rate on 401 identified jail suicides in 1986.
20
As previously reported, project staff analyzed data on 339 of the 401 jail suicides
identified for 1986. The following demographic findings will be presented in relationship to
jail facility type.” For purposes Of this analysis, two facility types were utilized: Holding
Facility (which normally detains persons for less than 48 hours) and Detention Facility (which
normally detains persons or house committed/sentenced offenders for more than 48 hours,
but less than two years). Thus, the two facility types are more distinct by the length of time an
individual is confined (i.e., more or less than 48 hours), rather than the jurisdictional agency
which controls a facility.
With a data base of 339 cases, 30% (102) of the jail suicides took place in holding
facilities, while detention facilities accounted for 70% (237) of the deaths. In regard to the
location of the facility, 65.8% of the suicides occurred in urban facilities, 21.6% in suburban
facilities, and 126% in rural facilities.
A)
1.
Race
As can be seen by Table 7, 7l.6% of the victims were White, 15.7% were Black, and 12.7%
14
As previously reported, a jail is defined as an facility operated by a local jurisdiction (e. g., county,
municipality, etc.), whose purpose is the confinement of inmates apprehended byl a w enforcement
personnel. Jails, as defined here, will, to the maximum extent possible, include temporary holding
and petrial detention facilities, lockups, “drunk tanks,” etc., which normally detain persons for less
than 48 hours, and facilities which normally detain persons or house committed/sentenced offenders
for more than 48 hours, yet usually less than two years In addition, all state police lockups are
included within this definition, as well as local jails operated by state correctional agencies, i.e.,
Alaska, Connecticut, Delaware, Hawaii, Rhode Island, and Vermont.
21
were designated as “Other.” Therewere no significant differences foundbetween holding and
1s
detention facility suicides in regard to race. These findings compare favorably with previous
studies that indicate Whites commit suicide in greater numbers than Blacks. Of interest,
however, is the fact that although Blacks comprise approximately 41% of the jail population,
they accounted for only 15.7% of the jail suicides in this study. The cause of this disportionate
relationship is outside the purview of this analysis.
As presented in Table 8, an overwhelming majority (94.4%) of the victims were male,
while only 5.6% were female. There were no significant differences found between holding
and detention facility suicides in regard to sex. These findings were not surprising since it was
closely proportionate to male-female, ratio in our nation’s jails.
3. Age
Table 9 shows that over one quarter (26.5%) of all victims were between the ages of 23
and 27. Almost half (47.5%) of the victims were between the ages of 23 and 32. The average
15
For purposes of this study, percentage differences greater than 10 will be considered a significant difference.
22
age was 30. There were no significant differences found between holding and detention
facility suicides in regard to age. These findings also seem to be proportionate to those age
groups found in the jail population.
4.
As indicated by Table 10, 51.6% of the victims were single, 4.2% separated, 12.7%
divorced, and 1.4% widowed. The remaining 30.1% were married or living under a commonlaw relationship. There were no significant differences found between holding and detention
23
facility suicides in regard to marital status. These findings are also proportionate to that of the
jail population. Although marital status alone can not be utilized as an indicator of suicidal
behavior in jail, the quality of a marriage and/or the recent loss of a “significant other” can
16
impact upon suicidal behavior.
5.
For purposes of this study, the most serious charge was broken down in four offense
categories. As can be seen by Table 11, 75.3% of the most serious charges were of a non-violent‘
nature. Minor other offenses accounted for 28.6% of the most serious charges, followed by
alcohol/drug-related offenses (26.8%), violent/personal offenses (24.7%), and serious
property offenses (19.9%). Further, significant differences were found between holding and
16
See Joseph R Rowan and Lindsay M. Hayes, Training Curriculum on Suicide Detection and Prevention in
Jails and Lockups, Alexandria, Virginia: National Center on Institutions and Alternatives, February,
1988.
24
detention facility suicides in regard to the most serious charge. While alcohol/drug related
offenses accounted for 46.1% of holding facility suicides, they were credited with only 18.3%
of such deaths in detention facilities. Further, while violent/personal offenses accounted for
only 14.7% of holding facility suicides, they were credited with 29.1% of such deaths in
detention facilities.
In regard to individual charges, seven particular offenses were found in almost 50% of
the jail suicides. As such, 35 suicide victims (or 10% of the entire study) had been confined on
driving while intoxicated charges, 28 for murder, 26 for burglary, 24 for public intoxication, 18
for assault, 17 for traffic offenses, and 17 for disorderly conduct.
Further, while minor other and alcohol/drug-related offenses account for
approximately 37% of the jail populaton (see Table l), they represent over 55% of the suicide
victim offenses. The cause of this disportionate relationship is outside the purview of this
analysis.
6.
In regard to additional charges, 47.5% of the victims had a second charge. Traffic
offenses, resisting arrest, and violation of probation accounted for 29% of these second charges.
Only 23.7% of the victims had a third charge. 17 (The distribution of second and third charges
can be found in Appendix C.)
7. Jail Status
As presented in Table 12, the overwhelming majority (88.7%) of the suicide victims were
being detained at the time of their death. Since holding facilities, by their definition, have very
few sentenced inmates, there were no significant differences found between holding and
detention facility suicides in regard to jail status. As was previously shown in Table 1,
l7
It should be pointed out that project staff recoded data on only the three most serious charges against the
victim. However, very few victims had more than three charges against them.
25
approximately 53% of all jail inmates are combined as detainees, yet almost 89% of the suicide
victims in this study were detainees. The substantial difference between these two groups is
closely associated with the length of incarceration prior to suicide (see page 36).
Prior publicity and research has hypothesized that, if an individual is arrested for a
DWI-related offense, the risk of suicide is greater if their incarceration is mandated by the
state’s drunk driving law. In March, 1983, one week after a new law in Ohio mandating 72-hour
jail terms for drunk drivers went into effect, three people arrested for DWI-related offenses
committed suicide. Newspaper stories on the three deaths and the new law appeared
18
throughout the country. However, the only prior jail suicide research that espouses to such
a relationship is inconclusive.
19
In an effort to gain greater insight into the potential relationship, project staff inserted
a question into the survey instrument dealing with a state’s DWI statute. As can be seen by
18 See the Wall Street Journal; June 7, 1983.
19 Special Commission to Investigate Suicide in Municipal Detention Centers, pp. 48-49.
26
Table 13; the issue of DWI statutes was applicable in 11.5% of the suicide cases. Of those cases,
only one-third (3.8%) of respondents stated the victim’s confinement was due to the state’s
drunk driving law. Although the research is consistent in linking intoxication to jail suicide,
these data do not seem to show a significant link between jail suicide and the presence of a
state’s drunk driving law. More comprehensive analysis, outside the purview of this study and
perhaps in psychological autopsy form, is necessary.
9.
Table 14 shows that only 21.8% of the suicide victims did not have a history of prior
arrests. Of those victims having a prior arrest record, minor other offenses accounted for 23.5%
of the most serious charges, followed by alcohol/drug-related offenses (23%), serious property
offenses (21.8%), and violent/personal offenses (9.9%). There were no significant differences
found between holding and detention facility suicides in regard to prior charge, although
holding facilities had a higher percentage of victims with alcohol/drug-related prior offenses,
while detention facilities had a higher percentage of victims with serious property prior
offenses. In regard to additional prior charges, 62.7% had two prior charges, and 51.3% had
three prior charges. (The distribution of second and third prior charges can also be found in
Appendix C.)
27
As indicated by Table 15; 60.3% of the suicide victims were under the influence of
alcohol, drugs, or both at the time of their incarceration. Alcohol intoxication accounted for
43.8% of this finding; drugs, 6.8%; and the presence of both alcohol and drugs, 9.7%. Further,
significant differences were found between holding and detention facility suicides in regard to
intoxication. The ovrewhelming majority (82.4%) of suicide victims confined in holding
facilities were intoxicated (from alcohol, drugs, or both) upon their incarceration. In contrast,
49% of suicide victims confined in detention facilities were intoxicated (from alcohol, drugs
or both) upon their incarceration. These findings are not surprising since jail suicide research
28
literature is replete with evidence that equates suicide with intoxication. Further, persons
taken into custody for alcohol-related offenses are often initially transported to a holding
facility.
B)
Experts theorize that jail suicides are more prevalent when staff supervision is reduced.
Findings from this study generally suppor tthis explanation. As can be seen by Table 16, over
30% of all suicides occurred during a six-hour period between midnight and 6:00 a.m.
Midnight to 3:00 a.m. was the highest period for suicides with 58 such deaths. Other peak hours
were 6:00 p.m. to 9:00 p.m. (48); 3:00 a.m. to 6:00 a.m. (45); and 9:00 p.m. to 12:00 midnight (40).
There were no significant differences found between holding and detention facility suicides in
regard to the time of suicide, although the 6:00 p.m. to 9:00 p.m. time period experienced the
most suicides in holding facilities, while the 12:00 midnight to 3:00 a.m. time period
experienced the most suicides in detention facilities.
W
As presented by Table 17, suicides were evenly distributed over all seven days of the
week, although Monday experienced the most suicides (16.2%). There were no significant
differences found between holding and detention facility suicides in regard to day of week.
Table 18 shows that suicides were evenly distributed overall 12 months of the year, with
December having experienced the most suicides (11.6%). There were no significant differences
found between holding and detention facility suicides in regard to month of year.
30
3.
Method and Instrument
As indicated by Table 19, the overwhelming majority (93.5%) of suicide victims chose
hanging as their method of suicide. There were not any significant differences found between
holding and detention facility suicides in regard to method of suicide.
As can be seen by Table 20, 47.9% of the victims used their bedding to commit suicide.
Over 33% used clothing other than shoelaces or belts. Further, significant differences were
31
found between holding and detention facility suicides in-regard to instrument used. Clothing
(other than shoelaces and belts) was utilized in 63.3% of the holding facility suicides, followed
by bedding 21%. In wide contrast, beddingwas used in 60% of all detention facility suicides,
followed by other clothing, 20.4%. These differences can presumably be attributed to the fact
that, due to nature and functions, holding facilities do not always confine individuals
overnight and, therefore, have less a reliance on bedding.
4. Time Span Suicide and Finding Victim
As presented by Table 21, 42.3% of the respondents stated that they found the suicide
victim in less than 15 minutes after the act. However, almost 25% of the respondents admitted
to finding the victim between 30 minutes and 3 hours. There were no significant differences
found between holding and detention facility suicides in regard to time span.
5. Isolation
Table 22 shows that two out of every three victims (66.9%) had been held in
isolation prior to their suicides. There were no significant differences between holding and
detention facility suicides in regard to isolation.
Isolation has many uses in jails. The “drunk tank” is used for the intoxicated individual
during the withdrawal process. The “juvenile wing,” as it is often referred to, is an isolation cell
32
used to keep juveniles separate from adults both in “sight and sound.” The “observation tank”
might be used for those individuals expressing suicidal tendencies. A “padded cell” is used for
the inmates diagnosed as being mentally ill. The “hole” is used for problem inmates. In most
instances, the use of isolation is for the convenience of the staff, and usually to the detriment
of the inmate because it unconsciously causes reduced staff supervision/observation.
whether its use is disciplinary or observational, isolation can pose a special threat to inmates
who have limited abilities to cope with frustration. Experts have theorized that “inmates ‘react
to solitary confinement with surges of panic, despair, or rage. They lo& control, break down,
regress.’ Others conclude: ‘it appears that inmates in dissociation and, to a lesser extent, in
protective dissociation, commit suicide proportionately more than inmates situated in other
areas’."20
6.
As part of the survey, respondents were asked if the suicide victims had any indications
of prior suicide attempts, mental illness, and/or medical problems. As indicated by Table 23,
84.1% of the victims did not have a prior suicide attempt that was known to officials. As
20
See Lindsey M. Hayes and Barbara Kajdan, And Darkness Closess In.. .A National Study of jail Suicides
Washington, D.C: National Center on Institutions and Alternatives, October, 1981, pp. 34-35 and
48-49.
33
detailed in Table 24, when asked whether there was any indication of mental illness in the
victims prior to their suicides, 80.7% of the respondents said they were not aware of any.
Finally, as can be seen in Table 25, 79.4% of the victims did not have any medical problems
known to officials.
34
There were differences between holding and detention facility suicides in regard to
prior suicide attempts, mental illness, and medical problems. Although in the minority,
suicide victims identified by respondents as exhibiting any of these three variables were more
likely to be found in detention, rather than holdingfacilities, i.e, 17.3% versus 11.1% for prior
suicide attempts, 23% versus 9.6% for mental illness; and 22.4% versus 15.8% for medical
problems. These differences can presumably be attributed to the likelihood of intake screening
being found more frequently in detention facilities. However, a closer examination of each
table also reveals a significant percentage (18 to 39%) of "unknown” responses to survey
questions regarding the three variables and, thus, calling into question the frequency and
extensiveness of screening see Section IV. Further, caution should also be exercised because
a significant percentage of jail facilities have inadequate intake screening procedures from
which to derive information regarding prior suicide attempts and history of mental illness
and/or medical problems. Research and psychological autopsies reveal a high correlation
between these variables and jail suicide.
As can be seen by Table 26, an overwhelming majority (88.5%) of the victims were not
screened for potentially suicidal behavior prior to their death? In regard to holding facilities,
only 3.4% of the victims were screened. A further discussion of screening can be found in
Section IV.
21
In addition, project staff asked for, and received, 75 screening forms from respondents. Upon closer
examination, however, 58 of these forms were found to be inadequate in regard to suicide prevention
screening, see Section IV.
35
8.
As presented in Table 27, over 50% of the victims were dead within the first 24 hours of
incarceration, and 28.5% occurred within the first three hours. Further, there were significant
diffeences between holding and detention facility suicides in regard to length of
incarceration. Data revealed that 64.3% of all holding facility suicides took place within the
first three hours of incarceration; 80.1% within the first six hours. In contrast, 12.9% of all
detention facility suicides occurred within the first three hours of incarceration; 19.4% within
the first six hours. Such differences are probably a result of the criteria by which each facility
operates, (i.e., 0-48 hours versus over 48 hours). Despite this probable explanation, however,
the fact remains that while the average length of stay in detention facilities is 6 to 11 days (see
Table I), over 30% of all suicide victims in these facilities are dead within the first 24 hours of
incarceration.
36
9.
The initial entry into a jail can be a frightening experience. For the first time arrestee,
the feeling is one of fear, confusion, and uncertainty of the immediate future. For the chronic
offender, re-entry might engender frustration at finding oneself in a situation to which he or
she vowed never to return. NCIA’s 1981 study found a significant relationship between
suicide and length of incarceration. Specifically, the characteristics of most serious charge,
isolation, and intoxication were found to be closely associated to the victim’s length of
incarceration prior to death.
In regard to most serious charge, 56% of victims charged with alcohol/drug-related
offenses died within the first three hours of confinement. In contrast, almost 50% of victims
charged with violent/personal offenses died after 15 days of confinement, and usually
between two and seven months. Only 8.5% of arrestees died within the first three hours. In
addition, 63% of the victims placed in isolation committed suicide within the first 48 hours of
incarceration, with over 30% of these victims dying within the first three hours of
confinement. Finally, over 88% of victims under the influence of alcohol and/or drugs at the
time of incarceration committed suicide within the first 48 hours of confinement, with over half
of these victims dying within the first three hours of confinement (see Appendix A).
In conducting the present study, project staff again analyzed these three variables as
they each relate to length of incarceration. The findings are presented below.
a)
Table 28 shows that 51.7% of all victims who were charged with alcohol/drug
related offenses died within the first three hours of confinement. In contrast, almost 60% of all
victims charged with violent/personal offenses died after three days of confinement, usually
between two and four months.
Although a table is not shown, alcohol/drug-related offenses did impact upon the
length of incarceration for detention facility victims. Over 35% of detention facility victims
arrested for alcohol/drug-related offenses died within the first three hours of confinement. In
contrast, 28% of detention facility victims arrested for violent/personal offenses died between
37
two and four months; 23% of serious property offense victims died between 2 and 14 days; and
28% of minor other offense victims died between 2 and 14 days.
There was no appreciable relationship found between length of incarceration and most
serious charge in regard to holding facility victims.
b)
As indicated by Table 29, over 62% of suicide victims placed in isolation died within the
first 48 hours of incarceration. In addition, over 31% of these victims died within the first three
hours of confinement. There was no appreciable difference between holding and detention
facility suicides in regard to length of incarceration and isolation.
However, further analysis revealed that, absent the isolation variable, 58% of all suicide
victims in the study were dead within the first 48 hours; with almost 29% occurring within the
first three hours (see prior reference to Table 27). When the use of isolation is introduced as a
38
variable; there is only a slight increase in suicides occurring within the first 48 hours (from 58%
to 62%). Therefore, although two out
of every three suicides occur in isolation, such a
phenomenon can perhaps be attributed more to a lack of supervision/observation than to
stress and other factors associated with length of incarceration.
The study found a very strong relationship between intoxication and length of
incarceration prior to suicide. As can be seen by Table 30, the vast majority (77.7%) of suicide
victims who were intoxicated died within the first 24 hours of confinement; and 48.1% of the
intoxicated victims died within the first three hours of confinement.
39
TABLE 30 - LENGTIf OF INCARCERAnON BY INTOXICAnON
INTOXICATION
'YES
LENGTH OF
INCARCE1lATION
CDMBINED
NO
-
N
~
N
G-3HoUl'l
63
48.1
8
9.4
71
32.9
UHoUl'l
20
15.3
6
7.1
26
120
7-9Houn
10
7.6
2
2.3
12
5.6
1~12Houn
1
:J
2
2.3
3
1.4
1~-18 Houn
1
.7
1
1.2
2
.9
19--24Houn
7
5.3
2
2.3
9
4.2
2S-48 Houn
5
3.8
6
7.1
11
5.1
2-140.,-
6
4.6
22
25.9
28
13.0
4
3.1
12
14.1
16
7.3
1-4 Moab
9
6.9
13
15.3
22
10.2
S-7Moab
3
2.3
10
11.8
13
6.0
8-12 Moab
2
1.6
2
.9
1.5-300.,-
.
MOle Than 1 Year
TOTAL
131
1110.0
Unknown -123
40
N
1
1.2
1
.s
15
100.0
116
100.0
A)
Experts generally agree that certain signs and symptoms exhibited by the detainee often
foretell a possible suicide and, if detected, could prevent such an incident. What an individual
says and how he/she behaves while being arrested, transported to the jail, and at booking, are
vital in detecting suicidal behavior. An individual may exhibit warning signs and symptoms
that include:
22
Depression (Physical Signs)
a. sadness and crying
b. withdrawal or silence
c. sudden loss or gain in appetite
d. insomnia
e. mood variations
f. lethargy
Intoxication/Withdrawal
Talking about or threatening suicide
Previous suicide attempts
History of mental illness
Projecting hopelessness or helplessness
Speaking unrealistically about future and getting
out of jail
Increasing difficulty relating to others
Not effectively dealing with present; is preoccupied
with past
Giving away possessions; packing belongings
Severe aggressiveness
Paranoid delusions or hallucinations
Properly trained jail personnel can effectively assess suicide potential both at the
booking stage and during subsequent phases of an inmate’s incarceration. During thebooking
stage, intake screening is imperative to suicide prevention. In addition to assessing suicide
potential, intake screening serves to detect most medical and mental health problems, and
addresses classification needs. Experts stress that intake screening must be performed on
22
See Joseph R Rowan and Lindsay M. Hayes, Chapter 11.
41
every arrestee immediately upon entry into the jail facility. Although intake screening can be
utilized to detect a great portion of potentially suicidal behavior, inmates can become suicidal
at any stage of their incarceration. Therefore, continued observation and awareness of
potentially suicidal behavior is an added key to prevention.
Intake screening is not meant to be an in-depth, time consuming evaluation of an
arrestee’s health needs. It is designed to be utilized by the booking officer as a form of triage
to detect suicidal behavior; physical injuries/trauma and infectious diseases; chronic and
acute mental illness; medications taken and special health requirements; and alcohol or drug
intoxication._
1.
It was once offered - ‘The American jail obtains very little information about the
prisoners committed to its keeping, retains little of what is obtained in any usable form, and
reports almost nothing of what is useable to higher authorities.‘= Although this harsh criticism
was directed toward jail record-keeping practices in general, it seems apropos to suicide
prevention screening.
While the importance of intake screening is fully realized by experts, there is skepticism
regarding its extent and quality. Although incomplete, previous research efforts have pointed
to the inadequacy of screening. In a 1982 survey of over 2,600 jails throughout the country, the
National Sheriffs’ Association reported that only 41% of such facilities conducted initial
medical screening on detainees.24 Further, a 1984 survey of police departments in
Massachusetts found that 89% of the responding facilities did not ask any questions regarding
23
Hans Mattick, The Contemporary Jails of the United States,” in Handbook of Criminology, ed. Daniel Glaser,
New York Rand McNally, 1974.
24
National Sheriffs’ Association, The State of Our Nation’s Jails. Alexandria, Virginia, 1982, p. 207-212. The
authors reported that “only a quarter of the jails in the smallest category (l-16 inmates) conduct an
initial medical screening whereas nearly 75% conduct medical screening in the largest category (63
up). This might have something to do with the larger jails being sued over a badly run medical
operation. Medical reasons ranked third for the category (63-up) as the basis for being currently
under court order.”
42
suicidal behavior of detainees upon their booking - “Some lockups, in responding to the
questionnaire, reported having the fear that asking about suicide may ‘put the idea into their
heads’.“
25
Screening was first promulgated in 1978 (later revised in 1981) by the American Medical
Association (AMA)‘s Standards for Health Services in Jails.
26
These forms, nationally recognized
and utilized throughout the country, are broken down into two sections - booking officer’s
visual opinion and officer-inmate questionnaire (see Appendix D). According to the AMA,
receiving screening is a system of structured inquiry and observation designed to prevent
newly arrived inmates who pose a health or safety threat to themselves or others from being
admitted to the facility’s general population and to get them rapidly admitted to medical
care."27
Some critics argue that these forms can not sufficiently be utilized alone to identify
potentially suicidal behavior. In fact, the 1978 and 1981 versions include only one specific
reference to suicidal behavior - “Does the inmate’s behavior suggest the risk of suicide?”
(1978); and “Behavior suggests risk of suicide or assault?” (1980). It should benoted, however,
that the early AMA forms were later revised in 1982 by the American Health Care Consultants,
Inc., and in 1986-1987 by the National Commission of Correctional Health Care (NCCHC). 28
The new form offers some improvement over the earlier forms in regard to suicide detection
- “Does inmate appear to be despondent?“, ”Does inmate appear to be irrational or ‘crazy’?“,
“Have you ever tried to kill yourself or done serious harm to yourself?“, “Is this the first time
25
Special Commission to Investigate Suicide in Municipal Detention Centers, p. 30.
26
See American Medical Association, Standards for Health Services in Jails, Chicago, Illinois: American Medical
Association, September, 1981.
27
Ibid, p. 22.
28
See American Health Care Consultants, Inc., Receiving Screening for Medical Emergencies and Potential Suicide
in District Lockups - A Training Program for the Chicago Police Department. Chicago, Illinois, 1982, and
the National Commission of Correctional Health Cam, Standards for Health Services in Jails, Chicago,
Illinois, January, 1987.
43
you have ever been incarcerated?“, (short version); “Behavior suggesting risk of suicide or
29
assault?“, Admits to previous “suicide attempt” (long version). These forms are accompanied
by detailed screening guidelines, designed to assist the examiner in making a better
determination of health risk assessment. The NCCHC screening forms were not critiqued for
purposes of this present study because survey respondents had not yet had access to them.
Thus, it can be argued that the above referenced screening forms, while nationally
recognized as models for overall health assessment, are somewhat limited in their ability to
detect suicidal behavior. As such, and as a supplement to initial health screening, various
jurisdictions have begun to develop screening forms that are specifically designed for jail
suicide prevention. One such jurisdiction is the state of New York.
In March, 1986, under the auspices of the Office of Mental Health, Commission of
Correction,UlsterCounty Mental Health Services, and Division of Criminal Justice Services Bureau for Municipal Police, the state of New York began to implement Suicide Prevention
Screening Guidelines in all of its jails and lockups. The screening form (see Appendix D) is
divided into four sections: observations of transporting officer, personal data, behavior/
appearance, and criminal history. Answers to the following questions/observations are
obtained:
l
l
l
29
Ibid, p. 65.
Arresting or transporting officer believes that detainee
may be a suicide risk.
Detainee lacks close family or friends in the community.
Detainee has experienced a significant loss within the
last six months.
Detainee is very worried about major problems other
than legal situation.
Detainee’s family or significant other has attempted
or committed suicide.
Detainee has psychiatric history.
Detainee has history of drug or alcohol abuse.
Detainee holds position of respect in community and/or
alleged crime is shocking in nature.
Detainee is thinking about killing himself.
Detainee has previous suicide attempt.
Detainee feels that there is nothingto look forward
to in the future.
Detainee shows signs of depression.
Detainee appears overly anxious, afraid or angry.
Detainee appears to feel unusually embarrassed or ashamed.
Detainee is acting and/or talking in a strange manner.
(a) Detainee is apparently under the influence of alcohol
or drugs.
(b) If YES, is detainee incoherent, or showing signs of
withdrawal or mental illness?
No prior arrests.
Many experts agree that the Suicide Prevention Screening Guidelines form is, by far, the
most comprehensive screening form developed to date, and it is beginning to be utilized in
other jail facilities outside the state of New York.
In conducting the present study, survey respondents were asked - ‘Were any written
forms utilized at booking to screen for potentially suicidal behavior in the victim? If ‘Yes,’
please enclose such form when returning this survey.” As previously indicated, only 11% of
the jail facilities were found to adequately screen detainees for potentially suicidal behavior.30
Project staff received 75 screening forms from respondents experiencing a jail suicide during
1986. A review of those forms points to further inadequacy in screening of the 1986 jail suicide
victims. As can be seen by Table 31, project staff distributed these 75 screening forms into five
categories. The vast majority (77.3%) of forms received were judged inadequate because they
were either facsimiles of the previously discussed AMA forms (1978 or 1981 versions), or they
30
This figure is admittedly “soft” for several reasons. First, if respondents answered “unknown” to
previous survey questions regarding prior suicide attempts, mental illness, and/or medical
problems, yet answered “yes” to screening the victim prior to his/her suicide, such affirmative
answers were changed to “no” by project staff. Second, if respondents answered “yes” to
screening the victim prior to his/her suicide, yet enclosed an inadequate screening form or one
that more resembled a booking form/arrest card, such affirmative answers were also changed to
“no” by project staff. In all, only 58 of 339 surveys were adjusted by project staff to more
accurately reflect screening of suicide victims. Regardless, had the surveys not been corrected,
70% of the respondents still reported having no screening procedures.
45
were medical assessment forms with little or no reference to suicidal behavior (Category A, B,
and C). Reference to suicidal behavior on these forms was, for the most part, limited to prior
history of suicide attempts. Only Category D and E forms, comprising 22.7% of the
respondents, were deemed acceptable because they were either independently and
exclusively utilized for the detection of suicidal behavior, or they adequately combined
medical and suicidal assessment criteria. In addition, such forms solicited observations from
the transporting officers.
Project staff are fully cognizant of the fact that an arrestee’s booking can be a chaotic,
time consuming process. Often, one officer is responsible for multiple bookings. However, as
previously discussed, intake screening is not meant to be an in-depth or unusually lengthy
evaluation of an arrestee’s health needs. It should be utilized for every arrestee immediately
46
upon entering into the facility as a form of triage. What an individual says and how he/she
behaves while being arrested, transported to the jail, and at booking, are vital for detecting
suicidal behavior. The importance of proper intake screening is magnified when as the present
research indicates, 89% of the suicide victims were not afforded any screening at the time of
their booking.
Recent research suggests that “there is clearly an inter-relationship between the issues
of staff numbers, staff training and written policies and procedures. . . and that the factors in
combination would have a powerful effect on reducing problems of suicides. . . ."
31
Experts
generally agree that a facility’s suicide prevention program should include the following
elements: identification, training, assessment, monitoring, housing, referral, communication,
intervention, notification, reporting and review?
In conducting the present study, survey respondents were asked -“Does your facility
operate a suicide prevention program? If ‘Yes,’ briefly list the procedures utilized to identify
and observe potentially suicidal inmates. (If necessary, please attach additional sheets.)” As
can be seen by Table 32, survey respondents were almost evenly divided regarding the issue
31
See Kimme Planing and Architecture, The Nature of New Small Jails: Report and Analysis, Champaign,
Illinois, October, 1985, p. 59.
32
See National Commission of Correctional Health Care, pp. 37-38.
47
of whether their facility had a suicide prevention program - 50.8% (yes) versus 49.2% (no).
The table reveals, however, that a number of respondents did not know whether their facility
had such a program or not.
Due to survey design, the question was structured in such a way to solicit a quantitative,
rather than qualitative, understanding of the extent of suicide prevention programs.
However, when respondents were asked to “briefly” list the procedures utilized to identify and
observe potentially suicidal inmates, answers commonly received included referral to mental
health services, screening, increased observation, and television monitoring. Further research
and analysis would be necessary to examine the quality and extent of these programs.
The findings also show that, in holding facilities, almost 32% of suicides took place in
the presence of a prevention program. In contrast, 58.3% of detention facility suicides occurred
despite the presence of a prevention program. Such findings are disturbing and, in lieu of the
fact that 85% of the detention facility victims were not screened (see Table 26), calls into
question the extent of suicide prevention programming in these facilities. Further research
and analysis is necessary to examine this issue.
B)
As previously discussed, NCIA completed the study - And Darkness Closes In..A
National Study of Jail Suicides for the National Institute of Corrections in October, 1981. The
study documented 419 suicides occurring in county and local jails during 1979, the year
selected for analysis. Demographic data was subsequently collected on 344 of these suicides.
The current study, which documented 401 jail suicides occurring in 1986, had a demographic
data base of 339 cases.
Table 33 comprises various demographic characteristics of the 1979 and 1986 jail suicide
samples. As can be seen, despite a seven-year interval, jail suicide demographic data has not
substantially changed. In the 1986 data, there was a slight increase in the percentage of White
suicide victims over the 1979 data. In addition, the average age increased from 28 to 30 years
old. In regard to the most serious charge, there was an increase in “minor other” offenses, with
TABLE 33
NOA'S NATIONAL STUDIES OF JAIL SUIODE:
DEMOGRAPHIC CHARACTERISTICS OF JAIL SUIODES
FROM 1979 AND 1986
1979 DATA
1986 DATA
White
BlaCk
67%
22
Other
11
72%
16
13
97%
3
94%
6
5%
29
16
10
15
4%
16
27
21
15
17
54%
30
30
16
18
CHARACTERISTICS
RACE
SEX
Male
Female
-
AGE
17 and Below
18-22
23-27
28-32
33-37
25
38 and Above
MARITAL STATIJS
Single
Married/Common-Law
Separated/Divorced/Widowed
S2%
MOST SERIOUS CHARGE
Alcohol/Drug Related
Serious Property
Minor Other
Violent/Personal
30%
27%
22
21
27
20
91%
9
89%
53%
47
78%
22
28
25
JAlLSTA1US
Detained
Sentenced
11
PRIOR CHARGES
One or More
None
49
CHARACTERISTICS
1979 DATA
1986 DATA
39%
9
44%
INTQXICADON
(AtTbneof~Uon)
Alcohol
Drugs
Both
Neither
11
7
9
41
40
20%
15
18
14
TIME OF smOPE
12iOO Midnight - 3:00 a.m.
3:00 a.rn. - 6:00 a.m.
6:00 a.m. - 9:00 a.m.
9:00 a.rn. - 12:00 p.m.
12:00 P.rn. - 3:00 P.rn.
3:00 p.m. - 6:00 P.rn.
6:00 P.rn. - 9:00 P·rn.
9:00 p.m. - 12 Midnight
11
11
7
7
10
10
12
13
15
14
12
11
METHOD
Hanging
Other
96%
4
94%
3%
9
32
44
5
5%
2
6
INSTRUMENT
Shoelace
Belt
Other Oothing
Bedding
Towel
Other
7
34
48"
.4
7
TIME SPAN
(Between Suicide and Finding Victim)
Less than 15 Minutes
15-30 Minutes
30-60 Minutes
1-3 Hours
Over 3 Hours
3
42CJ{,
32
15
8
3
68CJ{,
32
67CJ{,
33
36%
31
16
11
ISOLATION
Yes
No
50
1979 DATA
CHARACTERISTICS
1986 DATA
fRIOR SUICIDE A I I EMPTS
(Known to Officials)
Yes
No
17%
83
84
30%
70
19%
81
27%
9
4
4
3
4
6
14
8
13
5
2
1
29%
9
4
2
2
5
6
15
8
12
6
1
1
13%
Zl
70%
30
16%
fRIOR MENTAL ILLNESS
(Known to Officials)
Yes
No.
LENGlH Of INCARCERATION
(Prior to Suicide)
0-3 Hours
4~Hours
-
7-9 Hours
10-12 Hours
13-18 Hours
19-24 Hours
25-48 Hours
2-14 Days
15-30 Days
1-4 Months
5-7 Months
8-12 Months
More 1ban 1 Year
fACILITY TYPE
Detention (Over 48 Hours)
Holding (0-48 Hours)
51
a corresponding, although slight, decrease in the otheroffense groups. Further, there was a
significant increase in victims with prior charges, from 53% in 1979 to 78% in 1986.
There were also slight differences in regard to the instrument used to commit suicide
-most notably shoelaces and belts, two instruments that are most often routinely confiscated
from incoming arrestees. Although bedding clearly remained the instrument of choice, there
was a significant drop in the number of victims who utilized their belts, and a slight increase
in the use of shoelaces.
Absent the above variations, there were not any appreciable differences in jail suicide
characteristics from the 1979 and 1986 samples. Most of the key characteristics of jail suicide
- offense, intoxication, method/instrument, isolation, and length of incarceration - have
remained constant over time.
As previously stated, suicide is the leading cause of death in our nation’s jails. Jail
suicide rates, based upon average daily population figures, are often compared to the suicide
rate for the general population.34 Previously, experts have projected that the rate of suicide in
jail facilities is several times greater than that of the general population. For example, the
suicide rate for the general population in Texas during 1981 was 12.6 suicides per 100,000. The
suicide rate for all Texas jails was 137.5 suicides per 100,000, or approximately 11 times as high
as the suicide rate for the general population. 3 5 A 1984 study of South Carolina jails found the
suicide rate in jails to be 14 times greater than that of the general population.36 Earlier research
33
The calculation of jail suicide rates, as detailed within, does not not represent the official position of
the National Institute of Corrections.
34
Average daily population figures are utilized because yearly admission statistic are dramatically unreliable
and the vast majority of individuals spend considerably less time in jail during the year than in the
general population, thus making comparisons baaed upon yearly admissions inappropriate.
(Conversation with U.S. Department of Justice’s Bureau of Justice Statistics staff on February 11,
1988.)
35
William E. Stone, “Jail Suicide,” Corrections Today, December, 1987, p. 84.
36
John M. Memory, p. 2
52
efforts had documented a rate of 108 suicides per 100,000 inmates of Los Angeles county jails,
and 57.5 suicides per 100,000 in a sample of county jails in a midwestem state.37
There are several explanations for the higher rate of suicide in jail. First, an inmate can
be facing a crisis situation involving: 1) recent excessive drinking and/or use of drugs; 2) recent
loss of stabilizing resources; 3) severe guilt or shameover the offense; 4) sexual assault or threat
of such; 5) current mental illness; 6) poor physical health or terminal illness; and. 7) an
emotional breaking point. Second, from the inmate’s perspective, there are certain unique
characteristics of jail environments which enhance suicidal behavior. They include: 1) fear of
the unknown; 2) authoritarian environment; 3) no apparent control over the future; 4) isolation
from family and significant others; 5) shame of incarceration; and 6) dehumanizing aspects of
incarceration.
Some theorists argue that jail populations are biased in a number of ways that affect and,
perhaps, distort suicide rates. Stone has stated that: “It would be very easy to simply assume
that high suicide rates in jails are the result of poor conditions, poor administration and a larger
of public concern; however, the problem is much more complex. Many of the factors that
influence jail suicides stem from jails’ unique functions. This is not to say that jail
administrators do not bear the responsibility for suicide prevention, but that a larger
perspective is needed on the subject of jail suicides. Two of the primary problems that make
jails high suicide risk points are their unusual population and the high cyclic rate or the total
number of people exposed to a jail in the course of a year.“38
Stone argues that there are certain variables (including sex, age, marital status,
occupational status, alcoholism, etc.) which relate to suicide in the general population that are
predominantly found in jails and, therefore, making such environments more suicide prone.
37
See Bruce Danto (Editor), Jail House Blues, Orchard Lake, Michigan: Epic Publication, 1973, pp. 27-46 and
47-54.
38
William E. Stone,. p. 84.
53
He states: “The second major problem affecting the jail suicide rate is the ‘cyclic rate’. . . .What
is occurring in jails is that large numbers of a very suicide-prone population are submitted to
short periods of stay. You might say that our jails are ‘testing’ the suicide potential of a suicideprone group.Despite this possible distortion, the examination of suicide rate comparisons enhances
our general understanding of the jail suicide problem. During this national study of jail
suicides, project staff examined the most recent statistics available on suicide in the general
population. According to the Census Bureau, there were 12.3 suicides per 100,000 people in
the United States for the year ending 1985.“’
As previously reported, project staff identified 401 jail suicides for 1986. Of these deaths,
285 occurred in detention facilities, 116 in holding facilities. For purposes of this study, rates
of suicide in holding facilities were not computed due to the unreliability of average daily
population data. As such, with a base of 285 suicides and an average daily jail population of
265,517, there were 107 suicides per 100,000 inmates in detention facilities during 1986.”
Therefore, based upon this national study of jail suicides, it is projected that the suicide rate
in detention facilities is approximately nine timesgreater than that of thegeneral population.
39
Ibid, p. 85.
40
Rate based upon 29,453 suicides for a United States population of 240,344,000.
41
Average daily population statistics found in US. Department of Justice, Bureau of Justice Statistics Bulletin,
Jail Inmates 1986, Washington, DC: Bureau of Justice Statistics, October, 1987.
VI. SUMMARY/CONCLUSION
As previously discussed, project staff analyzed data on 339 of the 401 jail suicides
identified for 1986. Holding facilities comprised 30% of the jail suicides, while detention
facilities accounted for 70% of such deaths. Highlights of the data included findings that:
l
72% of victims were white.
l
94% of victims were male.
l
Average (mean) age of the victim was 30.
l
52% of victims were single.
l
l
l
l
l
l
l
l
l
75% of victims were detained on nonviolent charges, with 27% detained on
alcohol/drug related charges.
89% of victims were confined as detainees.
78% of victims had prior charges, yet only
10% were previously held on personal/
violent offenses.
60% of all victims were intoxicated at the time
of incarceration.
30% of suicides occurred during a six-hour
period between midnight and 6:00 a.m.
94% of suicides were by hanging; 43% of
victims used their bedding.
Two out of three victims were in isolation.
51% of suicides occurred within the first 24
hours of incarceration; 29% occurred within
the first three hours.
89% of victims were not screened for
potentially suicidal behavior at booking.
55
l
l
l
52% of all victims charged with alcohol/drug
related offenses died within the first three hours
of confinement.
78% of victims who were intoxicated died within
the first 24 hours of incarceration; 48% occurred
within the first three hours.
The suicide rate in detention facilities is projected
to be approximately nine times greater than that of
the general population.
In addition, holding facility data included findings that:
l
l
l
l
46% of victims were held on alcohol/drugrelated charges.
82% of victims were intoxicated at the time of
their incarceration.
64% of victims died within the first three hours.
97% of victims were not screened for potentially
suicidal behavior at booking.
Suicide remains the leading cause of death in our jails. We have learned from experience
that preventing jail suicide is a shared responsibility, beginning at the point of arrest and
ending with those who determine a facility’s budget. Further, tools to prevent such deaths research, written rules and procedures, staff training, intake screening, communication
between staff, and human interaction - work efficiently only if they too are shared.
Research remains an important tool in jail suicide prevention efforts. A leading
criminologist once stated, perhaps intrinsically, that “In the complex and costly business of
social action we should not leave to chance any area of decision-making or any aspect of any
situation that can be properly studied.“42 We have and will continue to learn from jail suicide
research. This report represents the second wide glimpse at the problem in seven years. Its
42
Leslie Wilkins, Social Deviance, Englewood Cliffs, New Jersey: Prentice-Hall, 1965.
56
strength lies in the fact that the findings confirm, with few differences, data from NCIA’s 1981
survey. The characteristics of intoxication, isolation and length of incarceration continue to be
key indicators of suicidal behavior. In addition, we can also begin to analyze for the first time
differences between holding and detention facility suicides.
While we know more about jail suicide prevention than ever before, the need for
additional research has never been greater. Future research efforts should focus on control
group (non-suicidal) comparisons, psychological autopsies, and successful jail suicide
prevention programs. Only by continuing to learn more about the problem and transmitting
that knowledge to those entrusted with the custody and care of inmates, will we be in the
best possible position to prevent the tragedy of jail suicide.
On an individual basis, experience has clearly demonstrated that almost all jail suicides
can be averted with implementation of a prevention program that includes written rules and
procedures, staff training, intake screening, communication between staff, and human
interaction. The key to prevention remains a capable and properly trained staff, the backbone
ingredient of a facility. Such a system, however, will not come to fruition without proactive
administrators who not only maintain an awareness of jail suicide as a national problem, but
take the initiative to prevent such an occurrence in their own facility.
VII. APPENDICES
A)
Summary of And Dark Closes In . . .A National Study of Jail Suicides (1981)
B)
Survey Instruments from Current Study
C)
Frequency Distributions of Additional Charges and Prior Charges
D)
Intake Screening Forms
E)
Bibliography: Jail Suicide Literature Review
APPENDIX A
APPENDIX A
A)
In October, 1981, NCIA completed the study - And Darkness Closes In.. A National Study of Jail Suicides
for the National Institute of Corrections. The study documented 419 suicides occurring in county and local jails
during 1979, the year selected for analysis.
As can be seen by Table 1, these suicides were distributed in 48 states, plus the District of Columbia.
From demographic data collected on 344 of these suicides, the NCIA study constructed a profile of the
victim. The victim was most likely to be a 22-year-old White, single male. He would have been arrested for
public intoxication, the only offense leading to his incarceration, and would thereby be under the influence of
alcohol. Further, the victim would not have had a significant history of prior arrests. He would be taken to an
urban county jail and immediately placed in isolation for his own protection and/or surveillance. However, less
than three hours after incarceration, the victim would be dead. He would have hanged himself with material
from his bed (i.e., sheet or pillowcase). The incident would have taken place on a Saturday night in September,
between the hours of midnight and 1:00 a.m Jail staff would have found the victim, they say, within 15 minutes
of the hanging. Later jail records would indicate that the victim did not have a history of mental illness or
previous suicide attempts
The scenario described above is, of course, based solely on a “hypothetical construct.” Detailed findings
of this study are presented below.
B)
As can be seen in Table 2, this study found that 67.3% of the victims were White, 21.6% were Black, and
11.1% were designated “Other” (including Spanish/Mexican, American Indian, and Unspecified).
As shown in Table 3, NCIA found that an overwhelming 96.5% of the victims were male, while only 3.5%
were female. This can most likely be attributed to the preponderance of males in our nation’s jails.
As can be seen in Table 4, NCIA found that almost 75% of the victims in its study were 32 years old or
younger, with 28.7% coming from the 18 to 22 year old category. Over SO% of the victims were between the ages
of 18 and 27. The average age was 28. It should also be noted that 13 juvenile suicides (17 years or below) were
recorded, comprising 45% of the suicide population.
TABLE 4 - A G E
18-22
23-27
28-32
33-37
38-42
43-47
48-53
54andOver
N
15
96
85
55
35
23
9
9
8
PERCENTAGE
4.5
28.7
25.4
16.4
10.4
6.9
2.7
2.7
2.4
TOTAL
335
100.0
17 and Below
UNKNOWN=9
As can be seen in Table 5, 53.5% of the victims were single, 9.4% divorced, and 1.0% widowed. An
additional 5.9% were separated. Only 30% were married or living under a common-law relationship.
5.
Table 6 lists the victim’s most serious and/or only charge at time of incarceration. As can be seen, 73.6%
of the most serious offenses fall within the non-violent Category. Alcohol/drug related charges account for over
30% of the most serious charges. Serious property offenses account for 222%; and the “minor other” category,
including such items as petit larceny, traffic offenses, violation of probation, etc., comprise 21.1% of these
offenses. In regard to the most serious offense being a violent crime, 26.4%, or only slightly more than one
quarter, indicated the presence of violence.
1
Offenses included in this category are public intoxication, driving while intoxicated, disorderly conduct,
resisting arrest, possession of a controlled dangerous substance, distribution of a controlled dangerous
substance, and narcotics (unspecified).
2
Offenses included in this category ate, burglary, grand larceny, auto theft, robbery (other), receiving stolen
property, arson, breaking and entering, entering without breaking, vandalism, and carrying a concealed
weapon and/or firearms.
3
Offenses included in this category are shoplifting, petit larceny, prostitution, sex offenses (other), trespassing,
unauthorized use of a motor vehicle, traffic offenses (other), violation of probation, contempt of court,
vagrancy, indecent exposure, status offenses, escape, forgery, embezzlement, and other.
4
Offenses included in this category are murder, negligent manslaughter, armed robbery, rape, indecent assault,
assault, battery, aggravated assault, and kidnapping.
6. Jail Status
As can be seen in Table 7, the overwhelming majority (91.4%) of suicide victims were on detention status
at the time of their death.
In regard to prior charges, data was obtained on 257 victims. Of these, 133 (51.7%) had one prior charge;
5
77 (30%) had two prior charges; and 47 (18.3%) had three charges
Further, out of the 133 cases with one prior charge, only 16 were violent offenses; of 77 cases with two
prior charges, six were violent; and of 47 cases with three prior charges, eight were violent. Thus, out of a total of
257 prior charges, only 30, or 11.6% were violent in nature.
8.
As can be seen in Table 8, almost 60% of the suicide victims in this study were under the influence of
alcohol, drugs, or both at the time of incarceration. Alcohol accounted for almost 40% of this finding; drugs, 9.4%;
and the presence of both alcohol and drugs, 113%.
5
It should be pointed out that Project staff recorded data on only the three most serious prior charges of the
victim. However, only a small percentage of victims had more than three prior charges.
C)
CHARACTERISTICS OF THE SUICIDE ACT
1.
Time
As can be seen in Table 9, almost 50% of the suicides occurred during the nine hour period between 9:00
p.m. and 6:00 a.m Midnight to 3:00 a.m. was the highest period for suicides with 65. Other peak hours were 3:00
a.m. to 6:00 a.m., (48); 6:00 to 9:00 a.m., (36); and 9:00 p.m. to 12.00 p.m. (49).
As can be seen in Table 10, almost 50% of the suicides occurred on either a Thursday, Friday, or Saturday,
with Saturday having the most suicides, 57.
As can be seen in Table 11, more suicides occurred during the month of September than any other single
month. Forty-two inmates took their lives during this month. The second greatest number of suicides occurred
during June when 40 inmates took their lives.
3. Method and Instrument
As can be seen in Table 12, an overwhelming majority of victims (95.9%) chose hanging as their method
of suicide.
In regard to the instrument used to commit suicide, Table 13 shows that 43.6% of the victims used their
bedding. Over 30% used clothing other than shoelaces or belts.
As can be seen in Table 14, over 35% of the respondents stated that they found the suicide victim in less
than 15 minutes after the act. However, 43.6% of the victims were not found until a 15 minute to one hour timespan had elapsed, with 26.8% not found until 30 minutes to 3 hours had gone by.
5. Isolation
As can be seen in Table 15, two out of every three victims (67.7%) identified in the NCIA study had been
held in isolation.
6.
As Table 16 indicates, when jailers were asked how many previous suicide attempts by the victims were
known to jail officials, almost 83% said that none were known. As detailed in Table 17, when asked whether
there was any indication of mental illness in the victim prior to his/her death, 70.6% of the jailers said they were
not aware of any.
7.
In one of the most alarming findings of the NCIA study, Table 18 shows that over 50% of the victims were
dead within the first 24 hours of incarceration, and an astounding 27% occurred within the first three hours.
As can be seen in Table 19, 55.7% of all victims who were charged with alcohol/drug related offenses
died within the first three hours of confinement. In contrast, almost 50% of all victims charged with violent/
personal offenses died after 15 days of confinement, and usually between two and seven months. Only 85% of
those offenders died within the first three hours.
The NCIA study also found a strong relationship between isolation and the length of incarceration prior
to suicide. As can be seen in Table 20, the majority (63%) of victims placed in isolation committed suicide within
the first 48 hours of incarceration. Moreover, over 30% of these victims died within the first three hours of
confinement.
The NClA study also found a very strong relationship between intoxication and length of incarceration
prior to siicide. As can be seen in Table 21, an overwhelming maiprity, 88.996, of victims under the influence of
alcohol and/or drugs at the time of arrest committed suicide within the first 48 hours of confinement. In
addition, over 50% of these victims died within the first three hours of confinement.
D)
As part of its research efforts, NCIA previously identified 16,909 county and local jail facilities in the
United States. There were 3,343 (19.8%) county facilities and 13,566 (80.2%) local facilities. However, as can be
seen in Table 22, county facilities accounted for 70% of the suicides in the study.
6
County jails are defined as commitment and pretrial (over 48 hours) detention facilities. Local jails are defined as
temporary holding facilities (less than 48 hours). “other” is defined as state facilities which detain or
commit individuals for less than one year.
In addition, NCIA discovered that 70.2% of all facilities experiencing suicide were located in urban areas;
17.4% in suburban areas; and 12.4% in rural areas. Whites comprised 69.8% of the victims in urban jails; Blacks
comprised 223%; “Other” (including Spanish/Mexican, American Indian, and Unspecified) comprised 93%.
In regard to facility and most serious charge, NCIA found that almost 32% of the victims charged with
violent/personal crimes committed suicide in county facilities, with 26.7% charged with serious property crimes.
In contrast, local facilities accounted for almost 50% of the victims charged with alcohol/drug related crimes and
26.3% with “minor other” crimes.
APPENDIX B
SECOND NATlONAL STUDY OF JAIL SUICIDES
INFORMATlON REQUESTED BY:
THE NATIONAL CENTER ON
INSTITUTIONS AND ALTERNATIVES
ON BEHALF OF THE
NATIONAL lNSTlTUTE OF CORRECTlONS
U.S. BUREAU OF PRISONS
U.S. DEPARTMENTOF JUSTICE
Dear Sheriff/Police Chief:
The National Institute of Corrections, within the U.S. Justice Department, has requested the National
Center on’ Institutions and Alternatives (NCIA) to serve as the coordinator of the Jail Suicide
In cooperation with Criminal and Juvenile Justice
Prevention Information Task Force.
International, Inc.. and with. assistance from the National Sheriffs’ Association, the NCIA is now
conducting a second national study of all suicides. You might recall that a similar study was conducted in
1981. With your assistance, the Project will utilize collected data on inmate suicides to generate
programmatic recommendations to confront this issue. This information can then be employed by your
agency and others in an effort to prevent future jail suicides.
DATA PROVIDED BY INDIVIDUAL FAClLlTlES WILL BE CODED AND HELD IN THE STRICTEST
CONFIDENCE. RESULTS OF THIS STUDY WILL BE PRESENTED IN SUMMARY FASHION, THUS
PREVENTING THE DIRECT LINKAGE OF SPECIFIC DATA TO THE PARTICULAR FACILITY FROM
WHICH THE INFORMATION ORIGINATED.
Data requested for this study (see over) should be limited to suicides or other deaths occurring between
In order to facilitate data compilation, we ask that you utilize the definitions provided on the back of this
form. When this is not possible, please inform us of specific differences in your reporting.
For your convenience in submitting the completed form, we have enclosed a self-addressed, business
reply envelope. We ask that the completed form be returned within thirty (30) days of its receipt. We also
ask that you return the completed form only if you had a suicide(s) or other death(s) during 1986 and/or
1986.
If you have any questions regarding completion of this form or the study, please contact Mr. Lindsay Hayes
of NCIA at (703) 684-0373. Thank you for your cooperation. Copies of the final report will be available
upon request.
Sincerely,
Joseph R. Rowan
Executive Director
Juvenile and Criminal Justice
international, Inc.
Project Director
National Center on lnstitutions
and Alternatives
Executive Director
National Sheriffs’ Association
PLEASE TURN OVER
DEFINITIONS
SUICICE: Any death of an individual while in the custody of any law enforcement agency resulting from or leadlng
diredly irom any seif-infliC1ed act perpetrated by that individual (NOTE: Eor pureeses of this study an inmate foynd
ba~ged ;" a facilitv V'lt who later dies e"royte to I-oo:oital or otber "ntth cart provider is classified as a "jail" sYicide and
sbQyld be rePOrted beloW.)
HOMICIDE: Any dea.th of an individual while in the custody of any law enforeament agency resulting from or leading
diredly from any non-seH-inflided act perpetrated against that individual by a seccnd party.
ACCIPENT: Any death of an individual while in the custody of any law enforcement agency resulting from or leading
diredly from any non-intentional, identifiable act.
UNPETERMINEP CAUSES: Any death of an individual while in the custody of any law enforcement agency.
.
resulting from or leading direaly from any unknown or unspecifiable act or agent
,.1>
JlAlL:
Any facility, operated by a local jurisdiction (e.g., ccunty, municipality, etc.), whose purpose is the ccnfinement
of inmat8$ appr~hended by law enforcement personnel. Jails, as defined here, will, to the maximum extent possible,
include temporary holding and pre-trial detention facilities, lockups, "drunk tanks," etc., which normally detain persons
for less than 48 hours, and facilities which normally detain persons or have committed/sentenced offenders for more
than 48 hours. In addition, all state police lockups are included within this definition, as well as local jails operated by
state corredional agencies, i.e., Alaska, Connecticut, Delaware, Hawaii, Rhode Island, and Vermont
NATIONAL: AliSO states plus the District of Columbia.
INMATE: Any individual in the physical custody of any law enforcement agency.
In the spaces provided below, please indicate the TOTAL NUMBER OF INMATE DEATHS IN EACH CATEGORY
occurring at your facility BeTWEEN JANUARY 1, 1985, THRU DECEMBER 31, 1985, AND JANUARY 1, 1986, THRU
DECEMBER 31, 1986. Plea. only complete the form below If your facility had a sulelde(s) or other
death(s) during 1985 and/or 1986_
Please call Mr. Lindsay Hayes at 7031684-0373 if further clarifICation is needed.
-------------------------------.----------
QUESnONS
1. Number of inmate dU1b1 between:
January 1,1985 and December 31,1985
January 1,1986 and December 31,1986
(a) Suicide
(b) Homicide
(c) Accident
(d) Undetermined Causes
(a)
(b)
(e)
(d)
Suicide,_ _
Homicide
Ac:cident~__
Undetermined Causn~__
---
2. Which of the following categories best desaibes your facility? (Plea. check only one category.)
(a) Facility for commitledlsentenced offend_,_ _
or4 to 48 hours,_ __
(b) Temporary holding facility for 0 to 4 hours_ _
(c) Pre"Trial detention facility (over 48 hours)____
3. Additional remari<s (a.g., differences in definitions and/or reporting practices; attach additional sheets if necessary).
The fotlowing will be used for Internal purposes only:
4. Completed by (nameMle):
5. Name of facility:
6. Address (street):
(City, State, Zip Code):
(County):
7. Telephone:
8. Date completed:
Please retum to: NCIA. 814 North Saint Asaoh Street. Alexandria. VA 22314. within 30davs of receiot.
SECOND NATlONAL STUDY OF JAIL SUICIDES
JAIL SUICIDES OF .1B§
STATE OF_ _ _ _ _ _ __
COUNTY OF_ _ _ _ _ __
(If appropriate)
JAIL FACILITY NAME
VICTIMS NAME
PATE OF SUICIPE
1;
....:-:....--------------------------------2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
(Please Use Additional Sheets as Needed)
DATA PROVIDED WILL BE CODED AND HELD IN
THE STRICTEST CONFIDENCE.
RESULTS
OF THIS STUDY WILL BE PRESENTED IN SUMMARY FASHION, THUS PREVENTlNG THE
DIRECT UNKAGE OF SPECIFIC DATA TO THE PARTICULAR FACJUTY.
Please retum to: NCIA, 814 North Saint Asaph Street. Alexandria. VA 22314, within 30 days of receipt.
I
SECOND NATIONAL STUDY OF JAil SUICIDES
JAIL SUICIDES OF 1Se
STATE OF_ _ _ _ _ __
JAIL FACILITY NAME
COUNTY OF~~_---
(If appropriate)
VICTIM'S NAME
DATE OF SUIClpe
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
(Please Use Additional Sheets as Needed)
DATA PROVIDED WIll BE CODED AND HELD IN THE STRICTEST CONFIDENCE.
RESULTS
OF THIS STUDY WILL BE PRESENTED IN SUMMARY FASHION, THUS PREVENTING THE
DIRECT UNKAGE OF SPECIFIC DATA TO THE PARTICULAR FACIUTY.
Please retum to: NCIA, 814 North Saint Asaph Street, Alexandria, VA 22314, within 30 days of receipt.
NATIONAL STUDY OF JAIL SUICIDES
PHASE II
SURVEY QUESTIONNAlRE
THE NATlONAL CENTER ON
INSTITUTIONS AND ALTERNATIVES
ON BEHALF OF THE
NATIONAL INSTITUTE OF CORRECTIONS
U.S. BUREAU OF PRISONS
U.S. DEPARTMENT OF JUSTICE
items contained in this questionnaire refer to suicide(s) occurring at your facility In 1988 as identified
during Phase I of this National Study of Jail Suicides. As appropriate in each question, please check
the appropriate box(es) and/or fill in the blanks. Use a separate questionnaire for each victim.
DATA PROVIDED WILL BE CODED AND HELD IN THE STRICTEST CONFIDENCE. RESULTS OF THIS
STUDY WILL BE PRESENTED IN SUMMARY FASHION, THUS PREVENTlNG THE DIRECT LINKAGE OF
SPECIFIC DATA TO THE PARTICULAR FACILITY FROM WHICH THE INFORMATION ORIGINATED.
if you have any questions regarding completion of this form or the study, please contact Mr. Lindsay
Hayes of NCIA at (703) 634-0373. Thank you for your cooperation.
2
7)
If the vidim had been arrested for Driving While Intoxicated or a related charge, was hislher confinement
mandated by your state's drunk driving law?
(1)
(2)
(8)
(9)
8)
_ _Ves
_No
_ _Not Applicable
_ _Unknown
If yes, please explain the mandatory
conditions they were under. _ __
Did the vidim have a record of prior arrests?
9)
(9) _ _Unknown
(2) _No
(1) _Ves
H the victim did have a prior arrest racord, please specify the prior charges.
DATE
CHARGE(S)
(10)
At the time of incarceration, was the victim under the Influence of:
(1) _ _Drugs Only
(2) _ _AJcchol Only
(3) _ _Drugs and AJcchol
(4) _ _Neither Drugs or Alcohol
(9) _ _Unknown
PART B:
1)
What was the date and time of victim's death?
I
2)
SUICIDE CHARACTERISTICS·
,.
Lm.
p.m.
T1me:
What was the method of suicide and Instrument used?
a)
b)
Method
(1) _ _Hanging
(2) _Overdose
(3) _Cutting
(4) _Shooting
(5) _ _Jumping
(6) _ _Ingestion of
Instrument
(01) _Shoelace
(02) _Belt
(03) _ _Other Clothing
(04) _
Bedding
(08) _ _Towel
(09) _ _Knife
(10) _Glasa
(11) _
Drugs (Specify )
(05)_~
(06) _ _Razer Blade
(07) _Gun
Faragn Q)jed(s)
(7) _Other (Specify)
(12) _ _Other (Specify)
(99) _Uricnown
(9) _Unknown
3)
What was the time span between suicide and finding of the victim?
(1) _ _Less Than 15 Minutes
(2) _ _Between 15 and 30 Minutes
(3) _ _Between 30 and 60 Minutes
4)
(4) __Between 1 and 3 Hours
(5) _ _Greater Than 3 Hours
(9) _ _Unknown
Was the victim Isolated from other inmates at the time of hislher death?
(1) _ _Vel
(2) _ _No
(9) _ _Unknown
H -Ves, - explain the type of isolation_ _ _ _ _ __
3
5)
Were there any known previous sulcld. att.mpts by the victim?
(1) _Yes
(2) _No
(9) __Unknown
6)
Were there any indications of m.nt.lllln... concerning' the victim prior to his/her suicide?
(1) __Yes
(2) _No
(9) __Unknown
7)
If -Ves,· explain these indications and methodes) by which
they were identifi.d. _ _ _ _ _ _ _ _ _ _ _ __
Were .ny wrltt.n forms utilized at booking to scr••n for potentially suicidal behavior in the victim?
(1) __Yes
(2) _No
(9) __Unknown
9)
If -Ves: explain these indications and methodes) by which
!h.y were identified. _ _ _..;.-_ _ _ _ _ _ _ __
Were there any indications of m.dlcal probl.ms concerning the victim prior to hislher suicide?
(1)- __Yes
(2)
No
(9) -Unknown
8)
If -Ves,· how many?_ _ _ _ _ __
If -V••,.. pl.... .nclose .uch form when returning
thl • •urvey.
What was the total number of hours, days, months, or y.ars that the victim had been held in your
facility prior to hislher death? (If less than two days, indicate in hours.)
_ _~Hours
D.ys
---Months
10)
____years
____Unknown
What was the maximum inmate capacity and population of your facility at the tim. of the victim's suicide?
_ _ _ _ _ _ _ _Capacity
Population
PART C:
FACILITY CHARACTERISTICS
_1)
Nam. of Faclllty:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
2)
Addr••• (Str••t):,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
(City, State,- Zip Code):,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
(County):,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
3)
T.lephone:
4)
In what year was your facility or9inally constructed? Date._ _ _ _ _ _ __
5)
What was the year of last renovation, if any? Dat.,_ _ _ _ _ _ _ _ __
6)
What is the location of your facility? (1) __Urban
7)
Which of the following categories best descrlb.s your facility? (Pl.... check only one category)
(a)
(b)
(c)
(d)
(2) __Suburban
(3) _ _Rural
Facility for CommittedlSentenced Offende,. _ _ __
Temporaty Holding Facility for 0 to 4 Hours
or 4 to 48 Hours,_ __
Pre-Trial Detention Facility (Over 48 Hours),_ __
Other (Please Specify):..-_ _
(OVER)
4
8)
How many suicides occurred in your facility in 1984 and 1985?
(1 ) _ _ _ _1984
9)
(3)_ _ _ _None
Does your facility operate a suicide prevention program?
(1) _Yes
(2) _No
(9) _Unknown
10)
(2) _ _ _ _1985
If -Ves: briefly rlSt the procedures utilized to Identify and
observe potentially suicidal inmates. (H necessary .please
attach additional sheets.)
Are there any external reporting requirements following a suicicte?
If -Ves,· explain the.. requirements and to whom reports ar.
made. (If necessaty, please attach additional sh..ts.)
Survey Completed By (NamemUe):,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Date Completed:
Ple.se check If you would like • copy of survey findings.
THANK YOU FOR YOUR COOPERATION
PLEASE RETURN THIS SURVEY AND
SCREENING FORM (IF UTILIZED) TO:
LINDSAY M. HAYES
THE NATIONAL CENTER ON INSTITUTIONS AND ALTERNATIVES
814 NORTH SAINT ASAPH STREET
ALEXANDRIA, VIRGINIA
22314
APPENDIX C
APPENDIX C
DISTRIBUTION OF ADDITIONAL CHARGES
SECOND CHARGE AGAINST VICIlM
ChaJ1te
N
Percenta2e
Violent/Personal
34
10.2
Serious Property
29
8.7
.Minor Other
57
17.0
Aicohol/Drug
39
11.6
None
176
52.5
Unknown
4
TOTAL
339
100.0
THIRD CHARGE AGAINST VICI1M
Charge
N
Percent~e
ViolentlPersonal
15
4.5
Serious Property
16
4.8
Minor Other
32
9.6
Alcohol/Drug
16
4.8
None
255
76.3
Unknown
TOTAL
5
339
100.0
-
DISTRIBUTION OF PRIOR CHARGES
SECOND PRIOR CHARGE AGAINST VICTIM
rh:a~
N
Percenta2e
Violent/Personal '
22
9.1
Serious Property
35
14.5
Minor Other
48
19.9
J\1oohol/Drug
46
19.2
None
90
37.3
Unknown
98
".
.
TOTAL
339
100.0
THIRD PRIOR CHARGE AGAINST VICTIM
Charge
N
Percenta2e
Violent/Personal
23
9.7
Serious Property
20
8.4
Minor Other
38
16.0
Aloohol/Drug
41
17.2
None
116
48.7
Unknown
101
TOTAL
339
100.0
APPENDIX D
Sample Form
Sample Form
Receiving Screening Form*
NAME
INMATE NO.
SEX
D.O.B.
OFFICER OR PHYSICIAN
DATE
TIME
BOOKING OFFICERS VISUAL OPINION
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
YES
No
Is the inmate conscious?
Does. the new inmate have obvious pain or bleeding or other symptoms suggesting
YES
NO
need for Emergency Service?
Are there visible signs of trauma or illness requiring immediate Emergency or
YES
NO
Doctors care?
Is there obvious fever, swollen lymph nodes, jaundice or other evidence of
YES
infection which might spread through the jail?
NO
Is the skin in good condition and free of vermin?
YES
NO
Does the inmate appear to be under the influence of alcohol? YES
NO
Does-the inmate appear to be under the influence of barbiturates, heroin or any
YES
NO
other drugs?
Are there any visible signs of Alcohol/Drug withdrawal symptoms?
NO
YES
YES
Does the inmate's behavior suggest the risk of suicide?
NO
Does the inmate's behavior suggest the risk of assault to staff or other inmates?
YES
NO
Is the inmate carrying medication or does the inmate report being on medication
YES
NO
which should be continuously administered or available?
OFFICER-INMATEQUESTIONNAIRE
20.
21.
22.
Are you presently taking medication for diabetes, heart disease, seizures, arthritis,
asthma. ulcers, high blood pressure. or psychiatric disorder? Circle Condition
YES
NO
Do you have a special diet prescribed by a physician?
YES
NO
Type
Do you have history of venereal disease or abnormal discharge?
YES
NO
Have you recently been hospitalized or recently seen a medical or psychiatric
NO
YES
doctor for any illness?
YES
No
Are you allergic to any medication?
YES
No
Have you fainted recently or had a recent head injury?
YES
No
Do you have epilepsy?
YES
No
Do you have a history of tuberculosis?
YES
NO
Do you have diabetes?
YES
NO
Do you have hepatitis?
If female, Are you pregnant? Are you currently on birth control pills?
YES
No
23.
24.
Do you have a painful dental condition?
YES
Do you have any other medical problem we should know about? YES
NO
No
12.
13.
14.
15.
16.
17.
18.
19.
1.
2.
3.
4.
(A copy of this form is included in the inmate's medical record)
*See American Medical Association (in cooperation with the Department of Governmental
Affairs, University of Wisconsin). Training of Jailers in Receiving Screening and
Health Education. Chicago. Illinois: March. 1978.
__ _-
DATE
'rll'lE -.--.--.------.
. ......
.. -.. ..•.
_
(Nnme of
IN:1t:.1'E NAME
-
---
In~t1tution)
_ _ _ _ _ _ _ _ _ _ _ _ _ SEX _____ D.O.B.
INNATI: NO. _ _ _ _ _ _ _ _ _O.FFICER/EXAl-UNF.R NAME:
ROOKING OFFICF,[{/EXl\HINER OBSERVATIONS
(\.,lher.c ::ppl:ic~hl~l' circle r.p:'cific condition)
1.
2.
3.
Uncollscious?
Visible sigrls of trauma or illness requiring illlmediate
Describe:
'~lDergellcy or doctor's care?
Obvious fever, swollen lymph nodes, jaundice or other
evidence of infection which might spr.ead through the
jail? Describe:
f---.-+----+-------
4.
Poor skin condition, vendin, rashes, 'or needle marks?
5.
Under the influence of alcohol, barbiturates, heroin or
other. drugs?
6.
Visible sie"~ of alc('lhr.:l/~rtt8 ,,,i.thrlrDWI\]?
(F.>rt"rp.me
perspiration, pinpOint pupils, shakes, nausC!Cl, cramping,
vomiting)
7.
nehavior suggests risk of suicide or ass:.\uit'?
8.
Carrying medication or report being on mp.dication?
List:
9.
Deformities (List):
OFFICER/ruw.llNER-TNMATE QUESTIONNAIRE
10.
Admits To The Follotdng (Indicate by number and letter belm.]):
1.
2.
3.
(Over one year ago)
(tUthin one year)
(Present now)
Allergies
Arthritis
Asthma
D2l1.rium Tremens(DT's)
Dent~l Condition
Diabc.tp.s
Epilc.psy
Fail\tjn~
lleart CondItion
H (Hospitalized)
M
(HedicatioI"ls - current)
_ _ _ _ _ _ Hepatitis
nigh Blood Pressure
Physicinn PreRcribed Diet
Psychiatric Disorder
Tuberculosis
Ulcers
Urin~ry Trnct Problems
Venereal Dl.se:lsc (V D) (\-!hich)
Other (Slled.fy):
--_._--
-------------------.
11.
Use alcohol?
a) If yes, how often?
b) How much?
c) When were you drunk last?
d) When did you drink last?
12.
Use any "street" drugs?
a)
If yes, what type, (s)?
(c) Row much?
b) How often?
d) When did you get high last?
e) When did you take drugs last?
13.
If female, is she:
a) Pregnant?
(Months)
b) Delivered recently?
(Date)
c) On birth control pills?
REMARKS (i.c. Unusual behavior, special diet, type of VD, ctc)
DISPOSITION/REFERRAL TO' (Please underline applicable response):'
a) General population
b) Emergency care
c) Sick call
d) Isolate
Developed by: The American Medical Association
Jail Medical Technical Assistant Program
Rev. July 1, 1980
March 18, 1980
(A
copy
of this form is included in the inmates medical record)
Sample Form
Sample Form
Receiving Screening:
Guidelines for Disposition
Question
1.
If yes, arrange for immediate transfer to hospital and refer to page
30 in "Emergency Care Guidelines." (E.C.G.)
2.
If yes, call doctor now and describe symptoms.
3.
If yes, isolate from other inmates, monitor condition frequently and call
doctor immediately if condition of inmate appears to get worse. Use-paper
plates-plastic utensils, dispose of immediately. Keep all bedding separate
from others-sterilize. In case of fever administer aspirin as ordered by
doctor. Call doctor during next regular office hours and describe symptoms.
4.
If yes because of rash or other unusual skin eruptions, isolate and
follow instructions in question number 3. If vermin is present, isolate and
instruct inmate in use of Kwell or other scabicide.
5.
If yes to alcohol, transfer to detoxification unit at hospital. Refer to
page 14 in E.C.G. If yes to drugs, find out if possible what and how much
the inmate has been taking (refer to page 14 in E.C.G.) and call doctor now.
6.
If yes, monitor closely and call doctor now.
7.
If yes for suicide risk, follow instructions on page 28 in E.C.G. for
suicide. If yes for risk of assualt, isolate, monitor closely, call a doctor
or mental health center now. (See page 5 in E.C.G.)
8.
If yes to carrying medications; place in inmate's locker, check that
medications in bottle are actually what was prescribed, and try to check
with prescribing doctor whether medication is to be continued, If cannot
accomplish the preceding, check with jail doctor for instructions before
administering any medication. If inmate reports being on medication, check
with doctor to get prescriptions.
9.
If yes, note and inform appropriate personnel.
10.
(See page 14 in E.C.G.)
If the inmate admits to the following specifics:
Currently on medications = check with doctor to get prescriptions.
Currently on special diet = inform doctor and notify kitchen staff.
Recently hospitalized = report to doctor during next regular
office hours unless there are symptoms indicating need
for immediate attention.
Allergic to mediciations= note names of drugs and inform doctor.
Painful Dental Condition = Refer to page 29 in E.C.G.
Diabetes now = report to doctor for orders for appropriate
medication and or diet plan.
Page 2
Epilepsy now = check for any medication being taken and
follow steps in question 8.
Fainting = check for recent head injury and refer to page 6
in E.C.G.
Hepatitis now = isolate and report to doctor during next
regular office hours.
Tuberculosis history or now = isolate and report to doctor
during regular office hours.
Venereal Disease = isolate and have testing done as soon as
possible, follow by administration of appropriate
prescribed medication.
13.
If pregnant or delivered recently, report to doctor during next regular
office hours. If on birth control pills follow sequence in question
number 8.
C • • If II
.n Of CorNe.....
~ .. II_... " ...III
SUICIDE PREVENTION SCREENING GUIDELINES
DITAINII'S NAill
IIU
DAnO'IIIITH
Ili0IT IIIIIOU. CHAIIGI(I)
N..... I 0' SCllIINING O"ICIII
NAill D' 'ACIUTT
--,=................ ......
r--,,--_.
~
CheCK approprIate column for each QuesI/on.
CoIumft
C_
A
VES
B
NO
,-
""-"
3. .0...1"" h•••• pertenc:ed. IItntflCllnt 10.. within the .......
_tn. (.
g ..
10.. of job. loss of r.l.tionstlip. de.th of close family ",.mb.r).
...
0 ...1"" la VI" _rriId .bout _tor problema other then ..... situation
(e.g .. s.noul financial or lamily probl.ml. a meclical condition or I.ar of
10ltng ,obI.
0'"
5. O...ln..·• 1.",lIy or ..",ftleant
(spou••• pa,.nt. clOIl lriend. 'over)
h•••tt.",ptecl or committed wield••
••
D....".. hal psych..trtc lllato". (Note curr.nt p.ychotroPlc medication•
and name of mo., flC.nt treatment agency.)
7. D...,,,.. h•• hl.tDfY of drug or eIcohoi abUII.
••
••
D.tlln.. hold. po..llon of respect In com ",unity (•. g.. protHSlonal. public
official) .nd/or IIIeged crtme I. ahoctIlnt In neture.
If VES, notify Shift Commander.
D...I".. I. thlnklnt .bout kllint hi"'.....
If VES. notify Shift Commander.
1G. D...ln.. h•• pre"'-wlcl• •ttllllpL (ChICK ",,,.t. and note melhOC1.)
11. D...I".. ,.... thlt there I. nothlne to look forw.rd to In Ute future.
.~
.
(••pre.lI. ,..Ungl of helpl...ne.. or hopel...n.II).
If VES, to 10 and 11. notify Shift Commander.
BEHAVIORI APPEARANCE
IItn. of .......1on (•• g.. crying.•motional flatnell).
12. D...I""
.ho_
13- O.tII"" .....,. Oftny .nldous. efnlkl or
'ng".
1... D...I"" a....,. to f", un_lIy .....,.".1Md or .....emed.
15. D...I".. I. KtIftt andlor tIIldng In ••lrIIne' IIIIm.r ('.g .. cennot locus
anentlon. h.anng or _ng thingl which are not the,.).
11. A. 0 ....".. ......rentIy under the Intluenca of .lcohol or drug ..
........................................_................. __ .... _........_...._....._._.._.............................. __.. _............................
•• It YES. I. . . .1".. incoherent, or IiIOwtnt signs of wlthd,._1 or
..1111_1 If VES to both A & B. notify Shift Commander.
CRIMINAL HISTORV
17. Noprtor ..........
_.-........ ........_-
."
TOTAL Column A
ACnONS
It total checkaln Column A . . . . or mo... noll.y ShiH Com.... nc:t.r.
ShIH Com.... nc:t.' notl.led:
SuperYlalon Inatltuted:
V. .
No
Routine
ActI.,.
D.taln" R.terNd to MedlceUM.ntal Hullll:
V..
No
Conatant
I ..... O.NCY
1tON....I ..O.NCY
medlcel
medlcel
men_lh••11Il
.... n ..lhe.11Il
If Vea:
MedlceUMental H••11It P.rsonnel Actlona: (To be completed by MedlceUMH ataft)
TIIiI
Y.. _ -
0-,.1 Com_talOb..",.IIon.
OBSERVAnONS OF TRANSPORnNG OFFICER
1. A~.tlnt or t,.n",ortlnt officer belle... th.t .....In.. ""y be • wldde
ItIlL If VES, notify Shift Commander.
PERSONAL DATA
2. 0 ...1"" IKII. cIoH t.""., or friend. In the _",unity.
I
I DATI
No_-
\.
INSTRUCTIONS FOR COMPLETING
SUICIDE PREVENTION SCREENING GUIDELINES - FORM 330 ADM
GENERAL INFORMATION
This form IS to De compleUld m tropllcate for all detaln. .s proor to ceU assignment.
Insert 100 copy In detainee's file. U detainee is referred. give secon:! copy to medical or mental healln personnel. The tnlrd cooyls available for use accorOI"g
to our faclllly 5 proceoures,
Comment Column'
Use to note'
, , Informallon about the detain. . Ihat officer f_s II relevant and Importanl
2. Information requested In QueSllons 6 and , C, and
3. informallon regarding oetelnee 5 refusal or Inablllly 10 answer Questions: See Below - General InstruCllons I
Enter Oelalnee's first and last name and m,ddle Inlhal.
Oetalnees's Name:
Enter male 1m) or female
Sex:
fI,.
Date of Birth:
Most Seroous CnargelS)'
Date:
Time: '
Name of FaCIlity:
Name of Screening Officer:
PsyChiatriC Problems Ourong
Prior Incarceration:
Enter oay. montn and year.
Enter the most senous charge or charges ~no more than two (2») from thiS arrest.
Enter day. month Ind year that form WIS compfeted.
Enter the time of day the form wal completeo.
Enter name of jailOr lock-up.
Enter name of officer completing form
Check YES if facility files show that during prior detention (;~tain ... anempted suiCide andlor was referred for menIal
health services. If "unknown". wnte unknown across ,pace,
INSTRUCTIONS FOR ITEMS l-l?
General Inltructlonl
Check tne appropnate YES or NO box for Ilems 1 - 17.
I! Information required to complete these Questions II unknown 10 screening officer. such Informat,on should be oblalned by asking detainee to answer
Questions, However. detainee has a right to refuse to ans_r.
U detainee refuseSlo answer Questions 2-1'. enter RTA (refused to answe" ,n the Comment Column na .. t to each Question, In addition complelethe YES
or NO boxes only If information IS known to you.
U during an otherwise cooparatlve interview. detaln4!l refuses to ans_r one or two Questlons~ Check YES in the box(es) next to the unanswered
QuesllonfS) and enter RTA in the comment box next to eaCh unans_red Question.
U detamee IS unable 10 answer all Quesllon 2-11. enter UTA (unable to answe" in tile Comment Column next to eaCh Question. Also enter reason fe.g ..
Intoxicated. not Engllsll speaking I for not answering these Question In the Comment Column next to Question 2. In addition complete tile YES or NO boxes
only If information IS known to you.
ObHrvatlon of Transporting Officer
ITEM (1)
SUICide risk: Check YES or NO box based upon tile vertlel report of the arrelllngltransponing officer or upon tile screening form completed by
the police agency. U YES. notify shltt commander.
Personal Data Queltionl
ITEM (2)
ITEM (3)
ITEM (4)
ITEM (5)
ITEM (6)
ITEM i7)
ITEM (8)
ITEM (9)
ITEM 110)
ITEM ,11)
FamllylfrlendS: Check NO box if someone other than a lawyer or bondsman would (1) be willing to post detain. .·s bail. (2) viSit detainee while
helShe is Incareenlled. or (3) accept a coUect call from detainee.
Significant lOSS: Ask all tnree components to thiS Quest,on-Iou 01 job. Iou 01 relatlonsnip and death 01 close friend or lamily member.
Worroed about prOblems: ASk about such problems as linanc,al. med,cal condition or fear ollos,ng JOb. Check YES il deta,nee answers YES to
any of tnese.
Fam,ly/slgn,flcant otller attempted su,cide: Sign,ficant other IS defined as someone wllo has an ,mportant emotional refalionsllip with tne
detain...
Psycnlatrrc H,story: Check YES box ,f deta,n. . f 1) has ever had psych,atric hOso,talization. (2) is currently on psyChotropic med'cahon. or 131
nas OlIn an outpatient psyChotherapy during the past s'x m.,nthS. Note current plycnotroplc med,catlon and name of the mOil recent trealment
agency In tile Comment Column.
Drug or AlCOhOl History: Check YES box tf detainee has nad proor treatment for al :Ohol/drug abuse or If pnor arrests were alCOhol/drug related.
RespeCland sllock,ng crome: CheCk YES If detainee IS very resoected for wOrk. cc mmunlty actiVities. etc. and/or the cnme'lshOcklng ,n nature.
e.g. ch'ld molestation.
.
...
•
Su,c,dal: Check YES box if dell,nee makes a su,c,dal statement or If lie responds YES to d,rect Quest'on. "Are you thinking about killing
yourseU?" U YES. notify shift commander,
Prev,ous anempt: Check YES box ,f deta,neeSlates he hasanempled su,c,de. If YES. note the method used in the Commenl Column If e,Iher YES
or NO. check deta,n. .·s wnsll and note any scars ,n Comment Column.
Hopeless: Check YES box ,I dell,nee lIates feeling hopeless. that he has g'ven up. that he feels helpless to make his life better.
U YES to bot" ,Iems 10 and 11. notify shift commanaer.
Behavior Appearance Qbaervationl
YES or NO muSl always be et!ec:k.-d for eaet! of these items: They are observation, mede by the senten,ng officer They a.. not QueSlions.
ITEM 112) DeDresSlon ,ncludes behav,or sucn as: cry,ng. emot,onal flatness. aDatny. letnargy. exlreme "dness. unusually SlOW reaCUonl,
ITEM (13) Oveny anxIous. alra,d or angry ,ncludes sucn benaVlors as: handwr,ng,ng. pacing. excesSIve fidgel,ng. profuse s_altng. curSIng. phYSical
v'olence. threaten,ng. etc.
ITEM (14) Unusually embarrassed or aShamed: Check YES box il deta,nee makes non-ehc,ted statements lnalcat,ng worry about how
fam,lyllr,ends:communlly Will resoond to hIS detention
. ITEM 115) ACI,ng ,n strange menner. ChecK YES bo. if·you o b _ any unusual beltaVlor or sDlleh. sucn as halluc,nauons. severe mood ,w,ngs.
d'IOrlenlatlon. ''''Indra ..... etc.
ITEM f16A) Deta,nee under the ,nfluence: Check YES if someone 'S apparenlly intoXicated on drugs or alconol.
ITEM (16B) Inconerence. w,thdra_l. or menIal illness: Withdrawal meanl phys,cal w,tndrawal from subllance.
" YES to bOIl! A & B. nOhfy shift commander.
. - Criminal Hlltory
--- --
ITEM (1 T) , No prior arresll: cneck YES box if IIIIS IS deta,nee's hrst arrest.
SCORING
Be sure to count all checks ,n column A ana enter lotal,n Ille space prov'ded. NOI,fy sn,ft commander 1) lOlal IS 8 or more. or 2) any snaded boxes are
ClleCked. or 3)lf you feel nOllficallon is appropriate,
DISPOSITION
Officer Actions
Sh,ft commande' notified' CheCk YES or NO Shiit Commander should be not,fted about detainee prior to ceil ass'gnmer.SuoervlSlon m'tltuleo: cneck apDrODnale supervlS'on OIlPosltlon Th,s section,s 10 be comDleted by Shift commander For deftnltlon of active con~tant
and rout,ne see N. Y S. CommiSSIon of Correctll)n M,nlmum Standards for Local Correcllonal FaCilities.
Dela.nee re'erred to med,cal ano menIal roealtn 08rsonnel' Check YES or NO." YES. cheCk emergencYlhonemf!'gency meo,calmenta. nea'!r. ';',,:.
secllon IS to be comDleled by sn,ft commander,
Medical/Mental Health Actions
APPENDIX E
APPENDIX E
BIBLIOGRAPHY: JAIL SUICIDE LITERATUREREVIEW
The following bibliography is a comprehensive history of publications
and videotapes regarding jail suicide research, prevention and training.
Included within, this bibliography is a listing of all documents utilized and
produced by the Jail Suicide Prevention Information Task Force.
Adelson, L., RW. Huntington, and D.T. Reay. “A Prisoner Is Dead.” Police,
13, 1968, pp. 49-58.
Advisory Commission on Intergovernmental Relations. Jails:
Intergovernmental Dimensions of a Local Problem. Washington, D.C.:
May, 1984.
Albanese, J.S. “Preventing Inmate Suicides - A Case Study.” Federal
Probation, 46(2), June, 1983, pp. 65-69.
American Association of Suicidology. Suicide Prevention Training Manual,
West Point, Pennsylvania 1981.
American Correctional Association. Standards for Adult Local Detention
Facilities, Second Edition. College Park, Maryland: April; 1981.
American Health Care Consultants, Inc. Receiving Screening for Medical
Emergencies and Potential Suicides in District Lockups - A Training
Program for the Chicago Police Department. Chicago, Illinois: 1982.
American Medical Association. Standards for Health Services in Jails.
Chicago, Illinois: September, 1981.
.
Recognition of Jail Inmates with Mental Illness,
Their Special Problems and Needs for Care. Chicago, Illinois:
September, 1977.
American Medical Association (in cooperation with the Department of
Governmental Affairs, University of Wisconsin). Training of
Jailers in Receiving Screening and Health Education. Chicago,
Illinois: March, 1978.
Anno, B.J. Analysis of Jail Pre-Profile Data. Washington, D.C.: Blackstone
Associates, June, 1977.
Anson, R.H. “Inmate Ethnicity and the Suicide Connection/A Note on
Aggregate Trends.” Prison Journal, 63(l), Spring/Summer, 1983,
pp. 91-99.
Atlas, R. Guidelines for Reducing the Liability for inmate Suicide. Miami;
Florida: Atlas and Associates, 1987.
Austin, W.T. and C.M. Unrovic. “Prison Suicide.” Criminal Justice Review,
2(l), 1977, pp. 103-106.
Avery, M. and D. Rudovsky. Police Misconduct: Law and Mitigation. New
York, New York: Clark Boardman, 1987.
Beigel, A.-and H.E. Russell. “Suicide Attempts in Jail: Prognostic
Consideration.” Hospital and Community Psychiatry, 23(12), 1972, pp.
361-363.
Bernheim, J. Suicides Inside Detention Centers. Text of a conference given at
the 10th International Congress on the Prevention of Suicide and Crisis
Intervention, June 19, 1979.
Burks, D.N. and N.D. DeHerr “Jail Suicide Prevention.” Corrections Today,
February, 1986, pp. 53-88.
Burtch, B. and R.V. Erickson. The Silent System: An Inquiry Into Prisoners
Who Suicide and Annotated Bibliography. Canada: Centre of
Criminology, University of Toronto, 1979.
Caffrey, T. New York MCC (Metropolitan Correctional Center) Suicide
Prevention Project - Revised Final Report. New York, New York:
Metropolitan Correctional Center, 1979.
California Department of the Youth Authority. Suicide Prevention in
Juvenile Facilities. Sacramento, California: 1982.
Centers for Disease Control. Suicide Surveillance, 1970-1980. Washington,
D.C.: U.S. Department of Health and Human Services, April, 1985.
Youth Suicide in the United States, 1970-1980.
Washington, D.C.: U.S. Department of Health and Human Services,
November, 1986.
Charle, S. “Suicide in the Cellblocks.” Corrections Magazine, 7(4), August,
1981, pp. 6-16.
Christianson, S. “In Prison: Contagion of Suicide.” Nation, 219, 1974, pp.
243-244.
Commission on Accreditation for Law Enforcement Agencies. Standards for
Law Enforcement Agencies. Fairfax, Virginia: May, 1987.
Correctional Service of Canada. The Prevention of Suicide in Prison Instructor’s Manual. Ottawa, Canada: Communications Branch for
Medical and Health Care Services, January, 1981.
The Prevention of Suicide in Prison Student’s Handbook. Ottawa, Canada: Communications Branch for
Medical and Health Care Services, January, 1981.
.
Cooper, H.H.A. “Suicide in Prison: The Only Way Out for Some.” Chitty‘s
Law Journal, 24(2), 1976, pp. 58-64.
Cox, V.C., P.B. Paulus, and G. McCain. “Prison Crowding Research - The
Relevance for Prison Housing Standards and a General Approach
Regarding Crowding Phenomena.” American Psychologist, 39(10),
October, 1984, pp. 1148-1160.
Criminal Justice Training Council. Suicide Prevention, Intervention and
Detection While in Massachusetts Lockups. Boston, Massachusetts:
July, 1985.
Danto, B. Crisis Behind Bars - The Suicidal Inmate - A Book for Police and
Correctional Officers. Warren, Michigan: The Dale Corporation, 1981.
. Jail House Blues. Orchard Lake, Michigan: Epic
Publications, 1973.
Danto, B., J. Eubank, and D. Walter. Suicide in Jail and Its Prevention.
Madison, Wisconsin: University of Wisconsin, 1980.
DeHeer, D.H. and H.S. Schweitzer. “Suicide in Jail: A Comparison of Two
Groups of Suicidal Inmates to Jail Suicide Victims.” Corrective and
Social Psychiatry and Journal of Behavioral Technology Methods and
Therapy, 31(3), July, 1985, pp. 71-76.
DeNoon, KS. B.C. Corrections, A Study of Suicides, 1970-1980. British
Columbia, Canada: British Columbia Corrections, 1983.
Embert, P. “Correctional Law and Jails.” In D. Kalinich and J. Klofas,
Sneaking Inmates Down the Alley. Springfield, Illinois: Charles C.
Thomas Publishers, 1980.
Esparza, R. “Attempted and Committed Suicide in County Jails.” In B.
Danto, Jail House Blues, 1973, pp. 27-46.
Farberow, N. Bibliography on Suicide and Suicide Prevention: 1897-1957 and
1958-1970. Rockville, Maryland: National Institute of Mental Health,
1972.
Fawcett, J. and B. Marrs. “Suicide at the County Jail.” In B. Danto, Jail House
Blues, 1973, pp. 83-106.
Federal Bureau of Prisons. Unusual Prisoners in the Jails. U.S. Department
of Justice: No Date.
Finnerty,.J.P. Suicide Prevention in Correctional Facilities. New York State
Sheriffs’ Association Institute, Inc., No Date.
Flaherty, M. An Assessment of the National Incidence of Juvenile Suicides
in Adult Jails, Lockups, and Juvenile Detention Centers. Champaign,
Illinois: Community Research Forum, August, 1980.
French, L. “Rage, Marginality and Suicide Among Forensic Patients.”
Corrective and Social Psychiatry and Journal of Behavioral Technology
Methods and Therapy, 28(3), 1982, pp. 7480.
French, L. and J.B. Porter. “Jail Crisis - Causes and Control.” In W. Taylor
and M. Breswell (Eds), Issues in Police and Criminal Psychology,
Lanham, Maryland: University Press of America, 1978.
Gibbs, J. Stress and Self-Injury in Jail. Unpublished Doctoral Dissertation,
State University of New York at Albany, -1978.
. “Psychological and Behavioral Pathology in Jails: A
Review of the Literature.” Paper presented at the Special National
Workshop on Mental Health Services in Local Jails, Baltimore,
Maryland, September 27-29,1978.
Goffman, E. Asylums. Garden City, New York: Anchor Books, 1961.
Goldfarb, R Jails: The Ultimate Ghetto of the Criminal Justice System.
Garden City, New York: Anchor Press/Doubleday, 1975.
Haley, M.W. Aberrant Behavior and Health Care Services in Local Jails.
Madison, Wisconsin: Wisconsin Department of Health and Social
Services, 1981.
Hardyman, P.L. The Ultimate Escape: Suicide in Ohio’s Jails and Temporary
Detention Facilities, 1980-1982. Columbus, Ohio: Ohio Bureau of
Adult Detention Facilities and Services, March, 1983.
Harris, K. Jail Suicides in Los Angeles County: July I, 1977 Through June
30, 1987. Los Angeles, California: Department of Chief Medical
Examiner-Coroner. 1987.
Hatty, S. and S, Walker. A National Study of Deaths in Australian Prisons.
Phillip, Australia: Australian Institute of Criminology, 1986.
Haviland, L.S. and B.I. Larew. “Dying in Jail - The Phenomenon of
Adolescent Suicide in Correctional Facilities.” Children and Youth
Services Review, 1980, pp. 331-342.
Hayes, L. “National Study of Jail Suicides: Seven Years Later.” Psychiatric
Quarterly, Forthcoming, Fall, 1988.
“And Darkness Closes In. . .A National Study of Jail
Suicides.” Criminal Justice and Behavior, 10(4), December, 1983,
pp. 461-484.
“Jail Suicide Prevention Information Task Force.” Jail
Suicide Update. Winter, 1986-1987.
.
“Litigation.” Jail Suicide Update. Spring, 1987.
.
“Training.” Jail Suicide Update. Summer, 1987.
“National Study of Jail Suicides:
Jail Suicide Update, Winter, 1987-1988.
Seven Years Later.”
Hayes, L. and J. Rowan. National Study of Jail Suicides: Seven Years Later.
Alexandria, Virginia: National Center on Institutions and
Alternatives, February, 1988.
Hayes, L. and B. Kajdan. And Darkness Closes In. . .A National Study of Jail
Suicides. Final Report to the National Institute of Corrections.
Washington, D.C.: National Center on Institutions and Alternatives,
October, 1981.
Heilig, S. “Suicide in Jails: A Preliminary Study in Los Angeles County.” In
B. Danto, Jail House Blues, 1973, pp. 47-56.
Henry, A. and J. Short, Jr. Suicide and Homicide: Some Economic
Sociological and Psychological Aspects of Aggression. Glencoe, Illinois:
The Free Press, 1954.
Hess, A. “The Self-Imposed Death Sentence.” Psychology Today, June, 1987,
pp. 51-53.
Hogarth, D.J. Suffolk County Jail Lifeline: Manual of Suicide Prevention.
Boston, Massachusetts: Suffolk County Jail Lifeline Group, 1980.
Hopes, B. and R. Shaull. “Jail Suicide Prevention: Effective Programs Can
Save Lives.” Corrections Today, December, 1986, pp. 64-70.
Hudson, P. and J.D. Butts. “Jail and Prison Deaths: A Five Year Statewide
Survey of 223 Deaths in Police Custody. North Carolina, 1972-1976.”
Popular Government, Spring, 1979.
Institutions, Etc. “Jail Suicides: Almost One A Day.” 4(l), 1981, pp. 17-18.
Jenkins, R.L., P.H. Heidemann, and S. Powell. “Risk and Prevention of
Suicide in Residential Treatment of Adolescents.” Juvenile and
Family Court Journal, 33(2), May, 1982, pp. 11-16.
Kalinich, D. and P. Embert. The Fatal Chain of Events: Suicide Prevention in
Jails and Lockups, Detention Homes, and Other Secure Facilities, East
Lansing, Michigan: Ker and Associates, 1987.
Katzenstein, M. Suicide Prevention and Detention Program: Baltimore City
Jail. Baltimore, Maryland: Baltimore City Jail, 1980.
Kennedy, D.B. “Theory of Suicide While in Police Custody.” Journal of
Police Science and Administration, 12(2), June, 1984, pp. 191-200.
Kimme Planning and Architecture. The Nature of Small Jails: Report and
Analysis. Champaign, Illinois: October, 1985.
Kovacs, M., A.J. Beck, and A. Weissman. “Alcoholism, Hopelessness and
Suicidal Behavior.” Journal for the Study of Alcohol, 37, 1976, pp.
66-77.
Levinson, W. ‘The Need for Screening, Medical and Psychiatric Treatment
and Alternatives Within Our Jails: An Analysis of the Data.”
Unpublished Paper, August, 1986.
Loeffelholz, P. “Cellhouse Observation Protocol.” Iowa Medical and
Classification Center Health Services Manual, Des Moines, Iowa:
Department of Corrections, 1987.
Malcolm, B. J. “Today’s Problems in Penology.” New York State Journal of
Medicine, 75(10), 1975, pp. 1812-1814.
Martin, S. Prison Suicide Study. Interdepartmental Memorandum. New
York: New York City Health Services Administration; 1971.
Mattick, H. “The Contemporary Jails of the United States.” In D. Glaser,
Handbook of Criminology, New York: Rand McNally, 1974.
Memory, J: Jail Suicides in South Carolina: 1978-1984. Columbia, South
Carolina: Office of the Governor, Division of Public Safety Programs,
1984.
McInturff, H. and S. Band. “The Complete Investigator.” FBI Law
Enforcement Bulletin, September, 1985.
Michigan Department of Corrections. Jail Suicides 1980-1983. Lansing,
Michigan: 1983.
Miller, R. (Ed.) “Prisoner Suicide - Caselaw and Standards.” Detention
Reporter, 30, April, 1986, pp. 3-14.
“Prisoner Suicide - Research and Literature.”
Detention Reporter, 31, May, 1986, pp. 3-14.
“Prisoner Suicide - Assessing the Operational/
Physical Setting.” Detention Reporter, 32, June, 1986, pp. 1-16.
.
“Prisoner Suicide - Prescriptions for Prevention.”
Detention Reporter, 33, July, 1986, pp. 3-12.
.
“CCTV - Closed Circuit TV.” Detention Reporter, 23,
September, 1985, p. 3.
Nagle, B.N. “Considerations in Constructing or Renovating Police Facilities.”
FBI Law Enforcement Bulletin, April, 1977, pp. 9-15.
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of County and Local Jails. Washington, D.C.: 1981.
National Commission on Correctional Health Care. Standards for Health
Services in Jails. Chicago, Illinois: January, 1987.
.
Receiving Screening for Medical Emergencies and
Potential Suicides. Chicago, Illinois: 1982.
National Sheriffs’ Association. The State Of Our Nation’s Jails. Alexandria,
Virginia: 1980.
1980.
. Jail Officer’s Training Manual. Alexandria, Virginia:
National Institute of Corrections. Suicide in Jails. Boulder, Colorado: Library
Information Specialists, Inc., December, 1983.
New York City Board of Correction. Prison Suicide - Report and Urgent
Recommendations for Action. New York, New York: 1972.
State Office of Mental Health, New York State Commission of Correction,
Ulster County Community Mental Health Services, and Division of
Criminal Justice Services - Bureau of Municipal Police. The New
York State Local Forensic Suicide Prevention Crisis Service Model Policy and Procedural Guideline Manual for County Correctional
Facilities. Albany, New York, March: 1986.
.
The New York State Local Forensic Suicide
Prevention Crisis Service Model - Policy and Procedural Guideline
Manual for Mental Health Programs. Albany, New York: , March, 1986.
The New York State Local Forensic Suicide
Prevention Crisis Service Model - Policy and Procedural Guideline
Manual for Police Lockup Facilities. Albany, New York: March, 1986.
.
Suicide Prevention and Crisis Intervention in County
Jails and Police Lock-ups - Trainer’s Manual. Albany, New York:
March, 1986.
Nielsen, E. “Suicidal Behavior in Jail: A Preventive Approach.” Crisis
Intervention, 11(l), 1980, pp. 19-27.
North Dakota Combined Law Enforcement Council. “Suicidal Behavior in
Jails.” North Dakota Correctional Officers Training Manual, Part II,
June, 1981.
Novick, L. and E. Remmlinger. “A Study of 128 Deaths in New York City
Correctional Facilities (1971-1976): Implications for Prisoner Health
Care.” Medical Care, 16(9), 1978, pp. 749-756.
Postill, F. and J. Gallagher. “A New Approach for the Prevention of
&e-Arraignment Suicide.” Issues in Correctional Training and
Casework, Richmond, Kentucky: Eastern Kentucky University,
Department of Correctional Services, October, 1987, pp. 26-30.
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Psychiatry, 24 June, 1981, pp. 532-535.
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. Preventing Suicides in Police Lockups: Training Key
#376. Gaithersburg, Maryland: International Association of Chiefs of
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.
Curriculum on Professionalization of Correctional
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.
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. Jail Inmates 1986. Washington, D.C.: Bureau of
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1986.
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and Incarceration Phenomenon.” Mental Health Education for Police,
Jail and Mental Health Professionals, Richmond, Virginia, June, 1986,
Chapter VII.
Whittleton, J. Suicide Intervention. South Carolina Criminal Justice
Academy, Columbia, South Carolina, No Date.
Wicks, R.J. “Suicide Prevention - A Brief for Correctional Officers.” Federal
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VIDEOTAPES
National Sheriffs’ Association. Suicide: The Silent Signals. Alexandria,
Virginia, 1985.
New York State Office of Mental Health, Commission of Correction, Ulster
County Community Mental Health Services, and Division of Criminal
Justice Services - Bureau of Municipal Police. Suicide Prevention
Screening Guidelines. Albany, New York, 1986.
Police Video Network and Television. 720 Deadly Seconds: A Countdown to
Tragedy. Pontiac, Michigan, 1987.
