Suicide Prevention for Inmates "If you are going to tolerate a few deaths in your correctional system, then you've already lost the battle." - Commander, Orange County Jail MCC New York Special Housing Unit EFTA00036447

Why Should I Care? Isn't this _ a Psychology Program'? • An inmate suicide represents major liability exposure of the agency and in some cases, staff could be held personally liable for the death. EFTA00036448

Suicide Statistics FY 2012 of • Numb• er Suicides — 29 • Number of Attempts — 1,304 • Number of Suicide Watches — 2,595 • Locations — SHU (9), GP (17), FMC (2), Other (1) Of these 29 suicides 62% had a history of mental illness, 31% had a history of a sex offense and 5% were on p• rotective custody status ("I • EFTA00036449

Suicide Prevention Program P.S. 5324.08 • All Staff need to read and be familiar with this policy. Nobody can say one suicide is no big deal, it can't be helped, but when it happens it puts a microscope on your area and the institution. EFTA00036450

Suicide Prevention Program • No such thing as a bad referral. During day watch refer to Psychology. Non-duty hours to on-call psychologist. Report any inmate that you feel may be suicidal or that you have other mental health concerns about. Make sure your officers are similarly trained to make referrals. If you refer and the inmate dies, that is on psychology. If you don't refer and the inmate dies, that is on correctional services. EFTA00036451

Suicide Prevention Program • All staff are required to attend annual refresher training on suicide prevention during ART. SHU officers are required to have suicide prevention training in SHU quarterly. This is ordinarily done by psych services adding the information to the SHU post orders. The officers meet this policy requirement when they read and sign the post orders. EFTA00036452

Suicide Prevention Program Watches — Call the Operations Lieutenant immediately and notify Psychology staff if concerns are present. Any Shift Lieutenant can put on a watch during emergency or non- duty hours. While policy allows any staff to place an inmate on watch, the intent is that this call will generally be reserved for shift LT. Some institutions preference is to sit the inmate down where shift LT can observe until on call psych shows up. Only Psychology can terminate the watch. EFTA00036453

Suicide Prevention Program • If inmate companions are used, staff should provide two checks during an 8 hour shift. Initial log (critical for liability). • Maintain the integrity of the watch. Strip search the inmate going in and out of watch. Search the cell before the inmate is placed in the suicide watch cell. Only those things authorized by Psychology are allowed in the cell — everything else out. EFTA00036454

Suicide Prevention Program What's New? • Psychology will provide SHU (copy to Correctional Services, Health Services, and Unit Team) a list of inmates (Hot List) with mental health conditions who may become dangerous, self-destructive, or suicidal when placed in SHU. The list will be updated as needed. • When a `hot list' inmate is placed in SHU, Correctional Services supervisor shall notify Psychology immediately. EFTA00036455

Historically High Risk Groups • Pre-Trial Prisoners • Mentally Ill • Inmates Who Voluntarily PC • Low Security Inmates — Poor Adjustment with Sudden Loss of Relationship EFTA00036456

Suicide Watch • The Warden decides if the watch will be conducted using inmate observers or staff. It is based upon a recommendation by psych and depends on the level of acting out expected by the inmate. • Why constant visual supervision? We use constant observation to prevent an inmate from killing themselves. An inmate committed suicide while on watch at MDC Los Angeles. He drowned himself in his toilet while the inmate observer when back to his cell to use the restroom (10-15 minutes). • Do you think that an inmate can kill themselves under constant observation? Inmate at Seagoville cut a hole in his mattress cover and cut his wrist. He slid his arm inside the cover so the observer could not see the blood. One drop of blood dripped through on to floor, the observer saw it and summoned help. • Why 15 minute log entries? So psych can monitor inmate behavior, sleeping, eating taking meds, etc. EFTA00036457

Challenging Inmates... Tough for Everyone! • Psychology realizes that inmates who try to manipulate the system are really problematic for Correctional Services. • No matter how many times you have reported it in the past... If an inmate makes a statement about suicide, or makes gestures that indicate they are trying to make you think they will commit suicide, go ahead and report it. • The danger with them is that they can unintentionally kill themselves if the officer doesn't walk by or make that round at the expected time. EFTA00036458

What is Your Role? Your Example is critical! • Communicate and work closely with psychology • You set the example — if all staff think suicide prevention is important and they emphasize it with others then all staff will respond EFTA00036459

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