suicide prevention training - mother jones...suicide resistant cells bureau of justice statistics...
TRANSCRIPT
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U.S. Marshals Service Suicide Prevention Training
Suicide Prevention Training
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Presenters
Robert Nagle, Psy.D. Federal Bureau of Prisons National Suicide Prevention Coordinator
Claudia Hill-Bickham, B.S. Correctional Subject Matter Expert Correctional Management and Communications Group
Theo Anderson, M.A./MBA
Chief, Detention Standards and Compliance
Headquarters United States Marshals Service Prisoner Operations Division
Anita Pollard, Capt, USPHS, M.S.B/RN
National Institute of Corrections
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Overview
Psychology of Suicidal Prisoners
Suicide Resistant
Cells
Bureau of justice Statistics and
Analysis
National Resources
& Information
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Robert Nagle
Robert Nagle, Psy.D. Federal Bureau of Prisons National Suicide Prevention Coordinator
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Robert Nagle
“Homo sapiens are relational creatures; we live in family units, tribes, villages,
and cities…Most suicides can almost always be linked to interpersonal issues.” (Jobes in Flemons & Grolnick)
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At – Risk Groups
Inmates: 1. in pre-trial status.
2. experiencing a mental illness, including a
personality disorder.
3. in restrictive housing units (i.e., Special Housing Unit, Special Management Unit, mental health seclusion, and Secure Treatment Programs).
4. convicted of a sex offense.
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Vulnerability Prison Setting
Vulnerability Prison Setting
SITUATIONAL TRIGGERS Break up of relationship, bad news
Visit does not happen Threats, bullying, debts
Sleeplessness Disciplinary Sanctions
Transfers Unexpected Sentence
Peer suicides or attempts Increase in any prison stress
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Why Death by Suicide Now?
Why Death by Suicide Now?
• Suicidal crises usually emerge from problems with relationships
• Something or someone has touched on the inmates sensitivity (i.e., perceived rejection, frustrated need, breakup)
• Usually a perceived rejection or slight by a person playing a significant role in their life
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Precipitants of Self-Injury
Exploiting a Vulnerability
• Violence & intimidation from other
prisoners
• A sense of helplessness
• Role minimization and/or deprivation
• Grief when family are experiencing
social problems
• Cumulative impact of limited privacy
& autonomy over ones daily routine
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Single Cell
Suicides in secure units occur in single cells
Double Cell all inmates unless there is a compelling reason not to do so
Place at-risk inmates in higher visibility cells
Reduce or eliminate the presence of tie-off points
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Private Spaces
• Suicides most frequently occur in
private spaces such as bathrooms,
showers, mop closets, or cells.
• Important prevention measures
include frequent rounds, not allowing
inmates to cover windows, and
establishing professional and
meaningful relationships.
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WARNING SIGNS Specific to Inmates
WARNING SIGNS Specific to Inmates
• Suicidal threat anytime
• Rehearsal behaviors observed by staff
• Trying to obtain a single cell
• Hording medication
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Four Basic Responses
Four Basic Responses
1. LISTEN and HEAR
2. Take thoughts and feelings seriously.
3. Support and affirm.
4. Refer to Psychologist, medical professional, or shift
supervisor.
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Four Staff Responsibilities
Four Staff Responsibilities
1. Recognize warning signs that tell us inmates may be experiencing problems.
2. Communicate concern and empathy to the behavior and take appropriate actions.
3. Respond correctly to those problems.
4. Follow-up and monitor inmates who have been identified and treated.
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Summary (Robert Nagle)
Summary (Robert Nagel)
Each of us has important Responsibilities with Suicidal Inmates:
Consider the inner world of these inmates and communicate concern and empathy for their distress.
Recognize when conditions for a suicide “perfect storm” exist (vulnerability, prison induced stress, situational triggers).
Respond correctly to the behavior.
Follow-up on and monitor inmates who have been identified and referred.
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Claudia Hill-Bickham
Claudia Hill-Bickham, B.S. Correctional Subject Matter Expert Correctional Management and Communications Group
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Overview of Suicides in Correctional Facilities
Statistics of Suicide
Who, When and How
Jail Suicides
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Suicide Statistics – Who?
Suicide Statistics – Who?
• 93% male
• 67% white (*15.1% Black / 12.1% Hispanic)
• Average age: 35
• 38% had a history of mental illness (*40% History Psychotropic Medication)
• 34% had a history of suicidal behavior (*43% Held on violent charges)
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Suicide Statistics – When?
Suicide Statistics – When?
• 31% found dead 1 hour+ after last observation
• 24% occurred within first 24 hours
• 27% between 2 - 14 days
• 20% between 1 - 4 months
• 8% were on suicide watch
• Evenly distributed throughout the year
(seasons & holidays did not contribute to more suicides)
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Suicide Statistics – How?
Suicide Statistics – How?
• 93% used hanging as the method
• 66% used bedding materials as the instrument • 30% used bed/bunk as the anchoring device • Other anchoring devices: door hinge/knob, air vent, window
frame, towel hook, shelf, shelf, seat, plumbing fixture, sprinkler head, light fixture
• 2nd most popular method is drug overdose
• Drug hoarding • Cleaning chemicals
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Facility and Gender Comparisons
Facility and Gender Comparisons So how do jails compare against other detention or prison facilities with the number of inmate suicides.
• The first graphs compares suicides the number of suicides committed by men and women with in the community in the
United States. The overall number in light blue represents 11 suicides per 100k persons.
• Men have a higher rate than women at 18 suicides per 100k as compared to women at 4 per 100k.
• The State prisons did not separate data for men and women but revealed a rate of 14 suicides per 100k.
• In Federal prisons the rate was the same for males and females at 10 per 100k.
• In Jails the suicide rate is 36 per 100k.
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Jail Suicide Rates over past 35 Years
A National Institutes of Corrections study in 1986 revealed there were 107 Jail suicides per 100k. In 2002 a Bureau of Justice and
Statistics study revealed the rate had fallen to 47 Jail suicides per 100k; The most current Bureau of Justice
and Statistics as of 2006 reveal a continued decline reflecting 36 Jail suicides per 100k.
Overall the data reveals jails have
experienced a 50% decline over a 20 year period in the jail suicide rate for prisoner populations over 100k.
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Theo Anderson
Theo Anderson, M.A./MBA
Chief, Detention Standards and Compliance
Headquarters United States Marshals Service Prisoner Operations Division
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Prevention Through Operations and Training
Keep Sight Lines Open
Lighting Control CO’s control Cell lighting NOT the
prisoner!
Frequent Checks
Jail Suicides
• Attention • Training • National Standards • Policies and Procedures • Accountability • Supervision • Litigation
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Prevention Through Operations and Training
Increased awareness & assessment of the threat of a suicide… comprehensive suicide screening at intake. Increased communication and observation by CO’s assigned to housing units… Find out what’s going on.
Facility policies, procedures and post orders should clearly include suicide prevention guidance.
Staff supervision with regular 15 minute bed checks with documentation in daily logs or via electronic data keeping.
the use of privacy obstruction devices (towels, clothing or anything that blocks the full view at all times into a cell.
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Operational Practices
Operational Practices
“Institutionalize” suicide prevention and response practices.
Training when coupled with suicide-resistant cells reduces the opportunity and capability for suicide; Together they will still not
100% fully protect residents/inmates from self-harm.
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Self Harm Cells with Casual Observation
Can you see into the entire cell?
from the normal working position?
w/o removing a window cover ?
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Self Harm Prevention Cells & Option
Know the rules and guidance for use of Self Restraint Chairs and Tie Down Beds! -
- ----- -~BACK - NEXT..-
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Managing the Environment
Know your Surroundings!
• • • • • •
~ ~ • • • • • •
- ,....---------- -~BACK - NEXT..-
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Eliminating the Anchoring Point
Doors
Light Fixtures
Vents and Grills
Shelves &
Accessories
Windows
Showers
Plumbing
Sprinkler Heads
Bunks
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Camera Enclosures
Eliminate Anchoring Points - .------------.. ..--... .. BACK - NEXT.._
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Light Fixtures
Eliminate Anchoring Points ..:==:=. ~ .-.
_.BACK - NEXT._
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Vents & Grilles
Eliminate Anchoring Points
Vents Should Have:
3/16” or Smaller Openings
(1/8” Preferred)
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Plumbing Fixtures
Eliminate Anchoring Points
SAFER LESS SAFE
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Showers
Eliminate Anchoring Points
LESS SAFE SAFER
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Sprinkler Heads
Eliminate Anchoring Points
SAFER LESS SAFE
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Doors & Hardware
Eliminate Anchoring Points
LESS SAFE
NOTE: Cell Doors should swing
OUT!
SAFER
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Detention Windows
Eliminate Anchoring Points
SAFER LESS SAFE
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Detention Beds
Eliminate Anchoring Points
SAFER LESS SAFE
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Cell Shelving
Eliminate Anchoring Points
SAFER LESS SAFE
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Cell Accessories
Eliminate Anchoring Points
SAFER LESS SAFE
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Other Considerations
111111 I I · 1111111
l
I'
-· ----11
\.'
~
NEXT._
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Questions?
Questions?