Prisoner suicide

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Prisoner suicide is suicide by an inmate in a jail or prison.

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Risk factors

Signs that a prisoner may be at risk of suicide include giving away valued possessions, speaking as if they are not going to be around much longer even though they are not scheduled for release, withdrawing, becoming acutely intoxicated, having a recent history of severe addiction, being threatened or assaulted by other prisoners, having a history of psychiatric hospitalizations or suicide attempts, talking about death, having recently been arrested for an offense punishable by a long sentence or actually sentenced to a lengthy term, or having impulse-control problems. Prisoners who have recently received bad news from home or are demonstrating an inability to adapt to the institutional environment may also be at higher risk.

Prisoners with illnesses are at higher risk of suicide. Prisoners with AIDS have a suicide rate between 16 and 36 times higher than that of the general population. [1]

Objective tests such as the Beck Depression Inventory are of limited usefulness because a malingerer may fake signs of being suicidal, while a prisoner who does not want to be stopped from committing suicide may hide signs of being suicidal.

Incidence

Suicides in prison compared to the general population (Council of Europe members, average 2011-15) .mw-parser-output .legend{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .legend-color{display:inline-block;min-width:1.25em;height:1.25em;line-height:1.25;margin:1px 0;text-align:center;border:1px solid black;background-color:transparent;color:black}.mw-parser-output .legend-text{} Suicide rate in the general population, per 100,000 people per year Suicide rate in prison, per 100,000 inmates per year Suicides in prison compared to the general population (Europe, 2011-2015).svg
Suicides in prison compared to the general population (Council of Europe members, average 2011–15)
  Suicide rate in the general population, per 100,000 people per year
  Suicide rate in prison, per 100,000 inmates per year

In some European countries such as France, Belgium and Norway, the suicide rate among prisoners is ten times as high as among the general population, [2] but it is unknown whether this is because of the prison environment or because persons with marked suicidal tendencies are more liable to be imprisoned for crime. The apparent motivations for prison suicide are most commonly fear of other inmates, of the consequences of one's crime, or imprisonment, and the loss of a significant relationship. [3] Suicides occur most commonly in isolation cells. The most common time for suicides to occur is in the early morning hours. [4] Suicidal inmates are sometimes put on suicide watch and/or placed in special cells with no furniture or objects with which they could harm themselves. [5]

A study in New York found that 41% of prison suicides involved inmates who had recently received mental health services, [6] although only one-third of prison suicides are found to have a psychiatric history, as opposed to 80–90 percent of suicides in the general community. [3] Pretrial detainees tend to have higher rates of suicide than other inmates, with about a third of all prison suicides occurring within the first week of custody. [3] Custodial suicide is the leading cause of death among detainees housed in jails. [7]

According to data by the Council of Europe, in the Balkans the suicide rate in prisons is lower than in the rest of Europe: between 2011 and 2015 there were on average 53 cases of suicide each year for every 100,000 prisoners in the Balkans, and 87 in the rest of Europe. This may be explained by the fact that in Balkan countries the incarceration rate is relatively high – so the prisons are not populated by people that are particularly vulnerable – and the use of preventive detention is rather low. [2]

The World Health Organization (WHO) has criticised the fact that the rate of suicide in Norwegian prisons is one of the highest in Europe. [8]

Liability

In the United States, liability can arise under 42 U.S.C.   § 1983 and the Eighth Amendment to the United States Constitution if jail and prison officials demonstrate deliberate indifference toward a prisoner's suicidal tendencies, as suicidal inmates are regarded as being in need of medical care. [9] [10] In Farmer v. Brennan , deliberate indifference was established as a standard between negligence and acting with purpose or intent, thus amounting basically to recklessness. The Farmer decision has created difficulties for plaintiffs in proving suicide liability as a violation of constitutionally established civil rights. [11] The burden of proof appears to be higher than in malpractice cases. [12] Case law provides that liability only exists if prison officials had subjective knowledge of (or at least willful blindness to) an inmate's serious medical need. I.e., they cannot be held liable if they merely should have known, but did not actually know. [13]

Mere negligence is not enough for there to be a constitutional violation. The federal courts seldom allow recovery based on section 1983 absent extreme instances of deliberate indifference to a suicidal prisoner or a clear pattern of general indifference to suicidal inmates. There has to have been a strong likelihood rather than a mere possibility that a suicide would occur. Courts have also found that there is no duty to screen every prisoner for suicide potential, unless it is obvious that an inmate has such tendencies or propensities. Further, even if prison officials are aware of the inmate's suicidal tendencies and he does commit suicide, they are not liable if they took reasonable actions to prevent the suicide. In determining deliberate indifference, the practical limitations on jailers in preventing inmate suicides must be taken into account.

Examples of failures that can give rise to claims related to suicide in correctional settings include inadequate mental health and psychiatric examination, [14] failure to consider obvious and substantial risk factors in assessing potential for suicide, [15] failure to place an inmate on suicide precautions upon recognizing the obvious and substantial risk, failure to communicate the action taken to other providers [16] or to custody and jail staff, failure to adequately monitor an inmate on suicide watch and maintain an appropriate observation log, discontinuation of suicide watch despite prior knowledge of suicidal behavior of the inmate and potential continued risk, failure to follow policies and procedures related to suicide risk assessment, intervention, and prevention, failure to provide training to correctional staff, abrupt discontinuation of psychotropics in an inmate who is known to have made a serious suicide attempt in the recent past, and grossly inadequate treatment by professional standards or the lack of treatment plans, policies, procedures, or staff, creating a grossly inadequate mental health care system, and repeated examples of delayed or denied medical treatment.

One criticism of the current case law is that prison officials are incentivized to avoid screening inmates for suicidal tendencies, because if the screening is ineffective, or the jail fails to deter the suicidal attempt of a prisoner it knows is suicidal, the governmental entity and the jailer may be at greater risk of being held liable than if they had conducted no screening. Nonetheless, some jails screen anyway, since jail suicides are difficult on staff and on the municipality and often lead to legal action, and because some states mandate screening procedures and impose tort liability for failure to follow them. Elected officials may face political ramifications if they become the scapegoat for a prisoner suicide. [17]

Another factor that has led to more screening of inmates for suicide is that research has shown that suicide tends to be the result of a plan rather than impulsive, which makes the suicide potentially more foreseeable if proper screening is done. [18]

See also

Related Research Articles

<span class="mw-page-title-main">Self-harm</span> Intentional injury to ones body

Self-harm is intentional conduct that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury, and self-mutilation have been used for any self-harming behavior regardless of suicidal intent. Common forms of self-harm include damaging the skin with a sharp object or by scratching, hitting, or burning. The exact bounds of self-harm are imprecise, but generally exclude tissue damage that occurs as an unintended side-effect of eating disorders or substance abuse, as well as societally acceptable body modification such as tattoos and piercings.

<span class="mw-page-title-main">Solitary confinement</span> Strict form of imprisonment

Solitary confinement is a form of imprisonment in which an incarcerated person lives in a single cell with little or no contact with other people. It is a punitive tool used within the prison system to discipline or separate incarcerated individuals who are considered to be security risks to other incarcerated individuals or prison staff, as well as those who violate facility rules or are deemed disruptive. However, it can also be used as protective custody for incarcerated individuals whose safety is threatened by other prisoners. This is employed to separate them from the general prison population and prevent injury or death.

<span class="mw-page-title-main">Incarceration in the United States</span> Form of punishment in United States law

Incarceration in the United States is one of the primary means of punishment for crime in the United States. In 2023, over five million people were under supervision by the criminal justice system, with nearly two million people incarcerated in state or federal prisons and local jails. The United States has the largest known prison population in the world, it has 5% of the world’s population, and 20% of the world’s incarcerated persons. China, with four times more inhabitants, has fewer persons in prison. Prison populations grew dramatically beginning in the 1970s, but began a decline around 2009, dropping 25% by year-end 2021.

<span class="mw-page-title-main">Recidivism</span> Person repeating an undesirable behavior following punishment

Recidivism is the act of a person repeating an undesirable behavior after they have experienced negative consequences of that behavior, or have been trained to extinguish it. Recidivism is also used to refer to the percentage of former prisoners who are rearrested for a similar offense.

Prison rape commonly refers to the rape of inmates in prison by other inmates or prison staff. In 2001, Human Rights Watch estimated that at least 4.3 million inmates had been raped while incarcerated in the United States. A United States Department of Justice report, Sexual Victimization in Prisons and Jails Reported by Inmates, states that "In 2011–12, an estimated 4.0% of state and federal prison inmates and 3.2% of jail inmates reported experiencing one or more incidents of sexual victimization by another inmate or facility staff in the past 12 months or since admission to the facility, if less than 12 months." However, advocates dispute the accuracy of the numbers, saying they seem to under-report the real numbers of sexual assaults in prison, especially among juveniles.

<span class="mw-page-title-main">Prisoner abuse</span> Mistreatment of imprisoned people by authorities

Prisoner abuse is the mistreatment of persons while they are under arrest or incarcerated. Prisoner abuse can include physical abuse, psychological abuse, sexual abuse, torture, or other acts such as refusal of essential medication, and it can be perpetuated by either fellow inmates or prison faculty.

<span class="mw-page-title-main">Suicide prevention</span> Collective efforts to reduce the incidence of suicide

Suicide prevention is a collection of efforts to reduce the risk of suicide. Suicide is often preventable, and the efforts to prevent it may occur at the individual, relationship, community, and society level. Suicide is a serious public health problem that can have long-lasting effects on individuals, families, and communities. Preventing suicide requires strategies at all levels of society. This includes prevention and protective strategies for individuals, families, and communities. Suicide can be prevented by learning the warning signs, promoting prevention and resilience, and committing to social change.

Suicide watch is an intensive monitoring process used to ensure that any person cannot attempt suicide. Usually the term is used in reference to inmates or patients in a prison, hospital, psychiatric hospital or military base. People are placed on suicide watch when it is believed that they exhibit warning signs indicating that they may be at risk of committing bodily harm or purposefully killing themselves.

<span class="mw-page-title-main">Suicidal ideation</span> Thoughts, ideas, or ruminations about the possibility of ending ones life

Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life events without the presence of a mental disorder.

Suicide risk assessment is a process of estimating the likelihood for a person to attempt or die by suicide. The goal of a thorough risk assessment is to learn about the circumstances of an individual person with regard to suicide, including warning signs, risk factors, and protective factors. Risk for suicide is re-evaluated throughout the course of care to assess the patient's response to personal situational changes and clinical interventions. Accurate and defensible risk assessment requires a clinician to integrate a clinical judgment with the latest evidence-based practice, although accurate prediction of low base rate events, such as suicide, is inherently difficult and prone to false positives.

Estelle v. Gamble, 429 U.S. 97 (1976), was a case in which the Supreme Court of the United States established the standard of what a prisoner must plead in order to claim a violation of Eighth Amendment rights under 42 U.S.C. § 1983. Specifically, the Court held that a prisoner must allege acts or omissions sufficiently harmful to evidence deliberate indifference to serious medical needs. Though the Court credited Gamble's complaint that doctors had failed to provide appropriate care, it held that medical malpractice did not rise to the level of "cruel and unusual punishment" simply because the victim is a prisoner.

<span class="mw-page-title-main">HM Prison Chelmsford</span> Prison in Essex, England

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<span class="mw-page-title-main">LGBT people in prison</span> Lesbian, gay, bisexual, transgender and queer people in prison

Lesbian, gay, bisexual, transgender and queer (LGBTQ) people face difficulties in prison such as increased vulnerability to sexual assault, other kinds of violence, and trouble accessing necessary medical care. While much of the available data on LGBTQ inmates comes from the United States, Amnesty International maintains records of known incidents internationally in which LGBTQ prisoners and those perceived to be lesbian, gay, bisexual or transgender have suffered torture, ill-treatment and violence at the hands of fellow inmates as well as prison officials.

Farmer v. Brennan, 511 U.S. 825 (1994), was a case in which the Supreme Court of the United States ruled that a prison official's "deliberate indifference" to a substantial risk of serious harm to an inmate violates the cruel and unusual punishment clause of the Eighth Amendment. Farmer built on two previous Supreme Court decisions addressing prison conditions, Estelle v. Gamble and Wilson v. Seiter. The decision marked the first time the Supreme Court directly addressed sexual assault in prisons.

Infectious diseases within American correctional settings are a concern within the public health sector. The corrections population is susceptible to infectious diseases through exposure to blood and other bodily fluids, drug injection, poor health care, prison overcrowding, demographics, security issues, lack of community support for rehabilitation programs, and high-risk behaviors. The spread of infectious diseases, such as HIV and other sexually transmitted infections, hepatitis C (HCV), hepatitis B (HBV), and tuberculosis, result largely from needle-sharing, drug use, and consensual and non-consensual sex among prisoners. HIV and hepatitis C need specific attention because of the specific public health concerns and issues they raise.

<span class="mw-page-title-main">Incarceration of women in the United States</span> Topic page on incarceration of women

The incarceration of women in the United States refers to the imprisonment of women in both prisons and jails in the United States. There are approximately 219,000 incarcerated women in the US according to a November 2018 report by the Prison Policy Initiative, and the rate of incarceration of women in the United States is at a historic and global high, with 133 women in correctional facilities per every 100,000 female citizens. The United States is home to just 4% of the world's female population, yet the US is responsible for 33% of the entire world's incarcerated female population. The steep rise in the population of incarcerated women in the US is linked to the complex history of the war on drugs and the US's prison–industrial complex, which lead to mass incarceration among many demographics, but had particularly dramatic impacts on women and especially women of color. However, women made up only 10.4% of the US prison and jail population, as of 2015.

People with mental illnesses are over-represented in jail and prison populations in the United States relative to the general population.

Women in American prisons encounter numerous difficulties that often involve mental health problems, drug and alcohol issues, and trauma. These challenges not only make navigating the criminal justice system more difficult for women but also highlights broader societal issues such as, gender-based violence, economic inequalities, and lack of mental health support. People in prison are more likely than the general United States population to have received a mental disorder diagnosis, and women in prison have higher rates of mental illness and mental health treatment than do men in prison. Furthermore, women in prisons are three times more likely than the general population to report poor physical and mental health. Women are the fastest growing demographic of the United States prison population. As of 2019, there are about 222,500 women incarcerated in state and federal prisons in the United States. Women comprise roughly 8% of all inmates in the United States. This surge is largely attributed to the rising use of imprisonment for drug-related offenses rather than violent crimes. A considerable portion of incarcerated women are serving time for drug-related offenses, with the proportion increasing significantly between 1986 and 1991. Even among those in maximum security facilities, a majority are not imprisoned for violent felonies. The data also reveal that in states like New York, a substantial proportion of incarcerated women are serving time for drug-related offenses, with a smaller percentage incarcerated for violent crimes or property offenses.

<span class="mw-page-title-main">Correctional nursing</span> Nursing for prisoners

Correctional nursing or forensic nursing is nursing as it relates to prisoners. Nurses are required in prisons, jails, and detention centers; their job is to provide physical and mental healthcare for detainees and inmates. In these correctional settings, nurses are the primary healthcare providers. These nurses also work with crime victims and assist in expert witness testimonies, and are involved in a variety of legal cases, including paternity disputes and workplace injuries.

<span class="mw-page-title-main">Health of prisoners in Australia</span>

Health care of prisoners in Australia is a major concern to prison institutions around Australia with prison populations increasing in both numbers and rate with an imprisonment rate of 187.3 per 100,000 adults.

References

  1. ↑ CORREIA, KEVIN M. Suicide Assessment in a Prison Environment A Proposed Protocol. Criminal justice and behavior. (10/2000), 27 (5), p. 581–99.
  2. 1 2 3 Ferrari, Lorenzo (14 May 2018). "Why are there relatively fewer suicides in prison in the Balkans than elsewhere in Europe?". OBC Transeuropa/EDJNet. Retrieved 22 August 2018.
  3. 1 2 3 Alison Liebling (1999). "Prison Suicide and Prisoner Coping". Crime and Justice. 26 (Prisons). The University of Chicago Press: 283–359. doi:10.1086/449299. JSTOR   1147688. S2CID   144805322.
  4. ↑ Dennis Schimmel; Jerry Sullivan; Dave Mrad (1989). "Suicide Prevention" (PDF). Federal Prisons. 1 (1): 20. Archived from the original (PDF) on 2 December 2010. Retrieved 13 June 2010.
  5. ↑ "Walling up madness". Prison Insider. 14 April 2022. Retrieved 14 May 2024.
  6. ↑ BB Way; R Miraglia; DA Sawyer; R Beer (2005), "Factors related to suicide in New York state prisons", International Journal, vol. 28, no. 3, pp. 207–221, doi:10.1016/j.ijlp.2004.09.003, PMID   15950281
  7. ↑ O'Leary, William D. Custodial suicide: Evolving liability considerations. Psychiatric quarterly. (1989), 60 (1), p. 31 – 71
  8. ↑ Orange, Richard (13 December 2023). "EXPLAINED: How different is the Norwegian prison system really?". The Local Norway. Retrieved 7 March 2024.
  9. ↑ Roberts v. City of Troy, 773F. 2d720 (Court of Appeals, 6th Circuit1985).
  10. ↑ Greason v. Kemp, 891F.2d829 (11th Cir.1990).
  11. ↑ Hanser, Robert D. Inmate Suicide in Prisons: An Analysis of Legal Liability under 42 USC Section 1983. The Prison journal (Philadelphia, Pa.). (12/2002), 82 (4), p. 459 – 477
  12. ↑ Daniel, Anasseril E. Suicide-Related Litigation in Jails and Prisons: Risk Management Strategies. Journal of correctional health care. (01/2009), 15 (1), p. 19 – 27.
  13. ↑ http://scholar.valpo.edu/cgi/viewcontent.cgi?article=1258%5B%5D
  14. ↑ Comstock v. McCrary,273F.3d693(6th Cir.2001).; Steele v. Shah,87F.3d1266(11th Cir.1996).
  15. ↑ Williams v. Mehra,186F.3d686(6th Cir.1999)).
  16. ↑ Woodward v. Myres (2000)
  17. ↑ Franks, George J The conundrum of federal jail suicide case law under section 1983 and its double bind for jail administrators.. Law & psychology review. (22 March 1993), 17 p. 117 – 133
  18. ↑ Smith, April R. Revisiting impulsivity in suicide: Implications for civil liability of third parties. Behavioral sciences & the law. (11/2008), 26 (6), p. 779 – 797.
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