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NCCHC Jail Commander Conversations:

Suicide Prevention

This Jail Commander Conver- NCCHC Sample Observations • The officers who monitor
sations document is an easy-to- non-acutely suicidal inmates
use tool that gives commanders Observations related to suicide stagger their monitoring,
an in-depth look at frequently prevention however, it was common for
missed standards. This tool helps • No evidence of acute monitoring the monitoring to extend past
commanders have conversations for more than six months. Logs the 15-minute maximum time
with the health care team about were blank. period. We observed times
their health care operations. • The facility policy correctly when there was more than an
mandates the proper intervals hour between monitoring.
Purpose of Suicide Prevention between checks while monitor-
and Intervention ing non-acutely suicidal inmates. Potential Contributing Factors
The purpose of the Suicide However, the logs reviewed • There was no suicide preven-
Prevention and Intervention indicated a significant number of tion and intervention policy or
standard is to help prevent checks are completed at precise process.
suicides by implementing pre- 15-minute intervals, rather than • Understaffing, which did not
vention efforts and interventions staggered intervals not exceeding allow for constant watch of
for high-risk inmates. 15 minutes. acutely suicidal inmates.
• We reviewed eight logs of non- • Failure to assign clear respon-
Why Is This Important? acute suicide observation, and sibility to conduct suicide
Survey findings related to sui- noted that there were three large watches.
cide prevention and intervention blocks of time where no checks • Failure to conduct periodic
continue to be some of the most were recorded. Some of those checks of logs to ensure
frequently scored standards and blocks of time exceeded two custody following policy for
compliance indicators. Suicide is hours. suicidal inmates.
an inmate safety issue. Although • Acutely suicidal inmates were
suicides are unpredictable events, monitored via camera, although • Custody unclear of procedure
a suicide prevention program is the officer assigned to watch for acutely suicidal inmates
important in reducing the risk the camera was the only officer under contact watch and non-
for suicide during incarceration, assigned to the entire housing acutely suicidal inmates under
which saves lives and decreases unit, so that constant monitoring staggered watch.
litigation. was not accomplished. • CQI study on suicide was
As you know, suicide is a • When reviewing logs, we could nicely written including the
threat to all persons involved in not determine what type of mon- reasons for multiple suicides,
corrections. The rates of inmate itoring the inmate was assigned however the implementa-
suicide are far higher than the (either staggered or constant) tion of plans and follow-up
national averages, and even so the survey team was unable were not done and/or not
higher still for special popula- to see if requirements were met documented.
tions (including juvenile and for constant watch or staggered • A psychological autopsy was
LGBTI inmates). One reason intervals. not performed on all deaths
why jails have a higher suicide • Actively suicidal inmates are by suicide within 30 days or
rate (46 per 100,000 in 2013) than not removed from their cell and shared with key personnel.
prisons (15 per 100,000) is that placed on constant watch while
people who enter a jail often face awaiting a mental health evalu-
a first-time “shock of confine- ation. Those on close watch are Checklist for self-assessment
ment”; they are stripped of their not monitored at staggered inter- on next page.
job, housing, and basic sense of vals, and we observed watch logs
normalcy. Many commit suicide that were blank even though the
before they have been convicted CO told us that the inmate was
at all).
on watch.

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