Why Are There More Suicides In Jails Than In Prisons?

Why Are There More Suicides In Jails Than In Prisons?

Suicide prevention of  inmates has been the main focus of my job for the last five years. It is such an important topic because in the United States suicide is the leading cause of death to inmates in jail.

This gets little attention because when most people think about inmates committing suicides, they tend to think about inmates in prison and for obvious reasons:

  • Prisons are usually bigger and overcrowded
  • Inmates in prison are usually there for more violent/serious crimes than inmates in jail
  • Inmate in prison are usually serving longer sentences, sometimes life sentences

While those reasons are valid points, the facts are that inmates in jail are more at risk of suicide than inmates in prison. This is important to know because family members are often shocked when their jailed loved one commits suicide often before they have even been to trial.

One reason jails have a higher suicide rate (46 per 100,000) than prisons (15 per 100,00) is that people who enter jail often face a first-time “shock of confinement” situation. They are suddenly removed from their daily lives, their support system, stripped of their job, housing, and basic sense of normalcy.

Also for some there is the fear of the unknown and perceived lack of control over the future that causes extreme anxiety and depression. They’re not sure how long they will be incarcerated or if their loved ones will stand by them. That isolation from their family and significant others can cause tremendous anguish for many inmates.

Many have a distrust of an authoritarian environment. They may fear for their safety, of being assaulted physically and/or sexually.  The living conditions and perceived dehumanizing aspects of incarceration are also difficult for many inmates to accumulate to. Some have to strip search in front of officers, are housed with inmates they would never associate with in the outside world and have to deal with the sleeping, showering and using the bathroom in not so private settings.

Depending on the person and the crime, many inmates experience a great sense of shame about being incarcerated. I have met doctors, law enforcement officers, pastors and prominent members of society who got arrested for everything from domestic violence, DUI to child molestation and stalking charges. They all had a very hard time dealing with not only being in jail, but with the affects it had on their social status.

Jails Usually Don’t Know Who They Are Getting

Jails get people right out of their personal lives, meaning that they get severe alcoholics and drug addicts who end up going through excruciating detoxes that sometimes end with them taking their own lives. They get chronically mentally ill individuals who may be off their medication or highly suicidal. They get people in the middle of a divorce or custody battle that they can’t fight from behind bars. Jail staff may not have a clue about these issues until the inmate starts exhibiting symptoms or attempts suicide.

Because jails are getting people right off the streets, they face a higher risk of inmates dying from drug and alcohol related complications as well.

By the time these inmates are sent to prison, the prison staff already have a detailed history of the inmate from the jail. Inmates have been detoxed and ideally mentally ill inmates have been stabilized on medication.  Also, inmates usually have acclimated to being incarcerated and come to terms with what’s ahead for them.

Many inmates who commit suicide do so before they have even been convicted. They’ve already thought of the worse case scenarios, i.e., “My wife is going to leave me”; “I’m going to get beat to death by other inmates”; “I’m gong to get raped”; “I’m going to prison forever” and decided that death was the better alternative.

The rise of inmate suicides is also partially due to the increased number of mentally ill inmates being jailed. Jails have become the new de facto mental health institutions, but they simply are not equipped to handle inmates with serious mental illnesses and other behavioral factors. These inmates are not only at a higher risk of committing suicide, but are at higher risk of being assaulted, raped and taking advantage of by other inmates. They are also more likely to end up in disciplinary confinement situations due to their behavior and lack of understand or following rules. 

It is equally unfair to severely mentally ill inmates and corrections officers who aren’t adequately trained to deal with them.

Educating jail staff on recognizing signs and symptoms of mental health problems to include signs that an inmate may be suicidal is invaluable. Also, addressing a jail culture that may be toxic or conducive to worsening mental health symptoms and increasing the likelihood that an inmate will attempt suicide is crucial.

Unfortunately I’ve had to deal with numerous inmate suicides and attempted suicides.  We never want to lose an inmate to an untimely death, especially one that could have been avoided, no matter if it’s an assault, a medical condition or suicide.

chart

Overcoming Suffering While Incarcerated

Overcoming Suffering While Incarcerated

Working in a correctional setting, I often find myself reciting my favorite quote by Viktor Frankl; “To live is to suffer. To survive is to find meaning in the suffering.” The reason this quote appears to have such relevance when dealing with incarcerated people is that many of them see themselves as suffering. They are imprisoned, away from their families and often facing uncertain futures. Many become depressed, anxious, hopeless and unfortunately, suicidal.

When  I speak with inmates who see themselves and their situation as depressing and bleak, I remind them that yes, they may feel like they are suffering, but that is life. A large part of life for most people includes a great deal of suffering. There is joy, and there is pain. I remind them that they are not the only ones suffering. They are incarcerated with hundreds of other individuals going through similar situations and millions of people around the world who are going through their own struggles.

I encourage them to accept the reality of it. Learn from it. Figure out how to use this suffering to become a better, stronger person instead of dwelling on it and allowing it to punish you even more.

There is a popular saying in prisons that goes, “Do time, don’t let time do you”, which means to use your time incarcerated to better yourself, to live life even in the bleakest circumstances and to not just be miserable and unhappy counting down the months, years or even decades until you are released (if ever). Have something to look forward to and remember that suffering doesn’t have to last forever. This situation doesn’t have to be permanent. People find ways to live good, happy lives even while imprisoned for life.

I ask every inmate I evaluate, “What do you have to live for? What are you looking forward to?”  I want to know what will motivate them to not only survive the stressful environment of being in incarcerated, but also what will give them something to hold on to when they start struggling with depressing and negative thoughts.

Many will say they have kids to live for, or they’re young and have their whole lives ahead of them, or their family or goals they want to accomplish. These individuals tend to be much less likely to both get in more trouble while incarcerated as well as are less likely to attempt suicide compared to those who struggle with or can’t find a reason to live.

Lastly, I also try to help inmates to stop seeing themselves as victims. Many inmates think that they are being punished unjustly, or they keep getting arrested because they have bad luck. They blame the system, their friends, society. These inmates are more likely to deal with depression, suicidal thoughts and to become repeat offenders.

Instead, I try to help them see that things happen for them, not to them. Yes they got arrested and it sucks, but maybe this is going to save their lives by getting them off drugs, stop them from associated with that criminal element, teach them that they really do need anger management classes or that they really need to take their psychotropic medications. Hopefully this experience will help them reexamine their lives and make better choices.

When people see things as happening for them, instead of to them, they do time better, easier and even happier. They become inmate workers, earn GEDs and even college degrees while incarcerated. They tend not to look like the typical depressed, angry, bitter inmates that I encounter far to often.

The things I try to teach these inmates are invaluable to helping them survive being incarcerated and they can use it when they are released to hopefully live better lives and to not come back. It can also help all of us understand that we’re not special, things happen, life sometimes sucks, don’t take it personal, don’t dwell on it, learn from it and grow from it. It’s when we get stuck feeling down, victimized, hopeless, worthless and negative that we stop fully living life and start suffering though life. That’s when we start living in a prison of our own construction regardless of if we are incarcerated or not.

Finding Purpose: The Difference 5 Years Can Make

When I worked at an inner city high school, my main goals were to prevent teenagers from getting into trouble, dropping out of school, producing children and hopefully to give them tools they can use to become successful adults.

It wasn’t always easy. At times it was frustrating and even disappointing, but I showed up each day motivated and inspired.

Many of the teenagers were like I was when I was their age; lost, unmotivated and trying to figure out where I fit in. I had no one to talk to or guide me. I wanted to be that person for them.

There were times we cried together, we laughed together, even got angry with each other.

We cried over the sudden death of parents, the shooting deaths of cousins and friends, even a couple of suicides. We laughed because sometimes we had to laugh to keep from crying. We got angry with each other because I challenged them and in return they challenged me.

There were disappointments as well. Students I worked so hard with and who made so many improvements fell victim to peer pressure and ended up in trouble. Some dropped out of school, some got kicked out school.

One school year, five of the girls in my program got pregnant and I blamed myself for not protecting them better. Four of the five ended up dropping out of high school. It took my mentor at the time to remind me that I am not responsible for other people’s actions although I felt completely responsible at the time.

Mostly there were successes.

Students that were on the verge of dropping out or getting kicked out of school actually graduated. Students who had gotten a reputation as bad kids learned to control themselves and were no longer getting disciplined left and right. Other students that were labeled emotionally disturbed learned to control their emotions and behaviors. Some of the toughest, most defiant teenagers ended up being positive leaders of their class.

It was the best and most rewarding job I ever had because despite the stress and frustration that came with trying to motivate teenagers deemed unable to be motivated, there were so many emotional rewards.

I saw students who never thought about going to college asking me for help with college applications.  Young men who once preferred to steal from others asking for help with job applications. Teenagers who so many thought had no future, were actively thinking about, planning and taking positive actions towards their future.

Fast forward some short years and I now work at a corrections facility. I have the same stress as I did working in the high school, only without the emotional rewards. Instead I deal with adults and juveniles who are where I was trying to prevent the kids I worked with from going.

In the jail the population I deal with is mostly those who have or claim to have a mental illness. Unfortunately most of them are manipulators and sociopaths. They don’t really want to change and most of them won’t. They want to use the system and society to get whatever it is that they want and will lie, cheat, steal and even kill to get it.

Of course there are those with severe mental illnesses. Some of them I feel should be in a treatment center and not in jail. There are homeless people that I feel like never should have been arrested in the first place. Those people I understand. Those people I will work hard for every minute of every day.

Sadly, 90% of the people I deal with are sociopaths. They will pretend to be mentally ill if it will prevent them from being housed in a certain area of the jail, make the judge or their family feel sorry for them or possibly reduce their sentences. They are not mentally ill.

It’s frustrating because I feel like part of my job is to help people realize they can change for the better. Most of these people don’t want to change. They want to get out of jail so they can go back to robbing, stealing, smoking meth and being the type of person you wouldn’t want to have to deal with.

I’m talking about child abusers, child molesters and murderers who either sit across from me crying, wanting me to feel sorry for them as if they were the ones victimized, or they couldn’t care less because they’ve already been institutionalized and going to prison for 10 or 20 years doesn’t mean anything to them.

Last week I sat across from a man who is accused of murdering his ex-girlfriend and mother of his child with an axe and all he could do was cry about his stomach hurting and the poor medical attention he feels like he’s receiving. I was disgusted, but of course I couldn’t say or show that so I just listened to him complain.

My main job is to prevent inmates from committing suicide and to offer mental health treatment to the mentally ill. My job is not to necessarily treat or expect anyone to get better. We don’t do counseling here at the jail because most people are only here for about 45 days before getting released or sent to prison and most people here don’t want counseling.

While to some degree that should be less stressful, it’s actually more frustrating because I like to consider myself an agent of change and would like to see people evolve into better versions of themselves.

Working in a psychiatric setting, I saw patients get better and get released. Working in the high school, I saw teenagers grow and change into capable young adults. Working in the jail, dealing with adults who have been in and out of the system most of their lives and juveniles who have already succumbed to the thought that they will be criminals for the rest of their lives, I don’t get to see much if any change.

Sure, I would like to think I have saved some lives here. I would like to think that I have reached some people and they will go back out into the community and be responsible. I don’t really know how much of that is true. I would prefer to be able to say that I’ve cut down on the number of people being re-incarcerated, or increased the number of people who got out and got jobs, got off of drugs or did something to be a positive citizen.

Sometimes I still think about the students I worked with over the years and hope none of them ever have to experience being incarcerated, but I know some of them have because  I ran into one of my students here, 2 years later, an adult, incarcerated for stealing a car and running from the police.

I was disappointed. Not even at him, but at myself because I had worked with him so hard to prevent this. I had to once again remind myself that I am not responsible for other people. I just really hope I planted a big enough seed in the others that I will never have to come across any of them again behind bars.

So if I look happier and healthier in the other picture, it’s because I was. I felt like I was making a difference and actually saw the fruits of my labor. Sure the pay was horrible, but at the end of the day I usually left with a genuine smile on my face.

You do have to create meaning and purpose in your life and that goes with your job as well. You can’t just do a job for the money because if you lose the job, you lose the money and what would it all have been for? So I do look forward to coming to work to make sure that no one kills themselves because of lack of mental health treatment; to make sure that those who need mental health services are receiving them and that I’m educating anyone I can on mental health so that they will understand when a mentally ill inmate is actively hallucinating or in a psychotic state, that it is not just an act.

I always say that only 10% of the people I deal with in jail are truly mentally ill and the other 90% are faking in order to gain sympathy or favor. It’s that 10% that give my work purpose.

The Mentally Ill and Incarceration: A Broken System

The Mentally Ill and Incarceration: A Broken System

Working in a jail or prison is like working in a large mental health hospital, without all the necessary trained staff needed to actually run effectively.

As a matter of fact, the biggest mental health providers in our nation right now are our jails. The three biggest mental-health providers in the nation today are: the Cook County Jail in Chicago, the Los Angeles County Jail and Rikers Island jail in New York.

These are no places for people who are severely and chronically mentally ill.

Decades ago when there were plenty of beds in state hospitals, the most severely ill were often locked away in asylums and forgotten in order to “keep society safe”. Often times they were locked away and offered no real help and suffered horrible conditions and treatment.

Today jails and prisons have become the new asylums.

The mentally ill often get into trouble due to their illness. Often the crimes are as harmless as sleeping on a park bench, trespassing or having an open container of alcohol. Rarely are they violent offenses.

A 2010 study by the Treatment Advocacy Center and the National Sheriffs’ Association estimated that 40 percent of the seriously mentally ill have been in jail or prison at least once in their lives.

In the county jail I work in I would say about 75% have some sort of mental illness while about 10% have a severe mental illness that should be treated at a psychiatric facility and not in jail.

Most jails and prisons, like us are understaffed. We currently have four full mental health professionals including myself and a psychiatrist. Ideally, we’d have at least three or four more but there’s not enough funding.

Many corrections officers are under trained when it comes to dealing with the mentally ill and the overall outlook of mentally ill inmates on both medical and security staff in jails and prisons is not usually conducive to effective treatment. Especially for the severely and chronically mentally ill who are often in and out of jail.

Like the young lady I met earlier this week. She’s a 38 year old woman who came up in the foster care system. She had came from an abusive and neglectful family and it’s unclear if the abuse and neglect caused her mental illness or if she was abused and neglected because of it. Either way, starting at a young age she suffered almost every kind of horrible abuse you can imagine.

As an adult she has been arrested over 20 times for everything from possession of cocaine, parole violations and battery.

In 2001 she was arrested for aggravated battery after she attacked and kicked a state hospital guard who ended up suffering a heart attack and dying.

In 2003 she was arrested after two men reported they had unprotected sex with her without knowing she was HIV positive. She later told authorities she knew she had HIV since 1999 and didn’t tell any of the at least 200 men she claims to have had unprotected sex with. She plead guilty and served 23 months.

She continues to cycle between being on the streets, going to jail, the state hospital and prison.

Often times no one wants to take her (the state nor DCF) because she is so mentally ill and has grown more and more violent.

When she came into our jail there was a big push to get her out and back to some place that could manage her better.She’s trapped in a system that in some ways may have helped create her and doesn’t want anything to do with her.

In many ways she has been abandoned since she was a child and as an adult who is now nearing the end stages of AIDS, she is still alone and abandoned.

Continuing to incarcerate the mentally ill over and over again doesn’t work. It doesn’t help anyone. We lock them up where they may or may not get treatment and then send them back out on the street where they may or may not get treatment.

What’s the solution?

We need more state and federal funding for mental health, reform treatment laws to address intervention, assisted outpatient treatment for released mentally ill inmates, expansion of mental health courts that offer treatment instead of incarceration and ideally a health care system that provides systematic health care for those suffering from a mental illness.

If we can find a way and the money to build a wall between between the United States and Mexico, surely we can do this!

 

 

 

 

Sitting Down With A Killer: Impressions On Interviewing A Psychopath

Today I sat face to with a man who had killed three people and tried to have a fourth person killed, a real psychopath. This wasn’t some disturbed person who lost his mind and killed three people in one violent, rage filled act. This was a man who killed his friends’ girlfriend, then still remained friends with the guy while he grieved over his dead girlfriend. Fast forward three years later, while still friends with the guy, he decides to not only kill him, but also to kill his new girlfriend.

Finally arrested for the murders, from behind bars he tries to elicit the help of another inmate to kill a key witness to the last two murders. This man has no remorse. No real feelings. He’s currently facing two life sentences with yet more charges coming. He is barely 30 and will spend the rest of his life in prison.

psychopathySitting across from me in a big empty room, un-handcuffed, unshackled and unguarded (the nearest officer is two flights of stairs below), this man who is covered in multiple tattoos, some gang related, one reading, American Nightmare, has a very cold disposition. It’s in his frozen eyes and the way he talks as if he couldn’t care less about anything or anyone in the world that reminds me that I am in the room with a man who pretty much has nothing to lose.

I can’t explain the feeling. It’s not fear I feel when he tells me I am asking too many dumb questions, or when he leans in with an attitude of authority as if he were the one in charge of this interview. It’s not even nervousness that I feel, but an awareness that I am in the room with a three time killer, who wouldn’t hesitate to make it four, or five. It’s like being in a room where a poisonous snake is being kept. You’re not necessarily always checking to make sure it’s still there, but you’re always aware of it and its potential to get loose. As he stated, “My life is over, although I am still alive. I’ve had many family and friends die in prison. There is nothing you can say to me.”

And he was right. There wasn’t anything I could say to him to make him “feel better”.  Often times I get called to speak to inmates who get sentenced to long sentences including life. Most of them are already mentally prepared for it, or at least think they are. Very few show any real emotions. Even fewer show any real remorse. A handful become suicidal. A very few even attempt suicide.

This guy’s advice to me when talking to inmates facing lengthy sentences was pretty spot on; “Don’t talk too much, just listen. Don’t ask too many questions. Don’t ask, ‘is there anything I can do for you?’”

In the real world, only 1% of the population meets criteria to qualify as true psychopaths, but in jails and prisons, that number jumps to 15%. I’ve talked to multiple killers before, some who have killed on accident, who killed on purpose, who killed out of anger, who killed out of greed, who killed out of jealous, who killed out of impulse and some who killed for apparently no reason at all, but none were as electrifying or showed such lack of empathy as this guy.

Here was a guy who killed his friend’s girlfriend, then stayed friends with the guy only to kill him and his new girlfriend three years later. The lack of empathy, manipulation and callousness it took to look his friend in the face day in and day out, knowing that he was the one that killed his last girlfriend is frightening.

During the hour I spent talking with this guy today I learned more about dealing with psychopaths than I could have by reading a 300 page book or taking a 9 week college course . It’s terribly fascinating.