After Bland died, her family and friends questioned whether she had really ended her own life. She was about to start a new job, had recently
rekindled her relationship with her mother, and seemed optimistic about the future. Why would she kill herself? The idea was “unfathomable,” her sister
toldreporters.
Suicide has been the leading cause of death in jails in every year since 2000, according to the latest Justice Department data. This is not the case in prisons, where inmates are more likely to die of cancer, heart and liver disease. There’s a reason for this difference. People land in jail right after they’ve been arrested. They’re often angry, desperate or afraid. They may be intoxicated or have psychiatric conditions that officers have no way of knowing about.
The experts we spoke with emphasized that entering jail is an instantly dehumanizing process. “You get clothes that don't fit you, you get strip-searched, you lose any semblance of privacy, you don't get to make many decisions that we all take for granted,” said Jeffrey Metzner, a psychiatrist at the University of Colorado in Denver who specializes in inmate mental health. “I don’t think most of us realize just how frightening that experience is,” added Steve J. Martin, a corrections expert who is monitoring reforms at Rikers Island Correctional Facility in New York City. “You have a total and absolute loss—immediate loss—of control over your being, over your physical being.”
Under these circumstances, people can deteriorate at an alarming speed. About two weeks after Bland's death, 20-year-old Brissa Lopez was arrested for allegedly fighting with her boyfriend, and arrived at a Texas jail around 4:47 a.m. She was “very cooperative” and “chuckled as she removed her tongue and lip ring,” according to a sergeant who admitted her. Staff checked on her at 6:15 a.m. Some 40 minutes later, she was found hanging from a fire alarm cage by a bedsheet.
Brian Schnirel was arrested by deputies in Palm Beach, Florida, for failing to appear in court for a DUI. After two days, he was found hanging from a shower vent. Catherine Rowell, an unemployed housekeeper, was arrested because she allegedly violated a protection order by being at her boyfriend's house. Three days later, she hanged herself with a metal braided phone cord.
In its last annual report on jail deaths the Justice Department found that 40 percent of the inmates who died in 2013, or 387 people, had been behind bars for a week or less. One-quarter of the suicides in our data occurred within the first three days. (This number should be considered low, since we have not yet obtained a cause of death for 237 cases.)
There are several distinct groups of people who can be at risk when they arrive in jail. There are those charged with violent crimes and sex offenses, who may fear long prison sentences or being targeted behind bars. Another group occupies the opposite end of the spectrum entirely—people who have been arrested for very minor offenses. We identified dozens of suicides of jail inmates who were arrested on low-level offenses such as public intoxication, drug possession, trespassing, traffic charges, DUI and theft.
Then there are those who have become enmeshed in a cycle of short jail stints because they can’t pay fines for minor violations or afford to post bond. (This is a particular hazard for minorities; research has
found that black Americans between the ages of 18 and 29 receive significantly higher bail than other racial groups, for example.) Bland herself had some knowledge of this cycle. While unemployed, she had racked up thousands of dollars in fines and fees in connection with traffic charges. Her lawyer believed he could get a 2010 marijuana charge dropped,
according to The Nation, but Bland couldn't afford to pay him, so she spent nearly a month in a Houston jail.
Although Alberto Petrolino was arrested after his ex-girlfriend called 911 to report that he was suicidal, he wasn't placed on suicide watch, his family said. He hanged himself within 72 hours of arriving in jail.
When someone’s existence is already precarious, even a short jail stint can seem like a catastrophe. People may fear that they will lose a job, or a relationship, or a home, or be unable to care for a child. These feelings are often amplified by other risk factors—drug and alcohol withdrawal, disrupted prescription medications, lack of basic medical or mental health care.
In March 2011, Donyale Thomas, a 32-year-old mother living on a fixed income in Berkeley, Missouri, arrived in the city’s three-cell lockup. At the time, Berkeley, like nearby Ferguson and many surrounding cities in St. Louis County,
relied heavily on fines and fees for revenue, and Thomas owed hundreds of dollars in municipal code violations. She is part of a lawsuit in which she says she was kept in the Ferguson jail for a week over outstanding tickets and denied access to medicine for her bipolar disorder and schizophrenia.
In the Berkeley jail, Thomas soon started to feel “like an animal,” she recalled. She was placed in a windowless cell with two bunk beds. “I wasn’t able to bathe or anything or take care of my hygiene. I wasn’t able to see my kids. There were like three or four women in the cell. Pads were laying around the cells,” she recalled. “My mind started going in other routes and started thinking all opposite things and crazy things.” After a while, she said, “It gets to the point where you think, ‘OK, I just want to find my way out of this.’”
Thomas said she told guards she was suicidal and they took away her blanket. A dispatcher was instructed to keep an eye on her via closed-circuit video. But Thomas had a backup plan. “I still had my bra on. So that’s what I ripped up and tied up there,” she said. Thomas’ cellmate alerted the guards, who reached her before she asphyxiated.
Frank McCall, the Berkeley police chief, argued that Thomas never really meant to kill herself. Her cell, he said, had “enough room where if they want to get up and pace the room, she could’ve paced the room three, four, five steps one way and back and forth.” He added that his officers weren’t aware of Thomas’ mental health issues: “We don’t know what she really has going on,” as he put it. But McCall believes Thomas’ real intent “was to get out of jail.” After the guards found her, they took her to hospital, where she was admitted for psychiatric evaluation. The doctors deemed her “not fit for confinement.”
811 total deaths
31 percent died by suicide. (253 people)
There were 201 suicides where we know
the number of days the prisoner was in jail.
51 percent of those suicides took place
within seven days. (103 people)
26 percent took place within
three days. (53 people)
SINCE SANDRA: JAIL DEATHS FROM JULY 13, 2015-JULY 13, 2016
This infographic shows the 811 deaths that occurred in jails between July 13, 2015 and July 13, 2016, according to Huffington Post reporting. The "suicides" category also includes apparent suicides—deaths where evidence strongly indicated suicide, but for which we could not obtain a definitive source like a coroner's report. Because we did not obtain cause of death in 237 cases, the number of suicides is likely higher.
In 1982,
fewer than half of jails reported doing even cursory medical screening of new inmates. Back then, the suicide rate was much higher—
107 per 100,000 inmates in 1986. Jails took some steps over the following decades to address this, and the suicide rate dropped almost threefold between 1986 and 2006, according to one study. And yet today, even though all inmates should ideally go through a screening process that includes access to mental health and medical professionals, those procedures aren’t always adequate or followed correctly. Due to this and other factors, in 2013, the suicide rate in jail was more than three times that of the
general population.
In many facilities, the first person to interview an inmate is an officer who is often poorly paid and sometimes minimally trained. He or she may have to make vital decisions about a person’s risk of self-harm and whether to call for additional mental health help. During the screening, jails may also take into account outside information from family members, the arresting officer and other sources.
But sometimes jails appear to miss even the most glaring warning signs. Alberto Carlos Petrolino, a 50-year-old chef and artist, was arrested last July, after his ex-girlfriend called 911 to report that he planned to kill himself on the Golden Gate Bridge, according to a lawsuit filed by the family. Petrolino's family contacted the jail to warn staff that he might try to take his own life, the lawsuit states; his mother was so worried that she took a bus to the jail, said Petrolino's son, Fabio. And yet Petrolino wasn’t treated by a doctor or placed in specialized housing for suicidal inmates, the family claimed. Within 72 hours of his arrival, Petrolino had hanged himself in a shower. (The San Francisco City Attorney's office did not respond to a request for comment.)
In other cases, the clues are less obvious. A person could be considered a suicide risk if he has harmed himself in the past, is worried about losing a job or partner, feels hopeless, suffers from drug withdrawal, or is visibly upset. In Bland's case, jail staff
did not take into consideration her reference to a
suicide attempt earlier in the year. “That's unfortunately what happens in a lot of jails that don't do a very good job,” said Lindsay Hayes, a national expert on jail suicide prevention. “They're only really listening for one answer: Are you suicidal now?”
In March, the Burkburnett Police Department in Texas arrested 22-year-old Marcus Johnson for possession of a fake ID. When he was booked into the police lockup, he told officers he had attempted suicide three times, including a few weeks earlier. He explained to the screening officer that he had depression and bipolar disorder and had previously been institutionalized. However, Johnson shook his head when asked whether he was currently suicidal and wasn’t put on suicide watch—even though his mother called the jail and told an officer her son urgently needed his psychiatric medication.
At one point, an officer checked in on Johnson and found him crying. No one came back to check on him for just over two hours, during which time he hanged himself with the drawstring of his pants. Michael Whaley, the Burkburnett city manager, said the police department is evaluating its policies as a result of the incident. Two officers involved were disciplined with a one-day suspension and a letter of reprimand, respectively.
In other cases, officers fail to notice signs that an inmate is experiencing drug or alcohol withdrawal, which could pose a suicide risk. Usually if someone is high or intoxicated, “their presentation is not subtle,” said Pablo Stewart, a psychiatrist who has served as an expert witness in corrections cases. “Come on, open your goddamn eyes, smell the guy—he's reeking of alcohol, look at his arms, he has track marks, look at his pupils...make a diagnosis,” he added.
Jason Johnston. (Photo: Cody Johnston)
In April 2015, Jason Johnston and his girlfriend were arrested for allegedly stealing between $500 and $1,500 worth of items from a Walmart Supercenter in Westworth Village, Texas. Johnston had a history of obsessive-compulsive disorder, attention deficit disorder and depression. He self-medicated with hydrocodone, turned to heroin because it was cheaper, and was using every day by the time he was arrested, said his brother, Cody.
Johnston was sent to a small lockup run by the Westworth Village Police Department. An officer who helped arrest him also did his mental health screening. He observed that Johnston "appeared to be nervous and upset," and was worried about his girlfriend. When Johnston couldn’t come up with around $190 for his bond, he became distraught.
Still, the officer did not list Johnston at risk for suicide or drug withdrawal, and placed him in a sparse cell alone. Westworth staffers weren’t required to check on inmates in person, an officer and a detective said when questioned later. Instead, the dispatcher was meant to monitor him over a surveillance camera once an hour. Johnston paced around his cell and chalked a note to his girlfriend on the ceiling. In a subsequent statement, the dispatcher did not mention the moment when he walked to the phone on the wall and tried to wrap its cord around his neck. Nor did she note seeing him remove the drawstring from his red athletic shorts.
She checked the camera around 4 p.m., and again at least an hour later. The second time, Johnston was hanging from his top bunk by the drawstring. He was later found to have opiates, hydromorphone, hydrocodone and morphine in his system. His brother was walking out of a baseball game when his father called to say that Jason was dead. “I didn't know my brother had been in jail,” Cody Johnston said. (The Westworth Village Police Department declined comment through their attorney.)
Jails with fewer than 50 inmates have a suicide rate five times higher than larger jails, according to a 2002 Justice Department study. Jonathan Smith, the former chief of the DOJ’s Special Litigation Section, said small police-run jails simply aren’t equipped to confine human beings. “In order to insure that [inmates] get adequate medical care and nutrition and are protected from violence and what have you, you can’t have a 10-person jail and do that in a meaningful way,” Smith said.
And yet all the experts we interviewed agreed that suicides are highly preventable in a controlled environment like a jail. “People often say, ‘Well, if somebody wants to kill themselves, they’re going to kill themselves,’” said
Margo Schlanger, a law professor at the University of Michigan who specializes in criminal justice. “That’s false. If you run a jail with an appropriate degree of suicide prevention, you get almost zero.”
The jail in Brazos County, Texas, which has around 650 inmates, has had only one completed suicide in the past 10 years, according to Kit Wright, a sergeant and nurse at the county sheriff's office. The county makes an effort to keep people with mental health issues out of jail: Last year, crisis intervention officers diverted 214 people to mental health facilities instead of charging them with a crime. And the jail employs another noteworthy tactic. After being screened by an officer, inmates go through a separate interview with a nurse. In this second conversation, inmates tend to be more open about things like drug use and mental health history. People will “answer one way to someone in uniform, and different to someone in scrubs,” Wright said.
Not every jurisdiction can afford around-the-clock medical coverage. But there are plenty of effective suicide-prevention strategies available, many of them surprisingly low-tech. “If you talk to any of the experts in the field, they will tell you that we know how to stop people from committing suicide in jail,” said Samuel Bagenstos, who formerly held the second-highest position in the DOJ’s Civil Rights Division. “You need to do decent screening of people as they come into jail, and you need to put people in places where it’s not easy for them to kill themselves. At some level, it’s not really rocket science.”
An officer who arrests someone shouldn’t do the mental health screening, Hayes said. Interviewing inmates in private makes it more likely that they’ll answer truthfully. He recommends that staffers have, at a minimum, eight hours of training on suicide prevention so they understand how to assess an inmate's actions and history. They also need clear instructions on when to call for medical or mental health personnel.
Getting the screening process right is crucial, because there is no way to make a cell suicide-proof. (The preferred term in the correctional industry is “suicide-resistant,” which means ensuring that cells don't have clothing hooks, corded phones, exposed sprinkler heads, laundry bag strings or mattresses that can be easily ripped.) As Raymond Patterson, a psychiatrist who has worked as a court monitor in corrections cases, explained, an inmate who’s determined enough could “run across the cell and jam [his] head into the door.”
What does make a profound difference, Patterson said, is when officers interact with inmates and pass relevant information to mental health staff. “How about you talk to him?” Patterson suggested. “And you ask him questions like: 'How are you? What's going on in your life?'” It can take
as little as five minutes for death to occur by strangulation, so people who are at high risk of suicide need to be under continuous watch. That means in-person contact, not watching remotely via a surveillance camera. (The Texas Commission on Jail Standards, for example, bans camera-only observation.) People at lower risk should be monitored in person at least every 15 minutes, at staggered intervals, Hayes said.
Before he died, Jason Johnston scrawled a note to his girlfriend on the ceiling of the cell. (Photo: Tarrant County Sheriff's Office)
Ultimately, though, the most difficult challenge is not figuring out how to prevent inmates from harming themselves. It’s compelling the jails to change the way they do things. Jail systems, for the most part, are “reactive, not pro-active,” Hayes said. They tend to change their policies only after there are multiple suicides in a short period, which can draw negative media attention and lawsuits.
At the beginning of the Obama administration, Tom Perez, the incoming chief of the DOJ’s Civil Rights Division, which is responsible for jail oversight, tried to step up investigations into jails and prisons. (In the Bush years, such efforts had “proceeded at a snail’s pace and resulted in relatively few enforcement actions,” according to a confidential
report circulated by the Obama-Biden transition team.) But Perez’s team found that it was incredibly difficult to figure out which jails were the most dangerous. “There was no national surveillance system that allowed there to be a sorting of the cases. They would come in pretty haphazardly,” said Jonathan Smith, the former DOJ official. “We would have cases where you wouldn’t get reports of deaths because the person died at the hospital, for example. Or they’d be discharged from the jail as they were being loaded into the ambulance, so it wouldn’t be reported.”
In theory, there was a straightforward solution: Focus on the jails with the most deaths. But the Bureau of Justice Statistics, which counts fatalities, keeps most of its data to itself. In order to encourage jails to participate, it only releases statewide totals, not the names of the most deadly institutions. BJS does not even share that kind of information with the rest of the Justice Department. “That was one of the things that frustrated Tom Perez to no end,” Bagenstos said. “How can we be sure we’re going after the places that were really the worst?”
And the most likely places to escape scrutiny are the small jails and police lockups where problems are so prevalent. “These are very, very resource intensive cases,” Bagenstos explained. For both the DOJ and outside advocacy groups, mounting complex lawsuits against institutions that hold only a handful of people can be hard to justify.
There was a time when many states carried out regular inspections of jails. But in 1996, Congress passed legislation that limited inmates’ ability to bring lawsuits challenging conditions in jails and prisons and circumscribed the power of federal courts to order reforms. Many states subsequently cut back on jail inspections or eliminated them altogether. All of this means that from the outside, it’s nearly impossible to identify when a jail has a problem until it's too late.
In the year after Sandra Bland died, the Texas Commission on Jail Standards, which oversees county jails, recorded 25 suicides. In at least 11 cases, they found a violation of minimum standards. The commission introduced a new intake form that includes simple questions like, “Are you extremely worried you will lose your job, position, spouse, significant other, custody of your children due to arrest?” It also spells out that an officer must call a supervisor if an inmate answers yes to a question. “The form has to be able to be done by anybody,” said Brandon Wood, executive director of the agency.
That form went into effect in December 2015. Last year, there were 33 suicides in county jails in Texas. This year, as of June, there had been eight. It would be premature to attribute the decline to the new form, said Diana Spiller, a research specialist at the commission, but its experts are “optimistic.” Simple acts, it seems, can save lives. The question is whether enough people are interested in that.
http://highline.huffingtonpost.com/articles/en/sandra-bland-jail-deaths/
