Running Head: PRISON SUICIDE AND SELF-INJURIOUS BEHAVIORS 1

Prison Suicide and Self-Injurious Behaviors

Edgar Luat

Dr. Hayden Smith

October 11, 2018

University of South Carolina

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THE CORRECTIONAL COOPERATIVE

The Sabbatine (2007) article describes a “Correctional Cooperative,” a program

aimed at minimizing reincarceration rates of the mentally ill by allowing stabilized

individuals to watch over other inmates. As we have decided jails to be the most

economical way to deal with the violent mentally ill, it is important to develop solutions

that are both efficient and effective. Three policies that I would suggest to further

cooperation between inmates would be: funding of vocational training, transition

planning initiatives between correctional and community mental health staff, and

contracting among hospital systems and community mental health centers.

Vocational training allows for easier access to employment after discharge,

reducing pressures to use drugs or commit crimes that correlate with rearrest

(Freudenberg, Daniels, Crum, Perkins & Richie, 2005). A mentoring network could be

developed where offenders are able to train other inmates in their respective community

work. Osher, Steadman, and Barr (2003) describe their APIC Model for community

reentry, where correctional facilities are immersed in community resources to connect

inmates with resources outside of jail. Successful services can be advocated for by

collective inmate feedback, allowing for allocation of funding towards these resources.

Lastly, contracts between community health centers and local hospitals have shown to

be remarkably cost-effective (Conklin, Lincoln, Flanigan, 1998). Allowing inmates to

teach each other healthy coping mechanisms can promote long-term reintegration into

the community.
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REDUCTION OF RATES OF SUICIDE AND SELF-INJURIOUS (SIB) BEHAVIORS IN CORRECTIONS

Forsyth & Forsyth (2007) describe the social history of a 21-year old inmate Sam,

who committed suicide prior to his case going to trial. Sam had a troubled childhood; he

was raped at five years old, grew up living with his paranoid schizophrenic mother, and

abused drugs and alcohol. These factors, that could have potentially humanized him to

a jury, became meaningless after his suicide.

As one of the highest causes of death in jails, it is therefore important that

measures are taken to reduce the rates of suicide threats, attempts and completion.

According to the World Health Organization (2007) properly trained correctional staff are

responsible for screening inmates upon arrival for risk factors such as a history of

current thoughts of suicide and substance abuse. As 51% of suicides happen within the

first 24 hours of incarceration, identified at-risk individuals should be closely monitored.

This includes when staffing is low during nights or weekends. Paying special attention to

an inmate’s housing assignment and avoiding isolation can also reduce situational risks

of suicide. Placing inmates in segregation or in solitary confinement can aggravate

symptoms of mental illness, potentially leading to inmate conflict and thus further

aggravation of suicidal tendencies.

Fagan, Cox, Helfand, and Aufderheide (2010) self-injurious behavior (SIB) and

suggest methods to identify, assess and treat it. Management plans are suggested that

steer away from maladaptive approaches such as the use of force, restraint, involuntary

medications, cell extraction, and temporary transfer. Medical treatment is to be provided

succinctly, as to not introduce healthcare staff as potential reinforcers of the behavior.

Spreading awareness of SIBs as a public health issue, educating staff about assessing
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lethality, training to identify signs of less common SIBs like hunger strikes, and

controlling access to self-injurious objects can help to mitigate the prevalence of SIBs in

correctional facilities. Additionally, treatment such as verbal and behavioral oriented

therapies are preferred over the prescription of psychotropics. Raising awareness is an

essential goal, as it is a means of acquiring funding from government grants or charities

in order to garner adequate resources needed to manage SIBs. This is of utmost

importance, as one of the major challenges that the reduction of both suicide and SIB

rates in corrections faces is a limited budget.

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REFERENCES

Conklin, T. J. Lincoln, T. Flanigan, T. P. (1998). A Public Health Model to Connect

Correctional Health Care with Communities. Am J Public Health, 88, 1249-1250.

Fagan, T. J. Cox, J. Helfand, S. J. Aufderheide, D. (2010) Self-Injurious Behavior in

Correctional Settings. Journal of Correctional Health Care, 16, 48-66.

Freudenberg, N. Daniels, J. Crum, M. Perkins, T. Richie, B. E. (2005). Coming Home

From Jail: The Social and Health Consequences of Community Reentry for

Women, Male Adolescents, and Their Families and Communities. Am J Public

Health, 95, 1725-1736.

Osher, F. Steadman, H. J. Barr, H. (2003). A Best Practice Approach to Community

Reentry From Jails for Inmates With Co-Occurring Disorders: The APIC Model.

Crime & Delinquency, 49, 79-96.

Sabbatine, R. (2007). An “Extended Care” Community Corrections Model for Seriously

Mentally Ill Offenders. Mental Health Issues in the Criminal Justice System, 55-

57.

World Health Organization. (2007). Preventing Suicide in Jails and Prisons.

http://www.who.int/mental_health/prevention/suicide/resource_jails_prisons.pdf