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4 myths about hangings in corrections

The actions taken in the first few minutes after a discovered hanging can be the difference between a hospital transfer and an in-custody death

By Lorry Schoenly

Hangings are relatively rare compared to other emergency events in corrections, but they can really screw up a shift and rattle staff involved in a post-hanging intervention. The actions taken in the first few minutes after a discovered hanging can be the difference between a hospital transfer and an in-custody death. Hanging is the most common form of successful suicide in corrections.

Do you need to be concerned about hangings in your correctional setting? Here are four myths that may hinder your vigilance and response to hangings in your setting

Myth #1: It won’t happen here — this is a small jail.
Although it might appear that most hangings happen in large urban jails, theBureau of Justice Statistics (BJS) Special Report on Suicide in State Prisons and Local Jails reports that the country’s smallest jails had suicide rates five times higher than the largest jails in 2002.

Jails holding fewer than 50 inmates accounted for 14 percent of all jail suicides. With smaller staffs and fewer resources, small jails need to remain vigilant to the potential for hangings. Detailed policies and procedures on prevention and post-hanging interventions should be in place. Emergency procedures for a hanging situation should be periodically practices and involve both custody and medical unit staff.

Myth #2: It won’t happen here — we have great suicide screenings and watch suicidal inmates closely.
Improved suicide prevention and management processes have definitely reduced hanging suicides in the correctional setting over the last two decades. As outlined in a prior column, incarcerated suicide rates in both jails and prisons have declined sharply, with jail suicides still more than three times the rate of state prisons.

Suicidal inmates are creative and will use any resource available to craft a noose and the leverage to asphyxiate by hanging body weight. Screenings can help weed out obvious potential for self-injury, but require a good mechanism for protecting those who do not pass the screen.

A strong communication process with mental health services is needed to complete the protective program. All corrections staff must be vigilant for indications of self-harm. Suicide attempts can take place later in the incarceration period triggered by court hearings, family issues such as divorce proceedings or custody issues, and classification changes such as administrative segregation placement.

Myth #3: Hangings are lethal. If found strung up and lifeless, no need to intervene.
The major factors leading to a hanging fatality is height of the drop during hanging and the suspension of the body (full or partial). Most hangings in corrections take place in the housing area (primarily the inmate cell) which leaves little chance for a full body suspension and great height.

This results in good chances of survival with early intervention. One study concluded that even if the victim is found to be lifeless, aggressive intervention with CPR and emergency medical transport is warranted.

Another study found overall mortality associated with hanging was 33 percent. Those who survived to admission to the hospital had a relatively low rate of severe functional disability. Initiate medical intervention immediately when a hanging is found.

A significant percentage of hanging victims will have spinal fracture, therefore spine immobilization and jaw thrust maneuvers should be taken into account at the scene. In order to accomplish this, easy access to a rescue tool, such as this seatbelt release device, is needed to quickly lower the person to the floor for emergency resuscitation intervention.

Myth #4: Every hanging is a crime scene. The inmate can’t be cut down until the location is photographed and evidence accumulated.
There have been reports of medical staff being delayed from attending to a hanging victim while crime scene investigation takes place. Minutes are precious in emergency treatment and can make a difference in ultimate survival. Cut down the victim and initiate emergency medical intervention as soon as the scene has been secured. Saving a person’s life trumps all need for determining criminality.

By dispelling these myths about inmate hangings, you can improve your hanging survival rate among those under your custody.

Dr. Schoenly has been a nurse for 30 years and is currently specializing in correctional healthcare. She is an author and educator seeking to improve patient safety and professional nursing practice behind bars. Her web-presence, Correctional Nurse, provides information and support to those working in correctional health care. Her books, Essentials of Correctional Nursing and The Correctional Health Care Patient Safety Handbook are available in print and digital on Amazon.

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