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NCCHC: Suicide prevention moves to a new level

Lindsay M. Hayes — a leading voice in jail suicide prevention and Project Director at the National Center on Institutions and Alternatives (NCIA) in Mansfield, Massachusetts — unveiled results of a national study of jail suicide at the National Commission on Correctional Health Care (NCCHC) conference in late October. Completed in May 2009, the study is a follow-up to the ground-breaking study 20 years ago which is credited with increasing the awareness of suicide potential in the jail setting.

Making Progress
In the decades since the original study, many practices have been implemented to reduce suicide risk, particularly at entrance into the system.

A majority of jails were found to have suicide screening mechanisms (77 percent) and a written suicide prevention policy (85 percent). Recent findings indicate a significant decrease in the percentage of suicides during the first 24 hours of incarceration, including a major decrease in suicides while intoxicated.

In fact, the suicide rate in detention facilities over the last two decades has reduced from 107 suicides per 100,000 inmates to an astounding 38 per 100,000 inmates — an almost three-fold decrease.

The New Frontier
The new frontier for suicide prevention is later in the incarceration period. More than 75 percent of jail suicides now take place after the first day behind bars. Suicide attempts can be triggered by court hearings, family issues such as divorce proceedings or custody issues, and classification changes such as administrative segregation placement.

Continuous Awareness
The challenge is to remain alert for suicide potential among the many other issues confronting corrections staff — especially at the middle and final points of the inmate’s sentencing when routine is established and attention shifts to other concerns. Officer training programs and briefing about suicide potential later in the incarcerated period are needed.

Communication Vital
Hayes especially emphasized the need for good communication among custody officers about inmate habit or pattern changes of import. “Don’t miss the telltale signs, pass them along to the next shift or to mental health care providers for follow-up,” He said.

Do not rely on inmate denial of suicide potential. Often the inmate stating “I’m fine” is not fine at all. Be alert for changes in demeanor, mood, and behavior.

The corrections community has made great strides in preventing suicide while in custody over the last two decades, especially during the first 24 hours of incarceration.

For more information visit the NCIA website. The National Study of Jail Suicide: 20 Years Later will be published by the National Institute of Corrections in early 2010.

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.

Follow on Twitter: www.twitter.com/lorryschoenly; Facebook; Blogging @ www.correctionalnurse.net; and LinkedIn.

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