September is National Suicide Prevention Month, an important opportunity to focus attention on one of the most serious and persistent challenges facing jails: preventing deaths by suicide.
People entering jails often arrive during periods of intense crisis. They may be experiencing mental illness, substance use or withdrawal, recent loss, fear, uncertainty, or disruption of family and community connections. The first days of incarceration can be particularly high risk, but suicide risk can emerge or change at any point during a person’s time in custody.
Preventing suicide requires more than identifying individuals who appear to be at risk. Effective prevention depends on a comprehensive approach that involves health and mental health professionals, custody staff, and administrators — and recognizes that everyone has a role to play.
Prevention Starts at Intake — but Doesn’t End There
Receiving screening provides an important opportunity to identify suicide risk, mental health needs, substance use, recent suicidal behavior, and other concerns. But screening at admission is only one part of prevention.
Risk can change in response to court dates, changes in legal status, family problems, bad news from home, placement in restrictive housing, conflict with others, withdrawal, or changes in physical or mental health. Staff throughout the facility need to recognize warning signs and know how to communicate concerns when a person’s behavior or circumstances change.
The NCCHC Standards for Health Services provide a framework for many of these practices, including receiving screening, mental health assessment, communication, emergency response, monitoring, treatment, and continuity of care.
Suicide Prevention Is a Team Responsibility
Custody officers often have more frequent contact with people in custody than anyone else and may be the first to notice changes in behavior. Health and mental health professionals bring clinical expertise in assessing risk and determining appropriate interventions. Administrators are responsible for ensuring that policies, staffing, training, communication, and the physical environment support safe practices.
That makes communication between disciplines particularly important. Information about suicide risk must reach the people who need it, while clear procedures should help staff understand what to do when they have concerns.
Education is another essential component. NCCHC conferences, webinars, and other educational programs regularly address suicide prevention and related issues such as mental health care, intake and screening, substance use and withdrawal, and restrictive housing. These programs provide opportunities to learn from research, experts, and the experiences of other correctional systems.
Learn From Every Serious Incident
When a suicide occurs, careful review is critical. A mortality review should look beyond the actions immediately preceding the death and examine the larger system.
Were risks identified and communicated? Were policies followed? Were observation practices appropriate? Did staffing, housing, or the physical environment contribute? Were there earlier opportunities for intervention?
The purpose is not simply to determine what happened, but to identify changes that may help prevent another death. NCCHC Resources conducts mortality reviews and suicide prevention assessments for correctional systems, providing an independent perspective on policies, practices, and potential vulnerabilities.
Keep Looking for Opportunities to Improve
No single screening tool, policy, training program, or clinical intervention can eliminate suicide risk. Prevention depends on layers of protection working together: effective screening, ongoing assessment, appropriate monitoring, access to mental health care, trained staff, communication between health care and custody, sound policies, and continuous quality improvement.
National Suicide Prevention Month provides an opportunity to examine those systems before a serious incident reveals a weakness.
For correctional facilities, perhaps the most useful question this September is a simple one: What can we do better today to reduce suicide risk and keep people safe?
Need help? Contact NCCHC for more information.
Additional Resource: Suicide Prevention Resource Guide: National Response Plan for Suicide Prevention in Corrections (2019, NCCHC and American Foundation for Suicide Prevention)
