Parsons v Ryan: Suicide Prevention Day, 2012, AZ DOC.

Remembering the suicide victims of Jan Brewer 

and Charles Ryan at the Arizona Department of Corrections.

 

 "SOS from Arizona's Other Death Row"

Firehouse Gallery and Cafe, Phoenix

June 2012

This is the state of suicide prevention in Arizona's Department of Corrections, under Director Charles Ryan. I hope the DOC responds to this critique with a detailed description of what else they're doing to reduce the rate of despair and violence that's driving Arizona prisoners to kill themselves at twice the rate than the national average for state prisoners. I want to know what the training consists of. So do the families who have already suffered a death in custody - as well as the loved ones of those mentally ill prisoners fighting to be safe and well in custody now. How have the conditions described below changed since Parsons v Ryan was filed?

If you have a loved one in prison with a serious mental illness whose safety or sanity you fear deeply for, please feel free to contact me. I'm just an artist and activist - I'm not a lawyer or professional anything, but I can refer you to resources in your community, and connect you with other families who share your struggle. 

Have your loved ones write me as well. 

Arizona Prison Watch  /  PO Box 20494  / PHOENIX, AZ 85036

thank you again to all the attorneys working on this case...but most of all, to the prisoner-litigants who had the courage to put their names and faces to the abuses and neglect going on behind bars in this state...

Peggy Plews 

480-580-6807

arizonaprisonwatch@gmail.com

Parsons V Ryan (p. 47)

2. Defendants Deprive Suicidal and Self-Harming Prisoners of Basic Mental Health Care

82. Defendants have a policy and practice of housing prisoners with serious mental health needs in unsafe conditions that heighten their risk of suicide. In FY 2011, there were 13 suicides in ADC prisons, out of a population that averaged 34,000 during that time. That is a rate of 38 suicides per 100,000 prisoners per year, more than double the national average suicide rate in state prisons of 16.67 per 100,000. Three prisoners committed suicide in one week in late January 2012, including a 19-year-old woman.

83. One factor responsible for such a high suicide rate is Defendants’ policy and practice of maintaining suicide watch facilities that offer no meaningful treatment. Usually the only people who interact with prisoners on suicide watch are correctional officers who check on them periodically, medication assistants who dispense pills, or psychology assistants who talk to them through the front of their cell. Plaintiff Swartz did not receive psychotherapy for more than two months in the summer of 2011 while on suicide watch at the Lewis facility. After he swallowed glass and was taken to an outside hospital, the hospital psychiatrist recommended that he be taken to an inpatient mental health unit. These units are in the Phoenix complex. Instead, Mr. Swartz remained at Lewis where he continued to harm himself. He finally was moved to the Phoenix inpatient unit almost three months after the hospital psychiatrist had made that recommendation, but after a short period of time he was again returned to Lewis. Plaintiff Thomas did not see a psychiatrist for 11 months despite being placed on suicide watch multiple times.

84. Defendants also have a policy and practice of holding suicidal and mentally ill prisoners in conditions that violate all notions of minimally adequate mental health care and basic human dignity, and are not compatible with civilized standards of humanity and decency. Suicide watch cells are often filthy, with walls and food slots smeared with other prisoners’ blood and feces, reeking of human waste. Mental health staff show a lackof professionalism and little compassion for prisoners enduring these conditions: for example, prisoners in suicide cells are taunted for being in “the feces cells.” When Plaintiff Swartz complained to a LPN about the unhygienic conditions of the suicide cell at Lewis, the LPN described him in the mental health notes from the encounter as “bitching about cleanliness – germs and disease.”

85. Defendants have a policy and practice of keeping suicide watch cells at very cold temperatures. Prisoners are stripped of all clothing and given only a stiff suicide smock and a thin blanket, making the extreme cold even harder to tolerate. Plaintiffs Rodriguez and Verduzco report that the suicide smock used in Perryville barely comes to the top of female prisoners’ thighs, so both their legs and arms are exposed to cold air. Many prisoners are also deprived of mattresses and as a result must sleep on bare steel bed frames, or on the floor made filthy with the bodily fluids of prior inhabitants. Plaintiff Brislan spent several weeks in a frigid suicide cell with no mattress.

86. Defendants have a policy and practice of exposing prisoners on suicide watch to gratuitously harsh, degrading, and damaging conditions of confinement. Prisoners are given only two cold meals a day, and are denied the opportunity to go outside, brush their teeth, or take showers. The only monitoring prisoners receive in suicide watch is when correctional officers force them awake every ten to 30 minutes, around the clock, ostensibly to check on their safety. In some suicide cells, bright lights are left on 24 hours a day. The resulting inability to sleep aggravates the prisoners’ psychological distress.

87. Mentally ill prisoners on suicide watch complain of correctional staff behavior that interferes with any therapeutic effect of being on suicide watch, including harassment, insults and taunts, and the excessive and practically sporting use of pepper spray. Prisoners at the Perryville suicide watch units, including Plaintiff Verduzco, have jerked awake when awoken by staff on the “safety checks,” and are pepper sprayed for allegedly attempting to assault the officers. Guards in the Perryville suicide watch units also frequently pepper spray female prisoners in their eyes and throats when they are delusional or hallucinating. Plaintiffs Rodriguez and Verduzco have asthma and rely upon inhalers, and they have had asthma attacks from the regular use of pepper spray in the women’s suicide watch unit. On multiple occasions after she was pepper sprayed in the eyes, nose, and mouth, Ms. Verduzco was dragged to a shower, stripped naked, and sprayed with extremely cold water to rinse away the pepper spray; she was then left naked to wait for a new vest and blanket. A prisoner in the Florence prison’s suicide watch unit reports that while there he was handed razor blades to swallow by other prisoners, and told “just die right away.” He started to swallow the blades, and security staff pepper sprayed him while he coughed up blood, and did not provide other emergency response.

88. Defendants’ policy and practice of holding suicidal prisoners in excessively harsh conditions does not prevent but rather promotes self-injurious behavior. Plaintiff Brislan has cut himself numerous times with razors and pieces of metal while on suicide watch at multiple prisons, including Tucson, Lewis, and Eyman’s SMU 1 and Browning units. At the Tucson prison, staff put him on suicide watch in a cell with broken glass on the floor which he used to cut himself. During another stay in suicide watch, Mr. Brislan was given a razor blade that he used to deeply lacerate both of his thighs. While on suicide watch in the Lewis prison during the summer of 2011, Plaintiff Swartz, on separate occasions, swallowed multiple foreign objects, including two large staples, plastic wrap, a piece of glass, a lead-head concrete nail, a spork, two pens, sharpened paper clips, a metal spring, a steel bolt, and two copper wires. As with Plaintiff Brislan, Mr. Swartz’s repeated suicidal gestures and ability to access dangerous objects while on suicide watch confirms that he was not being properly monitored and that any mental health treatment he might have been receiving was inadequate.

89. Defendants also have a policy and practice of improperly using the suicide watch cells to punish prisoners for alleged disciplinary infractions. An Eyman prisoner who went on a hunger strike to protest prison policies, but did not display signs of mental illness or distress, was put in a suicide watch cell for several weeks and was told by a mental health provider, “If you weren’t on this hunger strike, you wouldn’t have to live in the feces cell.”

AZ county jails seek to reduce liability, not suicides.

While county governments are rightly concerned about the cost of the impending shift of state prisoners to county jails, my greater concern is their effort to avoid civil liability for any suicides occurring in their facilities - see the item in red print below. There's no indication that they want to implement anything special to reduce the risk of jail suicides - just the responsibility they have for them.

I urge all families of prisoners and of free persons with serious mental illness to contact your local papers and county supervisors and complain about that proposal before it's implemented, lest jails begin to slack off on their suicide prevention programs to save money next. The Arizona Association of Counties has a good link to elected officials from each county - use it to express your disgust for that proposal. Their "advocacy toolbox" is also useful and provides links to contact your state legislators: please ask that they not allow counties to opt out on their responsibility to seriously mentally ill and suicidal prisoners.

You may also contact the AACo Executive Director, Nicole Stickler, at nstickler@azcounties.org. Her phone is 252-6563 ext 225.

The AACo's snail mail address is:

Arizona Association of Counties

1910 West Jefferson Street
Phoenix, AZ 85009

There is no good reason why loved ones should not be able to hold county jails accountable if their child or parent or spouse takes their life in their custody. Knowing they may pay for negligence is often the only real incentive county sheriffs have to invest in assuring that their facilities are managing high-risk prisoners safely.

-----------from Havasunews.com-------------

County officials agree inmate-shift next big hit to budgets

By JAYNE HANSON
Today's News-Herald

Monday, November 21, 2011

Arizona county officials locked down their collective opposition last week during the Arizona Association of Counties Conference in regard to the state’s looming inmate shift set for 2012.

The measure has Mohave County readying to swallow $2 million in additional costs when Arizona Department of Corrections shifts state prisoners back into county jails, or charges counties a service fee to retain prisoners in state facilities.

During a four-day AACo conference in Scottsdale, about 200 county government officials from Arizona’s 15 counties, and business leaders, gathered to identify and organize a game plan to present to Arizona state legislators. Repealing the inmate cost-shift was the big issue at hand, said one local county government official.

“That has the biggest effect on us,” said Mohave County Supervisor Buster Johnson, R-Dist. 3, on Sunday. “Because of the cost shifting it will affect all departments. In Mohave County, it is $2 million (anticipated costs). We now have to adjust our budget. We’ll have to do more cuts or find $2 million in revenue.”

According to a press release from Johnson’s office, Johnson was elected second-vice chairman to AACo during the conference. And Mohave County Treasurer Melissa Havatone was elected president of Arizona Treasurers Association, which is an AACo affiliate.

Other issues identified for the platform by Arizona county officials include 2012 election measures centering on all-mail ballots and in-full reimbursement of election costs to counties in the collective amount of $5 million to $7 million.

Pressure to implement a declaration to release counties of liability pertaining to inmate suicide, which Johnson said is showing an increasing trend in county jails across the state, also was an issued identified by AACo.

The group also plans to pressure Arizona legislators to address state’s “substantial” cutbacks on mental health services for inmates, Johnson said. The cuts affect availability of medications, therapy and counseling and increase the number of mentally ill inmates within county jails.

Required Board of Health valuation review classes also were nixed by AACo this year with a request to lift the requirement and create training that is at the county level and specific to each county.

Also along the lines of property valuations are AACo proposals pertaining to county assessors to correct errors in county tax rolls and better define regulations to do so, such as a designated time frame.

AACo members also are pushing to better clarify the definition of secondary and primary residence classification linked to new laws that eliminate specific property tax breaks to secondary home property owners in Arizona. The notification process involved with the new law and procedures to remedy incorrect property classifications.

You may contact the reporter at jhanson@havasunews.com.

COMMENT LEFT BY AZ PRISON WATCH:

"The most responsible way to reduce liability costs for jail suicides is the implement evidence-based programs and procedures for working with high-risk prisoners...not to try to be excused from responsibility for them altogether. Especially in Arizona, where we push our seriously mentally ill citizens behind bars at 9x the rate we hospitalize them, our county jails have a high burden of responsibility to keep them safe. If you don't want to pay for incarcerating them dying in your care, then support diversion programs and sentencing reforms for the mentally ill."

Suing over prisoner suicide in Buffalo: DOJ to settle for less.

The final thought from the DOJ in this article - that all they want out of this county in New York is compliance with the minimum constitutional standards for conditions of confinement in their jail - troubles me. No wonder Arpaio is actually pondering a presidential bid for 2012. There are no real federal consequences to individuals or communities for neglecting people to death - or even giving them the tools they need to kill themselves - if you're systematically violating their civil rights in the process - at least, not if they're prisoners. If this was a nursing home, on the other hand, the public would be outraged and people would at least be criminally charged by the state.

-------------------------

Small Jails Have Big Suicide Problem

County jails serve as de facto psychiatric wards.

Mother Jones Magazine

By Mosi Secret |

Mon Mar. 29, 2010 10:40 AM PDT

(This story [1] first appeared on the ProPublica website [2].)

At the 680-bed Erie County Holding Facility, a small jail on the shores of Lake Erie in Buffalo, N.Y., six inmates have committed suicide in the past five years, as many as at Rikers Island, the sprawling New York City jail that typically houses about 14,000 inmates.

In 2007, an Erie inmate killed himself by diving off a 15-foot railing in full view of sheriff's deputies. That same year, an inmate took his life after officials removed him from 24-hour suicide watch and put him with the other inmates. In 2008, two detainees used bed sheets to hang themselves from air vents, raising to 15 the number of inmates who had committed suicide this way, or tried to, since 2002.

County jails, most of them originally designed to hold low-level offenders, now serve, to some degree, as de facto psychiatric wards. Los Angeles County Sheriff Lee Baca famously referred to the jails he oversees as "the largest mental health institution in the country."

While large jail systems have made substantial inroads in safeguarding mentally ill inmates, sharply reducing suicide rates since the early 1980s, some smaller jails—hobbled by poor layouts, thin staffing and inadequate training—are struggling to meet the most basic requirements set by federal law.

Their shortcomings can take a deadly toll. Suicides account for more than two of five deaths at smaller jails, versus fewer than one of five in the country's 50 largest jails, Bureau of Justice Statistics show. Despite improvements in prevention techniques, inmates at smaller jails remain twice as likely as those at larger jails to die by their own hand. Detainees at the Erie facility kill themselves at a rate five times the national average.

"It is difficult for these small jails when they are competing with resources that go to free society," said Christine Tartaro, an associate professor of criminal justice at Richard Stockton College in New Jersey and co-author of the 2009 book Suicide and Self-Harm in Prisons and Jails.

The Justice Department’s civil rights division issued findings on six jails nationwide last year for providing substandard mental health care. Four were smaller jails, housing 1,500 inmates or fewer, the Erie County Holding Facility among them.

The Justice Department began its investigation into problems at the Erie County jail in 2007, but local officials denied its experts unfettered access to the facility and failed to make improvements voluntarily, court records show. Stymied, the department sued the county last September, alleging it had an "inability to supervise inmates, identify inmates at risk for suicide, correct deficiencies in cells that facilitate suicide attempts, and prevent likely suicide attempts."

Erie County officials did not return phone calls from ProPublica about the case. County Attorney Cheryl Green has asserted in court documents that the jail meets constitutional requirements and that inmates cannot expect "the amenities, conveniences and services of a good hotel."

A federal judge recently ordered the county to allow Justice Department experts into the jail, partly because three inmates have committed suicide there since oral arguments began in the case in December. Officials from the agency toured the facility last week.

Unlike prisons, which house offenders who have been sentenced, jails hold mostly pretrial detainees—people who have not yet been convicted.

New inmates may be detoxing from alcohol or street drugs. They often arrive without medical records and whatever prescription medications they are taking. Some may be upset following confrontations with police. Things can turn bad in a hurry: A census of jail suicides between 2000 and 2002 found almost a quarter of the deaths happened within 48 hours of admission, and nearly half occurred in the first week of custody.

A proper intake screening is critical, experts say. "You can pick up the signs and when there is a problem, you do a mental health study and then you take the precautions that are necessary," said Fred Cohen, an Arizona attorney who is an expert in correctional law and a federal court monitor for Ohio’s juvenile detention centers. "Most of the signs and symptoms of the likelihood of suicide are either ignored or the guys don’t know."

In Erie County, a 2008 report by the National Commission on Correctional Health Care found that the intake screenings were inadequate and that there was no documentation proving that the correctional officers performing them had been trained. They collected medical information, but often failed to record it properly: "The receiving screening information is not filed in the health record in almost 40 percent of the patient records reviewed," the commission reported.

Some smaller jails, especially older ones, lack the design features and equipment to monitor inmates identified as having suicidal tendencies. At more modern jails, that means glass-walled cells allowing for continuous observation, and Velcro smocks and tear-proof blankets that can’t be torn up and turned into nooses.

Cells at the Erie County facility, by contrast, provided inmates with "multiple ways to facilitate committing suicide," according to the national commission’s assessment. The jail’s old-fashioned steel beds, window bars, grab bars and removable wall plates could be used by inmates to harm themselves.

Experts say smaller jails often have too little staff to provide inmates with adequate care—a situation likely to worsen as state and local governments deal with shrinking budgets.

In 2003, Erie County eliminated several health care positions at the jail, including the head nurse and almost half of the mental health staff. The next year, the holding center began admitting inmates who had been held in the Buffalo Police Department’s lockup, further straining the staff.

"Medical staff report that they are not always able to take vital signs, feel rushed and experience burnout," the national commission’s report found. "The facility does not have a chronic care program; treatment plans are not developed even for inmates with serious mental illness; and progress notes are often not entered in the medical record."

In Erie County and elsewhere, those monitoring jail inmates are typically sheriff’s deputies with limited training in recognizing the signs of mental illness – most of their training prepares them to be street cops.

"The sheriff’s office has two very different sets of responsibilities," says David Fathi, director of the ACLU’s National Prison Project, who has litigated several constitutional claims against jails and prisons. "One is to be law enforcement patrol officers to the free world and one is to be correctional officers. … Often there is a preference among the deputies for patrol duty. To the extent that correctional work is thought of as a less desirable job function, it often gets short shrift in terms of training and resources. … My anecdotal experience it that seems to be more often a problem in smaller jails."

The Erie County sheriff’s deputies who work in the jail get just eight hours of training in suicide prevention screening, court documents show.

With six suicides since 2005 and many more attempts, the Erie County jail may yet emerge as a battleground for determining the minimum quality of care to which jail inmates are entitled.

It is facing heightened scrutiny from state regulators as well as the Justice Department. Earlier this month, the chairman of the New York State Commission of Correction, Thomas Beilein, ordered a comprehensive review of the facility’s suicide screening program and sent two investigators to inspect the jail. Erie County Sheriff Timothy Howard cooperated with that inspection.

Howard and other Erie officials continue to battle the Justice Department, however, maintaining that federal overseers have overreached in their demands [3]. With the long-sought tour complete, DOJ lawyers say they will soon return to court to force the county’s hand.

"If our lawsuit is successful, the Department would ask the Court to remedy unconstitutional conditions at the Holding Center to ensure that the jail is safe and humane," a DOJ spokesperson said in an e-mail. "We are not seeking fines or monetary penalties, or remedies beyond the basic standards of care guaranteed by the Constitution."

St. Tammany Parish Jail: Cruel and Unusual "suicide prevention"

Here's another sheriff that needs to be indicted for abusing his prisoners - a man after Arpaio's heart, I'm sure.

---------------------------------------------

Prison experts call St. Tammany Jail cages ‘inhumane’

by Richard A. Webster, Staff Writer
New Orleans City Business

Published: July 15th, 2010

Stunning and inhumane.

It’s how some of the country’s leading prison supply manufacturers describe St. Tammany Parish Jail’s use of small booking cages to house the mentally ill and suicidal.

“Did I hear that right?” Michelle Markum asked when told about the 3 feet wide, 3 feet deep and 8 feet tall cages the American Civil Liberties Union of Louisiana says are used to hold mentally ill and suicidal inmates for weeks, sometimes months.

“We deal with hundreds of prisons throughout the nation, and I’ve never heard of something like that,” said Markum, operations manager of ICS Jail Supplies in Waco, Texas. “I’m stunned.”

Mark Gaines, production manager for detention supplier Bob Barker based in Fuquay-Varina, N.C., one of the largest prison supply companies in the country, was also shocked.

“This is against ACA (American Correctional Association) standards,” Gaines said. “It’s inhumane.”

The ACA is a 140-year-old group that has established internationally followed standards for prisons. Its guidelines call for a one-person cell that’s used to house an inmate for more than 10 hours to have 70 square feet of floor space even if the inmate is on suicide watch.

The so-called squirrel cages at St. Tammany Parish Jail, which is not an accredited member of the ACA, cover 9 square feet.

None of the prison supply companies contacted sell cages similar to those used by St. Tammany or knew of other companies that sell them.

“If this was widely used, I would have heard about it or seen it somewhere,” Gaines said.

St. Tammany Parish Sheriff Jack Strain and his medical director, Dr. Demaree Inglese, have come under fire for using the cages to house suicidal inmates. The ACLU of Louisiana claims guards deny caged inmates the use of bathrooms, forcing them to urinate and defecate in cups or on themselves.

Strain and Inglese say the state’s failure to provide medical beds for inmates declared mentally incompetent has forced under-funded and ill-equipped parish jails such as St. Tammany’s to take on their care until a hospital bed is available.

They said they are making the best out of a bad situation.

“Safety has to come before comfort,” Inglese said. “It’s impractical to think we can deliver the same care as a hospital.”

That is a cop-out, said Lindsay Hayes, the country’s leading expert on suicide prevention in prisons and jails and a consultant with the U.S. Department of Justice’s Civil Rights Division.

Instead of preventing suicide, the use of the cages increases the risk, Hayes said. Inmates will be less likely to tell a doctor or guard they are suicidal knowing they will be locked up in a squirrel cage. And once inside, inmates will say anything to get out, even if they are still contemplating suicide, just to end the humiliation, he said.

"(Strain and Inglese) should take a trip around the country to any one of the other 3,500 county facilities and realize they are alone in the way they treat their mentally ill suicidal inmates,” Hayes said.

Every local jail has a backlog of mentally ill defendants who are waiting for treatment in the state hospital system, Hayes said, but St. Tammany Parish Jail is the only one that chooses to handle the backlog by putting people in squirrel cages.

“I’m hired to go into jails and assess their suicide prevention practices, and I’ve never gone into a jail and where I had to tell someone to stop locking people in cages. There’s no precedent for what they’re doing.”

Hayes takes particular aim at Inglese.

“What’s most disappointing is that the medical director seems to be very much involved in this,” he said.
Medical directors who disagree with prison policy either resign or refuse to comment, Hayes said. Instead, Inglese has defended the use of the cages.

“When a medical director makes very little comment about a policy, you can tell they don’t care for it, are embarrassed professionally by it and wouldn’t want their colleagues around the country to know that they work in such a system. But here you have a medical director on the record saying it’s the state’s responsibility and that’s just ridiculous.”

Cages similar to those at St. Tammany Jail are used in limited instances at maximum security prisons, Hayes said. Violent, mentally ill patients are sometimes placed in cages during court-mandated group therapy sessions, but only for an hour.

The abuse extends beyond the cages, according to affidavits the ACLU obtained from former St. Tammany prisoners.

They claim prison guards stripped inmates before they were put into the cages and forced them to wear bright orange Daisy Duke shorts that have “Hot Stuff” emblazoned on the front and back.

“Humiliating the mentally ill, the most vulnerable, is a sport that breaks the monotony and exemplifies unprofessionalism,” Hayes said. “So when you find a case like this, you’ll also find there are many other problems with this jail, not just how they treat their mentally ill.”

St. Tammany Parish President Kevin Davis hired a consulting firm to evaluate the jail after two high-profile escape incidents. In February, a design flaw at the prison allowed accused murderer Carlos Rodriguez to flee the facility. And in June 2009, four inmates, all facing murder or attempted murder charges, escaped from the jail. All were eventually apprehended.

The consultant’s report, released in June, recommends $2 million in improvements at the Covington jail. Davis has suggested paying for part of the upgrades by charging medical fees to inmates.

Despair Behind Bars: Suicide in Arizona Prisons

Today being International Suicide Prevention Day, I thought it would be a good time to remember both the victims and survivors of the kind of despair that drives one to take one's life. For some reason, Arizonans are much more prone to suicide than most of the rest of the country. As reported by the Arizona Republic last year:

"Arizona perennially finishes in the top 10 nationally for suicides per capita, according to the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. In 2007, 986 Arizonans died by suicide, twice the number of those who were murdered, according to Magellan. The rate of suicide was 15.9 per 100,000 people; in New York, the rate was 6.9 per 100,000.

Among people with serious mental illnesses, the risk of suicide is roughly six times higher than for people who have not been diagnosed, according to academic research..."

Considering that suicides in this state far outnumber homicides, one has to wonder why we allow life-saving mental health services to be cut each year while we busy ourselves with feeding increasing numbers of people - and public funds - to the criminal justice system.

Because of the nature of my blogs, my focus here has been on prisoners. My Arizona Prison Watch archives are not exhaustive of all prisoner suicides in the state over the past 15 months, but I believe I have accessed all those who were reported by the AZ Department of Corrections. They are as follows:

23 y.o. Lasasha Cherry (9/08/10) ASPC-Perryville/Lumley

28 y.o. Patrick Lee Ross (8/31/10) Great Plains Correctional Facility, OK (Cornell under contract with AZ)

28 y.o. Geshell Fernandez (7/23/10) ASPC-Perryville/Lumley

26 y.o. Anthony Lester (7/12/10) ASPC-Tucson/Manzanita

29 y.o. Robert Medina (7/11/10) ASPC-Eyman/Browning

17 y.o. Jerry Kulp (5/11/10) ASPC-Tucson/Minors' Unit

46 y.o. James Adams (3/14/10) ASPC-Eyman/Browning (Death Row)

28 y.o. Jesus Cota (1/10/10) ASPC-Eyman/Special Management Unit

47 y.o. Monte McCarty (12/26/09) ASPC-Eyman/Special Management Unit

18 y.o. Hernan Cuevas (10/10/09) ASPC-Phoenix, Baker Unit

32 y.o. William Englebert (8/22/09) ASPC-Tucson

30 y.o. Erick Cervantes (8/14/09) ASPC-Eyman/Special Management Unit


33 y.o. Dung Ung (6/25/09) ASPC-Lewis

37 y.o. Caesar Bojorquez (6/28/09) ASPC-Eyman/Browning


Another tragic loss this year was the life of 17-year old Presley Austin, who killed himself at the Arizona Department of Juvenile Corrections' Adobe Mountain School in Phoenix in May. By accounts of other kids there, Presley was bullied to death within a week of being placed in a unit with more violent youth after he was in a fight on the mental health unit. His was the first suicide at the AzDJC in seven years.

My condolences to all those loved ones left behind in the wake of these tragedies.

Prior to Marcia Powell's death in May, 2009, notices of inmate deaths were seldom posted at the ADC news site. Now they seem to be pretty consistently updated, regardless of cause of death, which I give Director Charles Ryan some credit for - as far as I know, they don't have to do that.

The high number of prisoner suicides is disturbing, however, and should be investigated more closely, if the ADC hasn't already done so - especially those in the Special Management Unit, where I believe there is a higher concentration of prisoners with mental illness held in solitary confinement. At Perryville, both of the women who suicided were on the maximum security unit, where prisoners with serious mental illness are also frequently held. Theoretically, while it may be a higher-risk population, the environments should be better controlled and the staff should have some specialized training.

The national average for suicides in prisons is 14/100,000. The Arizona Department of Corrections warehouses about 40,000 prisoners at any given time, with about 20,000 new ones replacing those departing each year.

There are several good resources on suicide in jails/prisons in the side column of Arizona Prison Watch. I'd also recommend the following posts/articles, for those interested:
Mentally Ill Offenders Strain Juvenile System

Man's Death in Private Immigration Jail Bares Difficulty of Detention Overhaul

Suicide Among Incarcerated Veterans

The other way we tend to die in custody

Top Ten Places to Suicide: Arizona.

(this post includes a link to a moving slide show of quilt panels made to memorialize suicide victims in Arizona)

Real Lives Loved and Lost: "Criminals" and Suicide.

SOS: Suicide in Massachusetts state prisons.

Teen Kills Himself After Being Put in Solitary for…Trying to Kill Himself

Illinois Youth Prisons See More Suicide Attempts


I should also note that corrections officers themselves are also at increased risk for suicide - far higher than that of prisoners. Two that I know of occurred over the course of the past 15 months. The first was an officer at Perryville prison for women, who shot himself on the prison grounds - along the perimeter - not long after Marcia Powell was killed. The second was a youth corrections officer at Adobe Mountain School in May, the same week Presley died. I'm sure there were more, however, and that all left heartbreak in their wake.

I know far less about the above officer's suicides than I do about the prisoners I've covered, but my condolences go out to their families, friends and colleagues as well. I have also survived the suicide of a loved one - my ex-partner, who was also my friend and colleague through the many years I worked with people who were homeless in Michigan. He sat down in front of a train. Losing him - particularly that way - was devastating to our entire community. I imagine the officers' deaths hit their respective communities hard as well.

This post is for those still here and struggling to survive. Don't give up hope, no matter where you are or where you're heading. Even in prison there is always a role you can play to make this a better world - and we need all the help we can get these days.

Suicide in American Jails.

Executive Summary of the National Study of Jail Suicides: Twenty Years Later

US Department of Justice/
National Institute of Corrections (April 2010)

Suicide continues to be a leading cause of death in jails across the country; the rate of suicide in county jails is estimated to be several times greater than that in the general population. In September 2006, the National Center on Institutions and Alternatives (NCIA) entered into a cooperative agreement with the National Institute of Corrections (NIC) to conduct a national study on jail suicide that would determine the extent and distribution of inmate suicides in local jails (i.e., city, county, and police department facilities) and also gather descriptive data on the demographic characteristics of each victim, characteristics of the incident, and characteristics of the jail facility that sustained the suicide.


The study, a followup to a similar national survey that NCIA conducted in 1986, resulted in a report of the findings to be used as a resource tool for both jail personnel in expanding their knowledge base and correctional (as well as mental health and medical) administrators in creating and/or revising policies and training curricula on suicide prevention. The study identified 696 jail suicides in 2005 and 2006, with 612 deaths occurring in detention facilities and 84 in holding facilities. Demographic data were subsequently analyzed on 464 of these suicides.


Following are some findings regarding characteristics of the suicide victims:

• Sixty-seven percent were white.

• Ninety-three percent were male.

• The average age was 35.

• Forty-two percent were single.

• Forty-three percent were held on a personal and/or violent charge.

• Forty-seven percent had a history of substance abuse.

• Twenty-eight percent had a history of medical problems.

• Thirty-eight percent had a history of mental illness.

• Twenty percent had a history of taking psychotropic medication.

• Thirty-four percent had a history of suicidal behavior.


Following are some findings regarding characteristics of the suicides:

• Deaths were evenly distributed throughout the year; certain seasons and/or holidays did not account for more suicides.

• Thirty-two percent occurred between 3:01 p.m. and 9 p.m.

• Twenty-three percent occurred within the first 24 hours, 27 percent between 2 and 14 days, and 20 percent between 1 and 4 months.

• Twenty percent of the victims were intoxicated at the time of death.

• Ninety-three percent of the victims used hanging as the method.

• Sixty-six percent of the victims used bedding as the instrument.

• Thirty percent of the victims used a bed or bunk as the anchoring device.

• Thirty-one percent of the victims were found dead more than 1 hour after the last observation.

• Cardiopulmonary resuscitation (CPR) was administered in 63 percent of incidents.

• Thirty-eight percent of the victims were held in isolation.

• Eight percent of the victims were on suicide watch at the time of death.

• No-harm contracts were used in 13 percent of cases.

• Thirty-seven percent of the victims were assessed by qualified mental health professionals; 47 of the victims who committed suicide and were assessed saw a clinician within 3 days of death.

• Thirty-five percent occurred close to the date of a court hearing, with 80 percent occurring in less than 2 days.

• Twenty-two percent occurred close to the date of a telephone call or visit, with 67 percent occurring in less than 1 day.


Following are some findings regarding characteristics of the jail facilities:

• Eighty-four percent were administered by county, 13 percent by municipal, 2 percent by private, and less than 2 percent by state or regional agencies.

• Seventy-seven percent provided intake screening to identify suicide risk, but only 27 percent verified the victim’s suicide risk during prior confinement and only 31 percent verified whether the arresting or transporting officer believed the victim was a suicide risk.

• Sixty-two percent provided suicide prevention training, but 63 percent either did not provide training or did not provide it on an annual basis.

• Sixty-nine percent of training provided was for 2 hours or less, and only 6 percent was for a duration of 8 hours.

• Eighty percent provided CPR certification.

• Ninety-three percent provided a protocol for suicide watch, but less than 2 percent had the option for constant observation; most (87 percent) used 15-minute observation periods.

• Fifty-one percent allowed only mental health personnel to downgrade and discharge inmates from suicide watch.

• Thirty-two percent maintained safe housing for suicidal inmates.

• Thirty-five percent maintained a mortality review process.

• Eighty-five percent maintained a written suicide prevention policy, but suicide prevention programming was not comprehensive.


Twenty years after the survey that was conducted in 1986, this national study of jail suicides found substantial changes in the demographic characteristics of inmates who committed suicide. Some of these changes were stark. For example, suicide victims once characterized as being confined on “minor other” offenses were found in the 2005–06 data to be held on “personal and/or violent” charges. Intoxication was previously viewed as a leading precursor to inmate suicide, yet recent data indicate that it is now found in only a minority of cases.


Whereas more than half of all jail suicide victims were dead within the first 24 hours of confinement according to 1986 data, current data suggest that less than a quarter of all victims commit suicide during this time period, with an equal number of deaths occurring between 2 and 14 days of confinement. In addition, inmates who committed suicide appeared to be far less likely to be housed in isolation than previously reported and, for unknown reasons, were less likely to be found within 15 minutes of the last observation by staff. Finally, more jail facilities that experienced inmate suicides had both written suicide prevention policies and an intake screening process to identify suicide risk than in years past, although the comprehensiveness of programming remains questionable.


In 2006, the suicide rate in detention facilities was 36 deaths per 100,000 inmates, which is approximately 3 times greater than that in the general population (Mumola and Noonan 2008). This rate, however, represents a dramatic decrease in the rate of suicide in detention facilities during the past 20 years. The nearly threefold decrease from a previously reported 107 suicides per 100,000 inmates in 1986 is extraordinary. Absent in-depth scientific inquiry, there may be several explanations for the reduced suicide rate. During the past several years, national studies of jail suicide have given a face to this longstanding and often ignored public health issue in the nation’s jails. Study findings have been widely distributed throughout the country and were eventually incorporated into suicide prevention training curricula.


The increased awareness of inmate suicide is also reflected in national correctional standards that now require comprehensive suicide prevention programming, better training of jail staff, and more indepth inquiry of suicide risk factors during the intake process. Finally, litigation involving jail suicide has persuaded (or forced) jurisdictions and facility administrators to take corrective actions in reducing the opportunity for future deaths. Therefore, based on this dramatic decrease in the rate of suicides, the antiquated mindset that “inmate suicides cannot be prevented” should forever be put to rest. This report offers recommendations in the areas of comprehensive suicide prevention programming, staff training, and future research efforts.


In conclusion, findings from this study create a formidable challenge for both correctional and healthcare officials as well as their respective staff. Although our knowledge base continues to increase, which has seemingly corresponded to a dramatic reduction in the rate of inmate suicide in detention facilities, much work lies ahead. The data indicate that inmate suicide is no longer centralized to the first 24 hours of confinement and can occur at any time during an inmate’s confinement.


As such, because roughly the same number of deaths occurred within the first several hours of custody as occurred during more than a few months of confinement, intake screening for the identification of suicide risk upon entry into a facility should be viewed as time limited. Because inmates can be at risk for suicide at any point during confinement, the biggest challenge for those who work in the corrections system is to view the issue as requiring a continuum of comprehensive suicide prevention services aimed at the collaborative identification, continued assessment, and safe management of inmates at risk for self-harm.

Real Lives Loved and Lost: "Criminals" and Suicide.

I'm extremely impressed with the humanity evident in this journalist's view on this man's struggle, and with the way he integrated it seamlessly into the narrative of the larger community. Austin Moffett wasn't just a petty criminal, he was a man whom others could identify with in his struggle and despair, which not everyone is criminalized for - and I don't doubt that criminalization resulting from his addictions and subsequent struggles paying the court were huge barriers for him getting on with his life. The court wants to be paid before they want you to even pay your rent.


I'm watching a good friend go through that right now with Maricopa County. They're threatening to put her in jail for falling behind on payments despite documentation that her employer stopped paying her with anything but promises for 4-6 weeks. She's into the court for $1500; her employer owes her $2,000, and the judge might pull her out of her job, cause her to lose her housing, and put her in a setting that could kill her (she has a compromised immune system because of cancer treatment) - all to punish her (at great expense, since she requires highly-specialized medical care) for not having their money on time despite her best-faith efforts to earn it. Then she'd come out of jail owing more than she did before, living on the streets with no job - and probably a serious opportunistic infection. Anyone who puts someone like her in Arpaio's jail should be charged with medical abuse.


Tell me who should be going to jail here, really. It's the guy with the keys.


Anyway, being criminalized can bring about some serious despair. The punishment never seems to end, whatever the sentence. Some judges seem to have very little appreciation for how much damage a criminal record and a few weeks in jail can do to a person's life - especially those who just spent the past year rebuilding it from the ground up.


Anyway, we need more journalists and articles like this.  Thank you, Pete and the Payson Roundup.


Thanks to the Moffett family, too, for having the courage to share this with us. It helps others immensely when you defy the shame and stigma that so oftens leaves families grieving in silence.

 The holidays and aftermath are a hard time for a lot of folks, especially those working on rebuilding bridges home. Take care of yourselves, and each other. 



- Peg


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Payson Roundup

Residents battle suicidal thoughts

By Pete Aleshire

December 29, 2009

Courtesy photo

This was the last photo taken of Austin Moffett (fifth from the left, back row) before he took his life in August. Austin’s family posed with Austin during a birthday party at Kohl’s Ranch. (From left) Lauree Moffett, Barry Moffett, Amber Moffett, Sydni Moffett, Austin, April Ray and Ammecy Ray. 

Austin Moffett loved skateboarding, the outdoors and most of all his family; however, after various setbacks, Moffett gave up on life and killed himself in August 2009. Before, he did, Moffett reached out to friends, but no one took his pleas seriously.

The night he took his life, Moffett texted a friend he was “going to do it” but it took that friend three hours to check up on Moffett and when he finally did, he found Moffett hanging in the garage.

If someone had taken Moffett’s threats seriously and told someone, he might still be here.

Just over the holiday weekend, three people attempted suicide and another three threatened to in Payson, said Sgt. Don Kasl.

Like so many people battling depression and suicidal thoughts, Moffett, 21, took his life when he was just starting to turn things around.

After his release from jail he moved to Arizona to be closer to family, was looking for a job and was excited about a fresh start. After 10 months in Payson, he did not receive support from the probation department, his mother said. He also got rearrested several times for minor offenses and was abusing various substances.

Regardless, Moffett’s mother, Lauree Moffett, and sister, Amber Moffett, say Moffett wanted to succeed and was excited for the future. So what would drive a 21-year-old to hang himself and why didn’t anyone see it coming?

Lauree and Amber say they did not see Moffett’s suicide coming, but his friends got several warning signs including a text message and an earlier failed attempt. They hope telling their story will raise awareness about an issue rarely discussed, but desperately needed.

So far for this year, the Payson Police Department has responded to 10 suicides, 39 attempts and 72 threats.
Just in the last weekend, three people attempted suicide and three made threats, Kasl said.

Nanci Stone, vice president of Rim Guidance Center, which provides behavioral health services to residents in Northern Gila County, said a lot of people who commit suicide do so when they are just beginning to feel better because they have the energy to go through with it. Ironically, when someone is really depressed, they often lack the energy to plan their own death, she said.

Since “it is very unpredictable,” when someone will commit suicide, Stone said any threats or comments of suicide should be taken seriously.

“Suicide doesn’t have a type, any person at any time who says they are thinking of harming themselves needs to be taken seriously,” Stone said.

In Moffett’s case, he had reached out to friends, but no one took his pleas seriously.

A week before he hung himself in a friend’s garage, several of Moffett’s friends and his girlfriend interrupted his first attempt. Although they successfully talked him out of it then, they told no one about the incident. Then on the night that he hung himself, Moffett texted a friend to say he was going to kill himself. Three hours after getting that text, his friend showed up to check on Moffett, but he was already dead.

The Northern Gila County medical examiner said often families and friends do not see the signs of suicide until it is too late.

“The signs may be there, but people ignore them,” he said.

Looking back, Lauree said she still does not see the signs leading up to her son’s death.

In November 2008, he moved to Payson after being released from a Kansas jail, and was working at Lauree’s workplace, Kohl’s Ranch.

However, after arriving in Payson, Moffett got in trouble with the law again for “petty crimes,” was living at various friends’ homes, had no car and was struggling to make court payments, Amber said.

Both Lauree and Amber admit Moffett had low self-esteem and struggled with substance abuse, but “he was someone worth salvaging,” they said. He was caught in “a vicious cycle.” Amber partly blames his substance abuse for his mental state the night he killed himself.

“He wanted a family and wanted to give everyone else the best,” Amber said. “He tried to make everyone happy and didn’t want to see them struggle.”

Amber said she talked with her brother hours before he hung himself and he gave no indication what he was going to do. Looking back now, she wishes Moffett had known it was OK to express his feelings.

Stone said it is crucial when someone begins to feel suicidal to talk to someone right away.

“When someone is suicidal, there are three critical things; they feel hopeless that things will not get better, hapless that they can’t do anything right and helpless that they do not know where to turn; however, those feelings pass,” Stone said.

The medical examiner pointed out there are at least five counselors in town available for help and various churches have members trained to deal with crises.

“Our job is to show them they have options,” Stone said. “We are here to help.”

Rim Guidance Center operates a 24-hour crisis line, (928) 474-3303, and counselors are available every day.
In early December, Lauree and Amber along with friends and family participated in the 2009 Out of the Darkness community walk in Phoenix to prevent suicide. They hope to start a suicide prevention walk in Payson. For more information on Out of the Darkness, visit www.outofthedarkness.org.

Originally published at: http://www.paysonroundup.com/news/2009/dec/29/residents_battle_suicidal_thoughts/

Top Ten Places to Suicide: Arizona.

UPCOMING EVENTS

December 10: International Human Rights Day

 

December 15: Fifth Special Legislative Session Begins

December 17: International Day to End Violence Against Sex Workers (Tucson Memorial Service).

December 18: SWOP-Tucson Demonstration at the Arizona Department of Corrections, Phoenix.

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This is an impressively-written article, and it's about time people caught on to how to deal with someone who's suicidal - I don't understand what took so long, or why this is novel. I'd like to see all the Department of Corrections and MCSO staff  take that class on managing suicidal crises. 

We've been killing ourselves at twice the rate we've been killing each other in Arizona. That says a lot about the gaps in mental health care, as well as the toll that internalized oppression takes on people here. 

I sure hope some of the 2010 political candidates have a better vision for the future than more prisons to bolster our economic base (and psychiatric "facilities" to keep the people who make us uncomfortable with their suffering off the streets). Look at the prospects they put on the horizon for us now:  no wonder we're all doing ourselves in. 

There's also a link to a very moving memorial following the article. Check it out.
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Magellan Health Services alters approach to suicide prevention

by Casey Newton - Dec. 10, 2009 12:00 AM
The Arizona Republic

 

Over the summer, feeling overwhelmed by her physical and mental-health problems, Katie Ayotte went into her bathroom and swallowed a large number of pills she took to treat her bipolar disorder

.

It was a suicide attempt, Ayotte said, one of several the 47-year-old Phoenix resident has made over the years. Ayotte survived, and as she recovered, she noticed a new approach her clinical team was taking.
Before, she would awake in an intensive-care unit to find a doctor

or nurse barking questions.

Did you think this would solve anything? Didn't you think about your family? What were you thinking?
This time, no one blamed Ayotte. Instead, she saw a doctor who got up from behind his desk and sat down next to her. "I'm concerned for you," he said. And together they began to create a "safe zone" for Ayotte, moving her medications

from the bathroom to the kitchen, where she would have trouble accessing them without her husband or another loved one noticing.

Ayotte's doctor had embraced the principles of an approach to treating suicide that is new to Maricopa County. This fall, Magellan Health Services, which was hired by the state in 2007 to improve mental-health care in the county, launched a new plan to reduce suicides.

Arizona perennially finishes in the top 10 nationally for suicides per capita, according to the National Center for Health Statistics, part of the Centers for Disease Control and Prevention

. In 2007, 986 Arizonans died by suicide, twice the number of those who were murdered, according to Magellan. The rate of suicide was 15.9 per 100,000 people; in New York, the rate was 6.9 per 100,000.(read more)

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Loved ones Lost to Suicide


The above link is to a slide show at AZ Central.com, which someone made to memorialize those whose lives have been lost to suicide. It's quite intimate and worth the journey if you give yourself a little time. 

- Peg