When a jail or prison inmate has been deemed a suicide risk for any reason, it is standard procedure to take steps to keep that inmate safe. This may include placing them in an isolated location for closer observation, like a receiving or segregation cell. Taking such steps is, of course, meant to accomplish the goal of keeping the inmate safe from self-harm.
However, beyond physical isolation, additional steps can and should be taken by correctional staff members to try and minimize the person’s sense of emotional isolation. The most important of these steps can be achieved quite simply through the use of good interpersonal communication skills.
In other words, we can save lives by talking to potentially suicidal inmates - especially if they are suffering an emotional or personal crisis. Doing so is a key element in any comprehensive suicide prevention program.
Possible causes for suicidal thoughts and actions
There are a number of reasons that inmates feel suicidal. Some may be suffering abnormal thoughts and feelings due to an episode of a serious mental illness - such as clinical depression, bipolar disorder, or schizophrenia. Serious depression, for example, is highly correlated with suicidal thoughts. Or, a person may be hearing voices telling him to kill himself. Some inmates may feel suicidal due to effects of alcohol or drugs, including withdrawal.
Other inmates may not necessarily be seriously mentally ill, but are feeling suicidal because of an emotional crisis that they are experiencing. Such inmates are sometimes referred to as short-term EDP’s (emotionally-disturbed persons). An inmate may become a short-term EDP for any of a number of reasons. Here are a few common examples:
- A setback or unexpected development in his or her legal/criminal justice situation
- A relationship problem with a spouse or boyfriend or girlfriend, etc.
- Problems regarding family members or friends, including worries about children
- Financial problems or difficulties
- A problem or conflict with one or more other inmates or staff members
Often, it is a combination of issues that causes a crisis.
Crisis situations are intense but temporary
It is not the facts of a situation per se that make that situation a crisis. It is the person’s perception that it is a crisis for him or her. The same or similar circumstances may be very upsetting to one person, but not to another. For example, a “Dear John” letter may quickly throw one person into a suicidal crisis, whereas another person may be only mildly upset for a short time. Or, bad news in a court case may cause one person to be very angry and upset whereas another person may take such news in stride.
In short, it does not really matter what anyone else thinks of an inmate’s crisis situation; if the inmate thinks it is a crisis, then for him or her it is a crisis.
During an emotional crisis, a person tends to have a negative and very pessimistic view of everything. Some people catastrophize, meaning that they perceive problems or events as much more significant than they really are and expect the worst imaginable outcomes. A person’s ability to use good problem-solving skills is usually reduced. It can be an intense and difficult time for that person.
The good news is that an emotional crisis does not last forever. It may continue for hours or even days, but usually the person will start to feel better and, with time, will be able to better cope with life problems.
Some people who are going through a serious emotional crisis may think about suicide as a way of coping with the crisis. Most such people do not really want to be dead, but instead they want the painful, difficult feelings they are experiencing to end and they see suicide as the way to achieve that.
In regard to jail and prison inmates, one thing that can compound this dynamic is that many have poor coping and problem-solving skills, rendering them unable to deal well with difficult emotions. Many have a lifelong history of dealing with crisis situations in their lives in non-constructive ways, such as alcohol, drug use, violence, angry outbursts, or criminal activity. Some have a long history of threatening or attempting suicide, or otherwise harming themselves, when they are very upset about something. Additionally, many have a history of behaving impulsively, meaning that they do things on the spur of the moment without thinking ahead to the consequences of their actions. Some inmates may, when faced with a crisis situation, impulsively decide to make a suicide attempt or otherwise harm themselves.
Nonetheless, no matter how severe the episode, the key takeaway from all the above scenarios is that while an emotional crisis may be very upsetting and painful for a person while it is happening, it will not last forever. It will usually last for a relatively short but intense period of time. Our goal is to keep that person alive during that period until he or she is less upset and is able to think a bit more clearly.
How we can help keep them alive
What does all this mean in regard to suicide prevention in a jail or prison? It means that it is important to pay some attention to the fact that an inmate who is a suicide risk may be going through an emotional crisis, and to take basic steps to keep that crisis from escalating to the point where something bad happens. That is why talking to and listening to an inmate is so important.
A key goal is to try and minimize the sense of emotional isolation that an inmate may feel, particularly when he or she is physically isolated as well. As noted, physical isolation may be necessary to best observe and monitor an inmate who is a suicide risk. However, such physical isolation may also result in increasing the person’s sense of emotional isolation — making him or her feel more alone with their difficult and negative feelings. When that happens, it is sometimes too easy for those difficult and negative feelings to escalate.
If people who are experiencing emotional crisis situations have an opportunity to talk out their difficult feelings, they are less likely to act out those feelings. That is one reason that mental health professionals spend time getting their clients to talk about what is going on with them, and then listen actively to them.
Correctional security staff members are not therapists or social workers, and they are certainly not expected to provide therapy to troubled inmates. But correctional professionals are people workers, and it is appropriate for them to use basic communication skills with troubled inmates, for the key purpose of trying to help the inmate feel less emotionally-isolated so that he or she will be less likely to act out inappropriately, perhaps via a suicide attempt.
Ask simple questions
This is not a complicated or time-consuming process. Simply stopping by a cell or room to ask an inmate how he is doing or if he needs anything is a good start. This can be done when making routine security checks. Asking questions accomplishes two goals: 1) It lets the inmate know that someone is concerned about him, and 2) it gives them an opportunity to talk out their feelings. The person may not want to talk (and of course cannot be forced to do so), but it is always better to at least provide an opening and hope that he or she will take that opening. Sometimes, even if an inmate does not want to talk initially, he or she may do so later.
It is equally important to use active listening skills and to pay attention to what the inmate is saying. Try to get him or her to keep talking. At all costs, avoid sarcastic, demeaning or condescending language.
Remember that your goal is not to be a therapist or a social worker, nor are you there to solve the inmate’s problems. Nor do you have to spend a great deal of time talking with inmates. A little goes a long way. You are simply a concerned human being allowing another human being who may be going through a short-term, but intense and difficult, crisis to “vent”. That alone can be enough to save a life.
Additionally, getting an inmate to talk provides an opportunity to collect information about the inmate’s thought processes and emotional state. Such information can help professional care providers to assess the person’s suicide risk.
And do not be afraid to directly address the issue of suicide with an inmate. For example, in a straightforward, neutral tone of voice, you can ask: “Are you feeling that you want to kill (or hurt) yourself?”
Often, it is better to be direct about suicidal feelings than to avoid them. This will provide an opportunity for the inmate to talk about possibly difficult feelings, rather than keeping those feelings locked inside.
In summary, it may be necessary to physically isolate an inmate as a means of suicide prevention. But it is equally important to take steps to try to minimize the person’s sense of emotional isolation. Use of good interpersonal communication skills—primarily talking and listening—is of upmost importance in that regard. It is part of being a corrections professional and it might just save a life.