By Jason Fagone and Megan Cassidy
San Francisco Chronicle
SACRAMENTO, Calif. — The suicide rate among California prisoners has climbed five years in a row and rose in 2019 to the highest level in at least three decades, reflecting a mental health crisis behind bars that appears to be worsening, according to experts, advocates for prisoners and the state’s top corrections official.
As of Tuesday, 36 people had killed themselves this year inside prisons operated by the California Department of Corrections and Rehabilitation. That amounts to a rate of 28.7 suicides per 100,000 prisoners — an increase over last year’s rate of 26.3, which was the state’s previous high since it began tracking the figure in 1990.
California has long struggled to prevent inmates from killing themselves, with numbers that compare poorly to other large American prison systems. This year’s rate is above the national average of 20 suicides per 100,000 people in state prisons, and is more than double the rate in the general U.S. population.
Twenty years ago, the prison suicide rate in California was 15.6, significantly lower than today. Back then, fewer people killed themselves, even though the prisons were more crowded.
Experts, judges and public officials say California’s deaths are the result of a system that for decades has failed to provide proper help to the state’s mentally ill prisoners, a population estimated at more than 30,000.
The new data was provided to The Chronicle by attorneys who represent those prisoners in a legal battle that has lasted for decades. Known as the Coleman case, it established in 1995 that prison mental health care was so poor in California that it violated inmates’ constitutional rights, according to a decision by a federal court.
Ever since, the Coleman court has forced state corrections officials to make reforms. A court-appointed Special Master has dispatched psychiatric experts to inspect prisons, analyze the circumstances of suicides and recommend changes.
Over the years, these experts have reported that many suicides in California prisons are the result of mistakes or policy violations by prison staff, and that many or most suicides could have been predicted or prevented. The experts have documented long wait times for mental health care, shortages of prison psychiatrists and failures to monitor prisoners with suicidal tendencies.
The state has adopted several of the experts’ recommendations and has made “some progress” on improving its suicide-prevention policies, according to a July decision by the Coleman judge. Still, crucial fixes are “dragging out and taking too long,” the judge said.
Michael Bien, an attorney who has represented mentally ill clients in the Coleman case for much of his adult life, called the new suicide figures “quite terrible and disappointing,” saying that California’s prisons “have more patients in the system than they can take care of.”
He added, “The suicide rate is just the most obvious statistic that emerges. We need to find a better way of taking care of mentally ill people than putting them in the criminal justice system.”
A corrections spokeswoman, Dana Simas, confirmed the accuracy of the new suicide statistics.
State officials are “concerned with the increase in suicides,” she said in a statement, “and we are committed to improving suicide prevention and mental health treatment delivery within our prisons in accordance with the Coleman court to ensure inmates receive the help they need.”
In October, agency Secretary Ralph Diaz told The Chronicle that California has “an inmate suicide crisis,” and that prison leaders and psychiatric providers were committed to reducing the deaths.
“Staff do care, and staff are trying to work to try and get ahead of these suicides — try to figure out why they’re occurring,” he said.
Over the past few months, prison officials have looked into expanding a San Quentin-based suicide prevention program called Brother’s Keepers, in which prisoners engage in peer-to-peer crisis intervention.
Marvin Mutch, a co-creator of Brother’s Keepers, said corrections officials reached out to him immediately following a September Chronicle article that highlighted the success of the program.
“My associates have been asked to work with certain prison officials trying to establish Brother’s models at specific prisons,” he said. “I’d like to see it systemwide.”
Mutch said he hopes to create a Sister’s Keepers program for women prisoners.
Prison officials’ enthusiasm for the program has seemed to wane in recent months, Mutch said. But he hopes he can make more progress in the new year.
“There’s an obligation that we have as a society to preserve the humanity of the people we’re caging,” said Mutch, a former prisoner at San Quentin. “Once the people who are caging you have stripped you of that identification ... then people start buying into that.”
The latest data show that of the 36 suicides this year, 10 occurred in special housing units where prisoners are kept apart, sometimes in solitary confinement. These include psychiatric cells and high-security isolation cells for prisoners who violate rules or have alleged gang connections.
Because the total number of prisoners in segregated housing is relatively small — just shy of 5,000 — the 10 suicides there amount to an extremely high suicide rate for the segregated population of 203.3 deaths per 100,000 people.
Another 2019 figure suggests that suicidal people behind bars aren’t getting the help they need: Several prisoners killed themselves soon after being evaluated and discharged by prison care providers, records show.
There are different levels of psychiatric care available in the prison system, such as outpatient care, “crisis beds” for inmates with suicidal tendencies and inpatient psychiatric programs. Eight prisoners in 2019 died by suicide within 30 days of leaving one of these higher levels of care.
The record-high suicide numbers this year may increase federal scrutiny of the state prison system at a time when it is already under the microscope.
Last year, the system’s chief psychiatrist, Dr. Michael Golding, filed an explosive whistle-blower complaint, accusing the prison system of altering key statistics about psychiatric care to make it seem as if sick prisoners were receiving better treatment than they were actually provided.
The state said the data errors were inadvertent and Golding was misinterpreting them, but the judge in the Coleman case disagreed. She wrote Monday that the corrections agency “knowingly provided false and misleading information” about its psychiatric care.
The judge issued the first in a series of “remedial orders” forcing corrections officials to make changes. The state has appealed similar orders in the past.
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©2019 the San Francisco Chronicle