Insight on Suicides in Arizona Prisons

Looking at the high fatality rate inside Arizona prisons has got to be disturbing to those families impacted by the sudden deaths of their loved ones. The fact is today, with one of the highest suicide rates in the country, Arizona officials have not dedicated sufficient attention to this most critical problem inside their prisons.  A closer look at the individuals committing suicides no longer suggests that suicides are committed due to their initial crisis of incarceration but rather, an isolated problem or sign of an inmate’s inability to do time under conditions imposed by the Department of Corrections rather than their length of sentence. Hence it is suspect that conditions of confinement are the driving forces in this disproportional higher rate of suicides being committed inside the more restrictive custody units than general population.

It must be clear that there is little research related to this theory that more suicides are successful in the higher custody levels than general population however looking at the press releases delivered whenever such a death notice is prepared, there is a distinct pattern of behavior and incidents at the higher custody levels than in general populations. This must support my theory that conditions of confinement inside level 4 and level 5 units offer little hope or relief that gives the prisoner a sense of doing time and returning back to general population to finish out their sentences.  

It is with high hopes that this document will encourage the Governor, Director and other prisons staff to conduct research, training and development of comprehensive prevention policies that include environmental impact statements on the psychological state of mind as well as the physiological impacts on the human body and wellness.  Of course there is my own theory about suicidal behaviors among Arizona prisoners housed in Level 4 and 5 custody units. It is my belief that suicidal behaviors are abnormal results within a solitary confinement setting and are orchestrated, manipulated or even deliberate wrongful attempts to gain attention and fulfill some desire to excite or create sympathy from staff to obtain some sort of favor in return for not doing such an act again.

This would make an assumption that the individual has the mental capacity to perform such manipulated acts or willful self-harm and not mentally impaired or otherwise under such psychological state of mind that he or she can’t execute or plan such deliberate attempts to gain the attention desired. It would also make the assumption that staff assigned make routine or mandated unit checks within time frames that could in fact abort such a deliberate attempt to hang or cut themselves with the staff arriving and treating the injuries within time frames that makes the act survivable and successful as a manipulated attempt to control the environment by negative behaviors.

Individuals depending on staff making their rounds on time for a successful discovery and intervention is a high risk factor with staffing patterns sparse and sometimes critically low to begin with on each shift. Their desperate desire to have contact, human contact, interaction and perhaps even an confrontation, fulfills their desire to be getting the attention wanted and the physical chastisement that comes from these pernicious practices of attempting suicides for the purpose of being recognized and treated as a person in need and not a person neglected.

However, my theory is completely flawed and subject to harsh criticism when the individual possess a mental impairment or is medicated so heavily that they cannot design or device such a deliberate plan for attention and actually experience real suicidal ideations that are based on current psychosis experiences due to diagnostic conditions left untreated or neglected for numerous reasons explained later on in this document.

It is my own opinion that many suicide attempts or successful acts are based on a form of concentrated anxiety and inability to cope with the environment and the conditions of confinement imposed by either policy designed to restrain the individuals in chemical or mechanical restraints every time there is human contact justified for either an escort to the shower, recreation or a visit or appointment out of their cell. It is likely the relatively condoned routine of keeping them inside a small 8 x 10 cell for 22 hours a day is enough to trigger their psychosis and belief that there is no hope for change and this is how they are going to life for the rest of their lives or are so disconnected from reality they are in another state of mind and become unreasonable in behavior.

 From a former deputy warden and  layman’s viewpoint, this enough to drive any human being crazy and if that mindset has already been established in the past or history, it is easier to be pushed over the edge whether they want to or not, it is a last resort to express their humanity.

Hence we need to look at precipitating factors and zero in on cause and effect of these two categories of human beings locked away inside level 4 and 5 custody units. Since one is more on the behavioral scale and the other on the mentally impaired scale, it should be prioritized to address the two separately to ensure all conditions are met related to risks, tolerant levels, individual coping skills and predictability. Secondary, we need to establish therapeutic environments for both categories of behavioral and severely  mentally ill to ensure there are no cross- over treatment / program elements that can taint the treatment process and cause a negative impact on those severely ill housed with the behavioral prisoners that may in fact taunt the mentally impaired to commit suicide.

It is highly probable that the conditions of confinement are primary causes for prison suicides. Other than the initial crisis of facing long prison terms, there are other risks associated with this perspective of “doing time” that involve factors ranging from protection from predatory or gang associated individuals, ridicule or abuse [physical and sexual] by other prisoners and harassment or misunderstandings with staff assigned to supervisor them and ill trained to comprehend or manage severe mentally impaired behaviors causing conflicts and misunderstandings that often result in aggression or altercation justifying their placement in a higher custody level with or without treatment intervention from mental health providers aware of the misconduct.  This is an abbreviated list of coping problems but the point is clear and should be addressed in thorough training and awareness of those signs related to the mentally ill.

Another perspective from a prisoner’s viewpoint is the unquestioned lack of trust between the prisoner and the administration or correctional officers. Already dealing with their own crisis of being incarcerated and losing control of their freedoms, decision making and apparent control of daily activities and programs, they are also isolated or abandoned by family and significant others.

Hence their custodial requirements are squarely based on what is perceived to be a total authoritarian environment unresponsive to their own needs or desires as well as necessities and treatment needs.

Focusing on the dependence on an authoritarian environment or correctional officers working around them, the need to communicate is often impaired and ineffective. It has been my experience that it is these are the exact barriers that offer the prisoner a chance of survival or hope if removed and replaced with a culture that is unresponsive to their medical / psychological treatment and their practical incarcerated needs. In many cases, a prisoner may have told someone he or she had been thinking of suicide but the message is never clearly understood hampering intervention methods. Whether this was triggered by “bad news” or other instances, there are significant references that demonstrate the predictability of behaviors when such a risk or event triggers their depressed behavior that also includes shame and remorse regarding their crime when it hits them all at once.

Since this is the first link in communicating risks or changes in behaviors or thoughts, there is a distinct operational factor that plays into the formula for disaster as there are predetermined logistical and other support mechanisms absent in the higher custody units where these suicides are more prevalent and occurring at an alarming rate or frequency.  “They often suggest such behavior be ignored and not reinforced through intervention. In fact, it is not unusual for mental health professionals to resort to labeling, with inmates engaging in “deliberate self-harm” termed “manipulative” or “attention seeking,” and “truly suicidal” inmates seen as “serious” and “crying for help.”  (Haycock, 1989a)

Finally, this document will end on a note that is most discerning to those working on this problem. Inside Arizona prisons there are multiple offenders suffering from different levels of emotional imbalance that requires special attention. Arizona prison officials have determined [with the support of mental health staff] that the prisoner is not dangerous and simply attempting to manipulate his or her environment. This suggests that the correctional staff assigned there adapts or accept this manipulation game as a pre-condition to accepting a suicide watch and not pay attention to detail or specific behaviors that includes being distracted from their duties, leaving the suicide watch area and not making timely rounds as required by their post orders.  Perceiving the threat as not-real, they are complacent in mannerisms and duty.

Source:

National Institute of Corrections -Prison Suicide: An Overview and Guide to Prevention By Lindsay M. Hayes Project Director National Center on Institutions and Alternatives Mansfield, Massachusetts June 1995