Troubled inmates strain jail staff

From the Coos Bay World, March 28 2009

Mental health concerns arise regularly

An anti-suicide suit is among two tools available to jailers at the Coos County Jail.Going to jail is tough. There are dozens of strangers, not all of them friendly. Birthdays, graduations and holidays come and go without friends and family. As the days pass, the lack of freedom wears on the psyche.

It’s a recipe for depression, anxiety and despair.

Coos County’s jail staff has coped with multiple mental health challenges recently. Along with an autistic murder suspect, the jail has seen two recent suicide attempts. One desperate inmate, deprived of other ways to harm himself, bit off a piece of mattress in the hope of choking to death.

PICTURE – An anti-suicide suit is among two tools available to jailers at the Coos County Jail to help an inmate cope with suicidal thoughts. Either the suit or a heavy black blanket can be wrapped around someone in difficulty while in the jail.

Officials say providing adequate services and security for such inmates is a struggle.

Every prisoner who enters the jail receives a medical screening, said Cpl. Darius Mede of Coos County Sheriff’s Office. Jailers ask if the inmate feels suicidal or has a history of hurting himself. The jail also heeds warnings from concerned relatives or friends.

When jailers identify someone who may be suicidal, he’s isolated and closely monitored.

Jailers take away anything that could be used in a suicide attempt, including the prisoner’s clothing. The prisoner is clad, instead, in an anti-suicide suit — a bulky, weighted wraparound garment that closes with Velcro.

Sgt. Delphine Green, jail administrator, said the suit is designed so it can’t be torn into pieces that could be used for hanging or choking.

“This is a way to keep them from getting cold and give them some coverage. You don’t want to take away their dignity,” she explained. “You just want to keep them from hurting themselves.”

Someone checks on the inmate every 10 minutes until a mental health specialist arrives.

“Once someone has been placed on suicide watch, he is not cleared until there is a mental health specialist that says it is OK,” said Mede.

As much as jailers try, Mede concedes the system isn’t perfect.

“We do our very best to make sure they don’t hurt themselves, but there are no guarantees,” he said.

Ginger Swan, director of the Coos County Mental Health Department, said there are obstacles to treating inmates with mental health issues. It can be an ordeal to move someone to a secure place for a counseling session. Some inmates have to stop taking certain medications because the drugs can be abused or sold to other inmates.

And while efforts are made to help those who seek help, the jail can’t keep track of everyone.

“They aren’t set up for that,” she said. “Even in the most watched settings, things can happen.”

Swan said some of the inmates who need mental health services have sought help before, while others only get it in jail. But not everyone who tries to commit suicide in jail arrived with a pre-existing mental health problem.

“If you’ve been free and now you are in a jail cell, and looking at spending a long time there, you could become so anxiety-ridden that you become suicidal,” she said.

Identifying those inmates is a nationwide problem, Swan said. Before coming to Oregon, Swan worked in the Oklahoma prison system. The state decided to offer psychology services in every correction facility. The subsequent staff training made a difference, but then the funding ran out.

“That system basically collapsed,” she said.

Whenever a jail system faces budget cuts, mental health services usually suffer.

“One of the first things you give up is psych services,” she said. “The No. 1 concern is security.”

Budget cuts have shrunk jail staffing in Coos County in recent years. Some swing and night shifts have as few as five deputies on duty. Those thin ranks limit flexibility when an inmate needs to go to the hospital.

If a doctor insists an inmate needs to spend the night at the hospital, the jail will post someone there to provide security, Mede said, though it means another deputy is called in and works on overtime.

“We have to deal with whatever we get,” he said. “We have to follow doctor’s orders and follow our policy.”

Swan said it’s not unusual for a jail to have several inmates attempt suicide in a short time.

“It’s the same thing with disruptive behavior,” she said. “It can become like a disease. It can become contagious.”

Having more guards or more programs might reduce the suicide attempts. But those steps would be expensive, and they wouldn’t entirely end the risk.

“If someone really truly wants to kill themselves, they will and there’s really no way to stop them,” she said.