DOC takes a strong look at suicides

ANSONIA >> It seemed like everyone in town knew a man who had been labeled a “troubled child” at a young age, and in adulthood he had a hard time shedding the label. The comments and quips continued well into his adult life.

He would later be diagnosed with bi-polar disorder around 2005, his former partner Patricia McDonnell said.

. He had a criminal history, but his family felt many of those crimes could have been avoided if he had received more help for his illness.

When he went to prison following a July 2013 arrest on first-degree burglary charges, his family said he cut ties with them. Things eventually improved; he began exchanging letters with McDonnell in March 2015. That lasted about a year, until McDonnell said a family emergency shifted her focus. She wouldn’t be able to provide financial support for him, but McDonnell said he responded well, even saying he was “relieved.”

Despite their renewed connections, she said something was still bothering him. The Register is not naming the man at the request of his family.

“He was severely depressed in jail,” McDonnell said. “I don’t think he talked much about it.”

But what happened on Aug. 6 was shocking: he was found dead of what was ruled suicide while in custody at Osborn Correctional Institute, a state Department of Correction facility. .

The state medical examiner would conclude Aug. 7 that he died from hanging, with the manner of death being suicide. His family said they didn’t find out about his death until two days afterward, because authorities didn’t immediately notify his family members.

Department of Correction spokeswoman Karen Martucci said there was no one listed as an emergency contact for the man. Following his death, Martucci said DOC staff scrambled to find a next of kin. They conducted cursory searches online to try to find someone.

Since the death is still under DOC investigation, Martucci said she couldn’t speak broadly about it.

“These folks lost a family member,” Martucci said. “Our hearts are with them.”

When authorities contacted the family, it wasn’t immediate family. Deputy Warden Gary Wright ended up calling the wife of one of the man’s cousins, who passed along the information.

The death marked the third suicide of an inmate under DOC supervision in 2016. Four months later, a Moodus woman was found hanged at York Correctional Institute, bringing the total to four.

Between Jan. 1, 2005, and Dec. 31, 2016, 307 inmates died while incarcerated under Department of Correction supervision, according to Martucci. Those figures include inmates who were transferred to an outside hospital for care. Martucci said the leading cause of death for inmates who die under custody is illness.

During the same 10-year span, DOC figures indicate 44 of the 307 inmate deaths were suicides. The annual numbers fluctuate every year; the DOC recorded only one inmate suicide in both 2006 and 2011. Its worst year during that span was 2005, when seven inmates took their own lives.

A year before that, in 2004, DOC Chief of Psychiatric Services Dr. Craig Burn said nine inmates committed suicide. As low as one is, Martucci said referring to 2006 and 2011, it’s still one life.

“In my mind, prevention is not enough,” Burn added. “There’s a cognitive distortion that takes place for the person who believes that they are that isolated, that hopeless and that permanent solution to their temporary problem is appropriate.”

A report published by the U.S. Department of Justice’s Bureau of Justice Statistics in December provides a larger context to the more than 50,000 prison deaths in state and federal prisons since 2001. The report estimates there were roughly 1.5 million people imprisoned annually through that time span. Connecticut’s correction system currently has about 15,000 inmates in 15 facilities.

Connecticut’s inmate suicides represent just 14.3 percent of all inmate deaths during that 10-year span. The DOJ’s report was compiled over a 12-year period, from 2001 to 2014, as opposed to the 10-year window provided by the DOC. During the timespan used by the federal government, 2,826 inmates in state prisons took their own lives. The report said suicides represented 7 percent of all deaths in state prisons in 2014, which was the largest percentage since 2001. Suicides jumped by 30 percent in state prisons from 2013 to 2014.

The number of suicides under DOC supervisions over a 10-year span reveals few patterns, yet it’s a reminder that work addressing suicides remains ongoing. It’s why a few years ago the DOC decided their new goal is not suicide prevention: it’s suicide elimination.

“We’ve taken a strong stance and efforts to eliminate—we used to call it suicide prevention, we call it suicide elimination now because that’s the goal,” Martucci said.

Working to prevent suicides

Encouraging more communication between inmates and their families is one way Martucci said the DOC is helping address the potential for self-harm. This means asking families to contact DOC if they believe their loved one is exhibiting signs that can suggest a potential for self-harm. That triggers another process Martucci said involves contacting the facility and its staff to identify the individual for support.

The DOC has created posters and videos in English and Spanish for suicide elimination as part of the campaign. It was the first department of its kind in the country to adopt the Zero Suicide concept, a nationwide initiative that follows guidelines to help eliminate suicides. The department’s website also has a page with information on mental health and suicide elimination.

Street culture can often creep its way into prisons, which is why another step DOC pushed wasn’t easy to implement. It involved encouraging other inmates to speak up whenever they noticed someone acting differently than usual. To some, it sounded too similar to snitching. DOC informed inmates of signs that something could be wrong, like an offender who has been sleeping more than usual, who is giving away possessions or simply not acting like himself. Martucci said they would encourage inmates to notify staffers if they saw such behavior.

“There was somewhat of a stigma of, if you as an offender go talk to someone, you’re snitching,” Martucci said. “So we really wanted to put that stigma to bed, to say ‘You’re helping.’”

Signs that someone may be suicidal in a prison setting mimic ones in the outside world. Martucci said other red flags include an offender not coming out for meals, acting less engaging and openly speaking about feeling hopeless.

“When that happens, that’s the trigger to act,” Martucci said. “That’s a positive scenario for us, where someone is vocally voicing their concerns for their own safety because now we know and now we can act accordingly.”

There can be additional triggers that lead someone to consider self-harm, which in a prison setting could add to an already difficult situation. The DOC also seeks to avoid so-called copycat incidents following a suicide or suicide attempt.

“We have a population where people can be sharing similar kinds of stressors,” Burn said. “We’re al- ways concerned with how other people that are incarcerated are going to process if someone tries to end their life.”

When inmates arrive at one of the DOC’s 15 facilities, their intake includes a mental health assessment. This involves a meeting with an offender to review and assess their mental wellbeing. Previous clinical incarceration records and community records indicating previous care are sometimes included.

Depending on what an inmate says, the DOC could suggest certain responses. Some inmates could be sent to Garner Correctional Institution in Newtown. This facility houses the highest-level mental health services housing inmates with “acute” mental health concerns. Burn said inmates can potentially be moved to an infirmaries or other specialized housing. The DOC also operates hospice care at three of its facilities, including Osborne.

When staff believes someone is in danger of self-harm, measures can be taken that include removing certain objects from their cell. Martucci said inmates have used various objects to attempt self-harm, especially a ligature for hanging.

Inmates will typically use an object not used for its intended purpose. It leads to a question Martucci said the public may ponder: How is it possible for someone to harm themselves in setting with constant oversight?

“It takes a relatively short amount of time to take your life,” Martucci said. It, unfortunately, doesn’t take much to close a person’s airway, Martucci said, which is why staff is trained to respond in a self-harm scenario. Staffers who respond to these situations can experience trauma, and Martucci said there have been cases where staff is severely impacted.

It’s led to a high rate of suicides among DOC staff, Martucci said, and an employee wellness committee was formed to address their own concerns.

“Medical staff, correctional staff, the person making the phone call to the family, it’s a traumatic event for all of us,” Martucci said.

The DOC can place people on “suicide watch,” which is a broad term involving several different measures depending on the situation. The DOC doesn’t usually use this term because it’s can vary so much.

Suicide watch can involve placing an inmate where there’s more staff touring, which Martucci said means there’s someone who will visibly see them more often than a general population setting. Other methods include placing an offender in an infirmary for prolonged observation or even in a cell area with a camera.

A final decision is made to tailor it to the individual’s behavior. Extreme cases would involve having a trained staffer sit outside an inmate’s cell to keep continuous observation.

“All these are kind of individualized issues,” Burn said. “There are a number of tools in the toolbox.”

The DOC’s protocol for suicides is triggered when a staff member first finds someone who has self-harmed or unresponsive. Lifesaving measures are applied. Martucci said all “front-line” staff members are trained in CPR and first aid but still call 911. Inmates are then taken to outside hospitals.

When an inmate is found dead and a suicide is suspected, the DOC isolates the area. Connecticut State Police arrive and begins an investigation, which is done in addition to the DOC’s own probe.

“The minute that the death is announced and we’ve done our due diligence of securing the area, making contacts to external law enforcement, family notification is our next piece,” Martucci said. “Obviously, that’s a very difficult phone call for a correctional warden to make.”