How much do we know about suicide and self-harm in prison?

By Rachel Crumpler

Christopher Brandon Propst, 44, died of an apparent suicide at Piedmont Correctional Institution on Saturday, November 18. The NC Department of Adult Corrections announced the death in a news release on its website next Monday.

Propst is the latest person to commit suicide in the state prison system. Five more suicides took place at the beginning of this year.

But this public, real-time reporting of suicides in prisons is not happening across the country. Only North Carolina and 15 other states provide information on suicides, which is frequently updated, detailed and freely released.

Recent research by the Third City Project has found extensive data gaps on deaths in custody. The Third City Project is made up of researchers in North Carolina who are working to publish data on cancer systems and health in response to data gaps identified during the epidemic.

Twenty-one states provided no information on suicides, shared data that was out of date, or required the information to be obtained through a public records request, despite the Death Reporting Act, which requires states to report data on in-custody suicides.

This significant reporting gap hinders public understanding of the cancer system, said Kate Lemasters, who helped evaluate the prison system’s suicide reporting policy as a doctoral student in UNC Chapel Hill’s Department of Epidemiology.

“We don’t have a baseline without data,” said Lemasters, who is now a researcher at the University of Colorado Anschutz School of Medicine, where he focuses on the intersection of incarceration and health equity. “There is no way to base research or policy or programs without actually knowing who is dying, how many, when and under what conditions.

“There’s really no way forward to try to improve outcomes.”

The team of researchers evaluated the conditions based on the availability of suicide data. Sixteen states provide updated, frequent, granular, and freely available suicide data. Credit: Map produced by Third City researchers reprinted from MapChart using a CC BY license

The widespread lack of transparent reporting is problematic, Lemasters said. In fact, he initially sought to study changes in suicide rates in prisons during the pandemic, suspecting that factors such as the spread of COVID behind bars, limited visits and more time spent in isolation to try to contain the disease could worsen inmates’ mental health. . health. But he discovered that he could not measure this. data does not exist.

And he knows there are many other research questions, policies and programs that cannot be adequately analyzed at a time when suicides in prison have increased across the country without improved data.

“Suicides are the types of deaths that these facilities play a huge role in preventing, and it’s pretty scary when those deaths are still happening,” Lemasters said.

Track suicides in prisons

Researchers from the Third City Project, led by Duke University’s Lauren Brinkley-Rubinstein, rated each state’s prison system according to the level of availability of in-custody suicide data.

States received an A if prison system data were provided consistently, were complete, were frequently updated, were available at the facility or individual level, and were freely available through statistical reports or news publications. That’s the rating North Carolina received.

Susan Pollitt, an attorney with the National Disability Rights Center, which specializes in advocating for the rights of people with disabilities in prison, has tracked the number of suicides in prison for years. In 2022, 13 cases of suicide were recorded, a record high rate.

Pollitt said he’s glad the prison system is releasing news in a timely manner, announcing confirmed suicides with basic information such as the person’s name, their age, date of death and the correctional facility where they died.

The information provided in North Carolina is detailed enough to identify facilities where suicides may be more common. Last year, for example, Pollitt noted that there were five suicides at Burt Correctional Facility in eastern North Carolina, indicating a need for further study of the situation there.

While North Carolina publicly reports more information than other states, Pollitt said the information provided is still quite limited.

“I wouldn’t give North Carolina an A,” he said.

For Pollitt, the A rating is more indicative of a low bar for data access nationwide, rather than North Carolina particularly excelling in this area. Pollitt, for example, wants the North Carolina prison system to provide more details when reporting in-custody suicides, such as whether the person was held in solitary confinement. Only three states—California, Florida, and Kansas—provide data on housing status at the time of death.

LeMasters agrees that a larger context of the housing status and mental health conditions of suicide victims can help identify trends and underlying patterns in who dies and why.

“If we see a lot of people dying by suicide, if they come out of solitary confinement, or if they have serious mental health issues,” Lemasters said, “I think that speaks to how we can we are and need to change the housing protocols. and around treatment.’

Pollitt said he can sometimes learn more about the circumstances surrounding a suicide by filing a public records request for the medical examiner’s investigation and autopsy report.

Furthermore, Pollitt said he believes it is a “flaw” that the state prison system does not publicly report suicide attempts. He said this information could be a useful indicator for understanding the mental health of inmates. The researchers found that six states—Alabama, Arizona, Arkansas, Connecticut, Michigan, and Tennessee—reported the measure.

“The curtains have to be pulled back on what’s going on in our prisons if we’re going to understand the problems and work together to solve them,” Pollitt said.

Track suicides in prisons

More transparency is needed about suicides at the state’s more than 100 county jails, said Luke Woolard, an attorney with the National Disability Rights Center who has tracked the deaths.

In March 2022, Disability Rights published a report on prison deaths in 2020, which showed 21 suicides. While no official report has yet been released by the organization, Woolard told NC Health News that Disability Rights counted 17 confirmed suicides in 2021 and 23 in 2022.

Woolard said Disability Rights matched these figures from public records obtained from the state Department of Health and the Office of the Chief Medical Examiner on deaths in custody. The state Department of Health has an oversight role in prison health care, while the Office of the Chief Medical Examiner performs autopsies and toxicology analyses.

After someone dies in prison, the inspector general of the state health department’s Division of Health Service Regulation conducts an investigation into the death. A death investigation can provide useful information, Woolard explained, such as whether the facility met the minimum requirements of state prison rules for things like screenings and levels of supervision. In recent years, Woolard said, many of these death investigations have found oversight failures and other deficiencies.

Public reporting protocols vary from county to county; some prisons publish news about suicides and some don’t. That means the primary and most reliable way to learn information about prison suicides is through public records requests, Woolard said.

But Woolard said the method of sharing information comes with more lag and isn’t as accessible, especially for community members who may not know what documents to request.

“It’s important that information is readily available to people who pay for these prisons with their taxes, and whose friends, loved ones or themselves may end up in these prisons,” Woolard said.

Woolard would also like to see more statewide mandatory reporting requirements for things like suicide attempts. He said the measure could provide a more complete picture of inmates’ mental health and prison effectiveness.

House Bill 841, introduced in May 2021 by Rep. Carla Cunningham (D-Charlotte), would have required prisons to report suicide attempts and required the state health department to conduct compliance checks after each incident. But the bill went nowhere, making it nearly impossible to track those incidents.

Woolard said timely and accurate data is vital to understanding and improving prison conditions.

“Transparency is incredibly important,” Woolard said. “Sunlight really is the best disinfectant in most cases, and it’s necessary for the lawyers, the communities and the families of the people in these prisons to know what’s going on.”

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