Correctional mental health in the USA

Custodial suicide and class action remedies: Current obstacles and future directions

Custodial suicide is a foundational concern for correctional systems. The incarcerated population is at an increased risk for suicide as compared with people living in the community. Sufficient suicide prevention is a critical component of a constitutionally adequate system of correctional mental health care. The remedial phases of class action litigations have animated improvement in suicide prevention in many correctional systems across the United States. In the current climate, many legal obstacles make it more difficult for plaintiffs to prevail in such cases, but it is expected that advocates will find novel approaches in response to these legal hurdles, such as greater reliance on state law remedies, and will seek to expand the scope of potential actions in emerging areas such as immigration detention. Defendants and courts will, in turn, need to respond to these changes. This article explores the history of relevant litigations, and the legal obstacles currently faced by plaintiffs, as well as future directions the authors consider will likely be taken. Practical issues such as appropriate measurement of improvement in the area of suicide prevention are also explored.

Suicide Decedents in Correctional Settings: Mental Health Treatment for Suicidal Ideation, Plans, and/or Attempts

Based on 2005 to 2014 data from the National Violent Death Reporting System, this study examined mental health treatment status of suicide decedents in correctional settings, focusing on those with prior/recent suicide ideation/plans/attempts. Of all decedents ( N = 1,727), 30% had prior/recent suicidal ideation/plans/attempts, and of them, 64% had not received mental health treatment while incarcerated. Multivariable analysis showed that those with past-month crime/violence (as a proxy for recent incarceration) and those with an alcohol problem had higher odds of not having received treatment. Coroner/medical examiner and law enforcement reports show that other life stressors and fear of jail environment contributed to despair. The findings underscore the importance of suicide risk screening at or shortly after incarceration and providing necessary treatment and support.