Experts: Inadequate mental health resources, policies contribute to Louisville jail suicides

More

If you’re thinking about suicide, are worried about a friend or loved one or would like emotional support, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or 1-888-628-9454 for Spanish speakers

Three of the six people who died in the Louisville jail over the past four months died by their own hands.

These numbers point to a crisis at the jail, one that jail records suggest has the potential to get even worse: Louisville Metro Department of Corrections staff have taken preventative measures to stop suicidal acts at least three times since the latest death on February 6, according to incident reports obtained by KyCIR.

The frequency of incidents, inadequate mental health services and policies experts find lacking suggest the Louisville jail is not a safe place for someone suffering from a mental health crisis.

Jasmine Heiss, the project director of the Vera Institute of Justice’s In Our Backyards initiative which focuses on mass incarceration at the local level, said correctional facilities are constitutionally mandated to provide adequate mental health and medical care. 

The Department of Justice investigates civil rights violations in jails, and the FBI is investigating one of the six recent deaths in Louisville.

“Very often people act as the constitutional rights of incarcerated people evaporate at the jailhouse door, and that should not be the case,” said Heiss.

The Deaths

In early December last year, Stephanie Dunbar got in two fights in two separate dorms. The 48-year old woman was moved to a single-person cell where she took her own life.

A few weeks later, corrections officers found 41-year old Garry Wetherill attempting suicide. Wetherill was taken to the University of Louisville hospital where he was taken off life support and died January 1.

A jail officer found Lesley Starnes, 36, attempting suicide shortly after midnight on February 6. Starnes was taken to UofL Hospital, where he was pronounced dead.

Three others have died from other causes since November: Kenneth Hall, 59; Rickitta Smith, 34; and Keith Smith, 66. The cause of death has not been announced, but corrections officers said they administered Narcan on Smith, usually a response to an apparent overdose.

Eight people died by suicide in the custody of Louisville’s jail between 2009 and 2019, with half in 2015 alone, according to data compiled by Reuters. Bureau of Justice Statistics data show suicides in local jails nationwide have been increasing, to 355 in 2019, the most recent data available.

Heiss says the increase of suicidal behaviors in jails over the past two years could be indicators of a larger mental health issues across society writ large.

“People have been struggling during the pandemic, mentally and emotionally,” Heiss said. “Our criminal justice system is so often just showing the symptoms of larger social issues and public health issues, so it makes sense that this would be echoed and magnified there.”

Mayor Greg Fischer announced new steps last week to address the conditions at the jail, including the hiring of two new public services assistant chiefs for jail oversight and consultant Gary Raney, a retired Idaho sheriff and jail death expert who will review the recent suicides, policies and procedures at the jail.

“While suicides in jails are sadly common, every death is a tragedy, and we must work to ensure we are taking all appropriate measures to combat them,” Fischer said in a press release.

Fischer said the jail is working with its healthcare contractor Wellpath to review its suicide assessment and prevention measures, as well as conducting one-on-one reviews with people held in single cells and increasing contact with new arrivals.

Louisville Metro Department of Corrections assistant director Steve Durham said the jail isn’t commenting further on the recent deaths while Fischer’s review is underway, and Durham didn’t respond to questions about jail policies.

Daniel Johnson, president of FOP Lodge 77, the jail staff’s union, said correctional officers are overwhelmed. With more than 150 staff vacancies, they’re unable to keep an eye out for all the signs of an impending mental health crisis, he said.

Two Incident reports dating February 6, the same day Starnes died, and February 7, indicate there was no mental health staff on the premises, leaving jail staff to deal with someone in a crisis without the help of a trained professional.

Wellpath’s contract requires the company to provide a mental health director on-site Monday through Friday, with psychiatric nurses and social workers on site all week for a combined total of 316 hours per week.

But jail officials and corrections officers say Wellpath is facing staffing problems of its own, and the jail is often without a mental health professional on site in case of emergencies.

“After 5 p.m., there is nobody. On the weekends, there is nobody,” Johnson said.

The contract states that incarcerated people can replace paid staff for certain jobs, including suicide watch, and Johnson says this is a common practice at the jail.

A Wellpath spokesperson didn’t respond to questions about its staffing levels or suicide prevention measures.

Jails across the country are shifting towards private medical providers, according to Reuters. The news organization surveyed every jail that holds at least 750 people and found those with private medical providers had average death rates 18 to 58% higher than jails where public agencies provide healthcare. 

“When there is a profit incentive built into the contracts, there sometimes can be a disincentive to promptly respond to things that may be more costly, or burdensome, ” said Heiss of the Vera Institute of Justice.

Anasseril E. Daniel, a psychiatrist and former director of psychiatric services at the Missouri Department of Corrections, says that most suicides can be prevented if jails implement policies that identify mental health concerns before a crisis arrives.

Daniel says the frequency of suicides and attempts in Louisville’s jail suggests a problem with the screening process.

LMDC’s suicide prevention and intervention policy states that new arrivals will be screened for mental health including suicidal behavior when they are first booked.

A more effective policy, according to Daniel, would use screening tools specifically designed to detect suicidal behavior, rather than including this measure as part of a more general screening policy.

Daniel says the National Commission of Correctional Health Care standard that many jails use as the basis for their policies requires using a questionnaire designed specifically to capture subtle signs of someone who may be at risk of suicide.

Jail policy also dictates that people meet with a mental health professional within 14 days if they are flagged for mental health concerns, though Durham said people make follow up appointments sooner as necessary. Two weeks is far too long, Daniel said, and people should meet with a licensed mental health professional within 72 hours.

About a quarter of suicides in jails occur within 24 hours of confinement, and half occur within the first two weeks, according to BJS data. Two people who died by suicide recently in the Louisville jail had been there for less than two weeks.

“We are losing valuable time to identify the at risk individual,” Daniel said.

Once someone is identified the jail can take appropriate steps such as placing someone under constant observation and regular contact with mental health staff.

“All of this points to the global issue of whether this jail is taking suicide prevention as a major issue,” Daniel said. “There must be a paradigm shift in the administration, and beyond that of course allocation of resources, finding appropriate mental health professionals to do the screening, monitoring and evaluation.”

Roberto Roldan contributed to this report.

 

Comments are closed.