Jeffrey Epstein’s death and America’s jail suicide problem

The Manhattan jail where the US financier Jeffrey Epstein was found dead on August 10, 2019.  | Atilgan Ozdil/Anadolu Agency via Getty Images

Suicide is the leading cause of death in jails.

Jeffrey Epstein’s death by suicide was shocking — but it also follows a far too familiar pattern of deaths in jails: Deaths from suicide in correctional facilities is common, particularly in jails.

Epstein, who was charged with sex trafficking in July and was awaiting his trial, was found dead at the Metropolitan Correctional Center Saturday around 7:30 am. At the time of his death, he was awaiting trial, and if found guilty, he faced the possibility of up to 45 years in federal prison.

New revelations after his death point to questionable decisions by the correctional facility officials. Epstein, who had been on suicide watch after being found unconscious with marks on his neck in late July, was deemed no longer at risk a few days before his death. An MCC official also told the New York Times that guards failed to check on him every 30 minutes, as protocol requires, the night of his death. And only one of the two people guarding Epstein was a trained correctional officer.

Shortly after Epstein’s death, Attorney General William Barr criticized the management of MCC.

“I was appalled, and indeed the whole department was, and frankly angry to learn of the MCC’s failure to adequately secure this prisoner,” he said during a New Orleans police conference on Monday. “We are now learning of serious irregularities at this facility that are deeply concerning and demand a thorough investigation. The FBI and the office of inspector general are doing just that.”

These “serious irregularities,” however, are more common than one might think. Jails are often understaffed and can be overcrowded with individuals with mental illnesses. A third of deaths within jails are caused by suicide — a rate far higher than that of prisons (jails are for people being held before trial and prisons are for people who have been convicted). More than 400 lawsuits have been filed in the past five years for negligence toward inmates, and 40 percent of those cases dealt with suicide within jails, according to a joint investigation by the Associated Press and the University of Maryland’s Capital News Service.

Epstein’s death is not an abnormality. It points to a larger systemic problem within correctional facilities.

Suicide is the leading cause of death within jails

Every year, more than 300 people die by suicide in jails, according to the Vera Institute of Justice. Those in jail are seven times more likely to die by suicide than those in prisons. The first few weeks are crucial: A quarter of these people kill themselves in the first 24 hours, and half die within two weeks.

Part of this is because of the “shock of confinement” when an individual is initially taken into jail. The feeling of having lost a sense of normalcy can often be traumatic and push inmates to make drastic decisions.

A larger problem is that there is a disproportionate number of people with mental illness in jails, said professor Christine Tartaro, a criminal justice expert at Stockton University in New Jersey.

“Incarceration is difficult for anybody to deal with,” she said. “But to deal with it while dealing with the symptoms of a major mental illness makes it very hard.”

A 2010 study from the Department of Justice shows that 38 percent of those who die by suicide in jails are mentally ill and 34 percent have a history of suicidal behavior. (The government hasn’t released new data on jail mortality rates since 2014.)

Jails are required to screen for mental illness and suicide intention before admitting an individual into jail. The screening process, however, is not foolproof: The assessments are often held in spaces that are loud and lack privacy, which prevents individuals from being fully open about their conditions, Tartaro said. Warning signs can also show up a few weeks later, which is why monitoring should be consistent.

Yet regular suicide prevention training to staff wasn’t provided in two-thirds of the jails the DOJ studied. And while most jails provided a protocol for suicide watch, fewer than 2 percent even had the option for constant observation.

Even when treatment is in theory available, it tends to be hard to access and inadequate. Jails are simply not equipped to care for inmates with mental illness and monitor warning signs, Tartaro said.

“Overall, I would say that our system is woefully inadequate, unfortunately, because we don’t have enough drug treatment beds, we do not have enough psychiatric beds,” she said. “And the fact that some of the jails are now the largest psychiatric facilities in the country is definitely problematic. Those are not what they were ever intended to be.”

A lot of issues in jails stem from budget issues, but increasing funding isn’t a popular idea

A large part of jails’ lack of training and understaffing boils down to budget issues. Unlike prisons that run on state or federal budgets, local jails often run on county budgets. Therefore, they’re competing with other county services that are available to the general public, such as building roads and libraries.

“The general public has not wanted to hear that we need more money for criminals, even though many [jail offenders] are pretrial, they have not been found guilty yet,” Tartaro said. “So there is this resistance. And politically, it just is not a politically popular option to say no, we’re going to put all this money in the jails at the expense of a lot of other county services.”

There’s some effort to help prisons prevent future deaths; although 63 percent of jails do not conducts reviews following jail suicides, Vera is working to change that. Last month, the organization introduced a “sentinel events review,” which is described as “an all-stakeholder, nonblaming, and forward-looking examination of the error.” Rather than looking at individual errors, such an approach would focus on root causes that led to the death of an individual, said Leah Pope, a senior research fellow for Vera.

“The criminal justice system has long been a really adversarial system, which is really focused mostly on identifying those bad actors,” Pope said. “And that often doesn’t provide you with keys about really what was the kind of underlying system failures that might have contributed to the death.”

Vera identified four factors as key to conducting successful sentinel events review that could prevent future suicides: a commitment to delivering health care, strong collaboration, communication, and a healthy organizational culture. Establishing these standards to avoid more deaths should be “urgent priorities for jails across the United States.”

A vast majority of suicides can be prevented, despite common perception that some deaths are inevitable, Tartaro said. But in order for prevention to happen, correctional facilities need proper training, supervision, and communication — which many have so far failed to implement.

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