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Unusually High Rate of Prisoners Suicides at San Antonio, Texas Jail

In 2009, all five of the Bexar County Adult Detention Center's (the jail) prisoner deaths were suicides by hanging and a sixth Bexar County prisoner being held in the Crystal City jail due to overcrowding at the jail, committed suicide. That was the year Bexar County Sheriff Amadero Ortiz took office. Ortiz promised to institute reforms to reduce the suicide rate among jail prisoners, but four years later those promises remain mostly unfulfilled. 2009 was a record year for suicides. That year, the jail's prisoner suicide rate far exceeded the national average for large jails. Yet 14 of the jail's 25 in-custody deaths between 2009 and 2012 were suicides, indicating a long-term, systemic problem. Prior to 2009, deaths from natural causes such as diseases exceeded the number of suicides at the jail.

The jail's suicide statistics stand out compared to other large Texas jails. Dallas County has 7,200 jail prisoners, yet only 4 of its 39 in-custody deaths between 2009 and 2012 were suicides. This compares to 14 suicides among 25 in-custody deaths for the jail's 3,800 prisoners. Likewise, Harris County's 8,800-prisoner jail system recorded only 4 suicides among 74 in-custody deaths in the same time period.

"There's no excuse," declared Ana Ianez-Correa of the Texas Criminal Justice Coalition, a criminal justice reform group which worked closely with Bexar County commissioners, especially Tommy Adkinsson, to reduce prisoner suicides at the jail. "Texans cycle through the local jails every year and let's not forget many of these people haven't yet been convicted of anything. ... What is the culture inside that jail? how is suicidal behavior being handled? 1 mean, even one suicide is too many."

One factor in creating a suicide-permissive environment is overcrowding. In June 2009, the jail's average daily population was 4,600. By June 2010, it had dropped to 4,100 and was down to 3,800 by June 2011. In June 2012, it fell to a low of 3,500, but was back at 3,800 by September 2012. A reduction in prisoner suicides has accompanied the reduction in prisoner population.

Ortiz touts the fact that "only" two of the jail's prisoners committed suicide in the first nine months of 2012 as proving that his reforms are working. But the jail is one of the 20 largest jails in the country and the average suicide rate for the nation's largest jails is about 27 per 100,000 prisoners. That means the jail should experience one prisoner suicide per year to meet the average. Ana the purported success of reforms does little to explain why the jail went from zero prisoner suicides in 2008 to 5 in 2009.

Along with the overcrowding problem has been a problem of insufficient jail staffing. The issue of appropriate levels of jail staffing even became a political issue during Ortiz's re-election bid in 2012. Ortiz claims that the staffing shortage forced jail staff to work overtime, sometimes even working two back-to-back eight-hour shifts. In turn, the stress of understaffing caused a lot of turnover in the jail staff, exacerbating the staffing shortage. According to the jail's administrator, Mark Thomas, about 10 guards quit every month.

An even bigger problem may be the rising numbers of mentally ill prisoners and the jail's inadequate response to this change.

"Even though our jail population has gone down by almost a thousand, our mental health beds are going up, they're increasing," said Mike Lozito, testifying in 2012 before the Texas House County Affairs Committee on the increasing demand for mental health beds and services at the jail. The committee became interested in the issue after officials noticed that mentally ill prisoners were cycling through the jail so often that it had become their primary source for mental health care.

"Our jail is essentially another mental health facility," said Joel Janssen, president of the union representing the jail's guards. He attributed this development to the state's dismal funding of mental health care.

The jail is just "another state hospital, like a mini state hospital," said Martha Rodriguez who runs the Detention Health Care System branch of University health Systems (UHS), the jail's prisoner health care provider. Rodriguez believes that the increased number of prisoners with mental health issues can be correlated to the increase in prisoner suicides. The UHS suicide prevention log for 2009 showed prisoners at the jail expressing suicidal thoughts 769 times. In 2010, it was 1,071 times and 1,038 times in 2011. By September in 2012, there had been 785 recorded expressions of suicidal thoughts.

In April 2010, nationally-recognized suicide prevention expert Lindsay Hayes delivered a report on the jail to the county that documented a long list of failures by the jail staff and recognizing at-risk prisoners. The Hayes report included a long list of recommendations to reduce the suicide rate at the jail. Some have been implemented. Many have not. In the period following the delivery of the report through September 2012, 8 of the jail's prisoners took their own lives.

Hayes noted that the jail had the proper mental health screening tools, but jail and UHS staff weren't using them. He said calling the 10-cell special section of the jail a "Suicide Prevention Unit" was a "misnomer" since it rarely housed prisoners on suicide watch and had no "appreciably enhanced services" other than two guards and one UHS staff.

The report said that "[i]t would appear that the jail system has an unexplained tolerance for potentially suicidal behavior that has resulted in the under-utilization of the Suicide Prevention Unit, as well as other units, for the housing of inmates."

The report also noted that staff failed to follow jail policies in ways that actually increased the chances of suicidal prisoners taking their own lives. For instance, by policy guards are not to take personal items from suicidal prisoners unless they displayed aggression toward themselves or others. Yet passive suicidal prisoners were routinely stripped of their property and clothing, clothed in "safety smocks" without undergarments and_ placed in isolation cells for 24-hours at a time. This type of confinement is known to increase suicidal tendencies according to the Hayes report.

The length of the suicide watch is also too short. The average of 24 hours is "considerably less than this writer's experience in consulting with other correctional facilities throughout the country," Hayes wrote.

In an attempt to show compliance with the suggestions Hayes made, Thomas pointed out a new 30-bed Special Observation Unit in a September 2012 interview. The unit's bay environment allowed constant staff supervision with the prisoners in close proximity. There was only one problem. It was empty and had never been used.

When Hayes made his report, jail staff wasn't receiving annual suicide prevention training. He suggested they do so. Over two years later, they still weren't. According to Ortiz, jail staff receives suicide prevention training ever other year. Hayes said it implemented a mandatory 3-hour comprehensive annual suicide prevention course for all its employees working in the jail.

Hayes also criticized the jail's booking area as being "noisy and lacking sufficient privacy to ask sensitive questions regarding a detainee's health care status." Thomas and UHS claim to have worked hard to increase the privacy of the screening process.

Those few improvements come too late for Robert Rodriguez, who committed suicide by jabbing a plastic spoon into his dialysis shunt and bleeding out on June 23, 2012. Rodriguez, 29, had been suffering from withdrawal of Klonopin, a prescription drug used to treat panic disorders and seizure, and had not been receiving his prescribed Xanax, another prescription drug used to prevent panic attacks. Guards had been describing Rodriguez's behavior as "mental" and he had become afraid that other prisoners and staff were trying to harm him. Yet the (HS mental health staff repeatedly cleared him to be housed in general population.

When faced with a prisoner suicide, staff at the jail circles the wagons and covers up--or at least it looks that way. One thing is for sure, they give the family of the deceased few details about what happened. This has so frustrated those families that some have sued just to find out what happened to their loved one.

"So much of what the county does, they do behind closed doors. And when people like this family come to ask questions about how this happened, why it happened, can it be prevented, they're stonewalled," said attorney Jesse Hernandez, who represented the family of Harlan McVea, who hung himself in the jail in 2009. "And it leaves them no choice but to come to folks like us and to file a lawsuit just to get the basic courtesies of finding out that happened to their loved ones. We don't know where the system failed these folks, and that's the problem. ... We have to file a lawsuit just to find out what went wrong and how it could have been avoided."

The "reforms" also can't help the other 13 prisoners who committed suicide at the jail since 2009. They seem a halfhearted effort to stem the tide of bad publicity with a too little, too late approach. Perhaps an inexpensive and confidence-building reform that should be initiated by the jail immediately is to have transparency when a prisoner dies in detention.

Source: San Antonio Current

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