State is faulted over rise in inmate suicides

An independent study of the state prison system, requested by the Department of Correction and due to be released tomorrow , has found serious shortcomings in the state's handling of inmates who are at risk of committing suicide.

The report, commissioned after a sharp increase in prisoner suicides in 2005 and 2006, concludes that prison policies and practices are contributing to the problem:

Guards and other staff members do not have enough training in suicide prevention.

Guards fail to check frequently enough on some inmates at risk of suicide.

Some cells used to house suicidal inmates have not been stripped of features they could use to harm themselves.

Inmates under suicide watch become even more isolated because they are denied visits, showers, phone calls, and time outside their cells,

Ten inmates killed themselves in state prisons in 2005 and 2006. Another prisoner was left brain dead by a suicide attempt. Five of the 11 inmates had recently been on suicide watches, and six had documented histories of mental health problems.

Prisoner rights groups have repeatedly criticized the state prison system for failing to address the needs of inmates with mental illnesses. Lindsay M. Hayes , a national specialist in prison suicide prevention who wrote the report, said suicidal inmates are being punished instead of being helped.

"Confining a suicidal inmate to their cell for 24 hours a day only enhances isolation and is anti therapeutic," he said in the report, a copy of which was obtained by the Globe yesterday.

Suicide watches, in which self-destructive inmates are kept in cells by themselves, average three days long, according to the report. Prison officials stress that the isolated conditions are not meant to be punitive, but to ensure inmates' safety.

The review was requested by state Correction Commissioner Kathleen M. Dennehy last year as the department drew criticism for the increasing number of suicides.

The review was conducted by Hayes for the National Center on Institutions and Alternatives, a nonprofit research center based in Baltimore. His 63-page report recommends widespread changes in prison rules and procedures, including eight hours of suicide prevention training for all correction employees and better internal communication on inmates' mental health.

The department has developed a plan in response to the report and expects to make the plan public later this week, a spokeswoman said yesterday. Officials declined to respond to more detailed questions about the report before it is released.

State Representative Ruth B. Balser said yesterday she plans to push the department to follow the recommendations in the report. As House chairman of the Joint Committee on Mental Health and Substance Abuse, she has filed legislation that would require each prison to have its own treatment unit for the mentally ill.

"It's important that the department take seriously that they do have a problem," the Newton Democrat said in an interview.

Some family members see the report as too little too late. Frances Armstrong of Chelsea said she believes her 22-year-old nephew, Andrew Armstrong , hanged himself in Souza-Baranowski Correctional Center in Shirley in 2005 because he was not watched closely enough and because he never received the mental health treatment he needed.

"I hate to sound angry, but if they did this [study] when the three people before him committed suicide, his life might have been saved, and the people in there now might be getting the help they need," she said.

The most recent prison suicide occurred three weeks ago, when Mark Cunningham , 37, was found hanging from an electrical cord in his cell at Souza-Baranowski. Cunningham, a convicted rapist who had been transferred to a segregated cell days earlier, was the fourth suicide in a state prison in two months.

In his report, which was based on documents, prison visits, and interviews with staff members over several months, Hayes notes that he has made similar recommendations before. Six years ago, when he reviewed suicide prevention practices at Bridgewater State Hospital, the department's psychiatric facility, he urged officials to expand suicide prevention training for prison employees from 2 1/2 to eight hours. His recent review found the training had not been extended.

The report also includes unsettling details about recent suicides, the vast majority from inmates hanging themselves. In two recent cases, inmates were hanging for more than 30 minutes before they were discovered, though prisoners on suicide watch are supposed to be checked at least every 30 minutes. In the report, Hayes urges the department to do away with 30-minute checks for suicidal patients, which he concludes are too infrequent, and instead check at least every 15 minutes and have constant observation for the most troubled inmates.

Some of the suicidal inmates were housed in cells where bed rails, ventilation grates, and gaps between bars could be used as anchors in hanging attempts, Hayes reports; one suicide occurred when an inmate hanged himself from a grate above a sink.

In two prison suicides, inmates were carried away from their cells before cardiopulmonary resuscitation was performed, and in two other cases, nurses struggled to find the necessary equipment to attempt resuscitation.

Other, more wide-reaching problems may be harder to address. Despite years of discussion about the need for more units where mentally ill inmates can receive appropriate treatment, "little progress appears to have been made in this area, and few, if any, alternative housing/programming options are available for inmates housed in segregation with serious mental illness," Hayes concludes.

Between 2000 and 2005, the number of mentally ill inmates in the system increased by almost 1,000, but the number of beds for those inmates did not change, the report finds.

The frequent isolation of suicidal inmates violates national prison standards, which call for them to be housed in the general population or in special mental health units, the report finds.

"These responses may be convenient for staff, but they are detrimental to the inmate," Hayes writes.

Jenna Russell can be reached at jrussell@globe.com.