Elements of State and Federal Prison Suicide Prevention and Response Policies

• Published date: 01 April 2024
• DOI: http://doi.org/10.1177/08874034241227885
• Author: Christine Tartaro,Emily Alas
• Date: 01 April 2024

https://doi.org/10.1177/08874034241227885

Criminal Justice Policy Review

2024, Vol. 35(2-3) 85 –110

© The Author(s) 2024

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DOI: 10.1177/08874034241227885

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Article

Elements of State and Federal

Prison Suicide Prevention

and Response Policies

Christine Tartaro1 and Emily Alas2

Abstract

There are no mandatory national standards for custodial suicide prevention and

response programs in the United States. While some professional organizations

do offer accreditation, those programs are optional. Recent research on jails found

that most facilities have formal suicide prevention policies, but they differ in their

comprehensiveness. Little is known about the elements of state and federal prison

suicide prevention policies. This study involves an analysis of state- and federal-level

department of corrections suicide prevention and response policies. Elements of

each jurisdiction’s policies were compared against a list of best practices, developed

by professional organizations and correctional suicide scholars, for suicide prevention

and response. Results revealed that, on average, department policies contain about

half of the recommended elements, and that some policies, including those that

could improve the culture of each institution, are not included in most departmental

policy documents.

Keywords

prison, suicide, mental health, policies

Prisons must contend with managing people who are mentally ill or experiencing a

mental health crisis, and the number of incarcerated individuals who experience men-

tal health problems has increased over the past 50 years (Johnson, 2011; Kolodziejczak

& Sinclair, 2018; Looman & Carl, 2015). The United States conducted a mass

1Stockton University, Galloway, NJ, USA

2Widener University, Chester, PA

Corresponding Author:

Christine Tartaro, Distinguished Professor of Criminal Justice, Stockton University, 101 Vera King Farris

Drive, Galloway, NJ 08205, USA.

Email: Christine.Tartaro@Stockton.edu

1227885CJPXXX10.1177/08874034241227885Criminal Justice Policy ReviewTartaro and Alas

research-article2024

86 Criminal Justice Policy Review 35(2-3)

incarceration boom, beginning in the 1980s, that resulted in a 500% increase of the

prison population (The Sentencing Project, 2022). This coincided with decades of

reductions in available psychiatric beds throughout the country, from 559,000 in 1955

to just 35,000 by 2012 (Torrey, 2016). These two factors, combined with the lack of

funding for community mental health programs, dearth of affordable housing, income

inequality (Frederick et al., 2018), and a get-tough-on-crime mentality, have contrib-

uted to the United States leading the world in incarceration and using correctional

facilities as de facto mental health institutions. The United States currently houses

1.2 million adults in prison (Carson, 2022), 37% of whom have been diagnosed with a

mental health disorder (Bronson & Berzofsky, 2017).

Prisons also house a disproportionate percentage of people who struggle with sub-

stance misuse or addiction (National Center on Addiction and Substance Abuse, 2010;

National Institute on Drug Abuse, 2020). Just as prisons were never intended to serve

as psychiatric facilities, they are also ill-equipped to provide the necessary levels of

substance abuse treatment and medical attention to people suffering from substance

misuse. Both people with mental illness and individuals struggling with substance

misuse are at high risk for suicide and are overrepresented by those who die by suicide

while in custody (Favril et al., 2018; Hayes, 2010; Patterson & Hughes, 2008; J. Shaw

et al., 2003).

While the “imported vulnerability” (Liebling & Ludlow, 2016) factors of mental

illness and substance misuse are important predictors of suicide in custody, it is

important to remember that people who are not mentally ill can also be at risk for

suicide (Liebling, 1992, 1993). The deprivations associated with incarceration,

including but not limited to separation from family and friends, security threats stem-

ming from being housed with other offenders, and lack of freedom and autonomy

(Sykes, 1958), weigh on people in prison, and individuals vary in their ability to cope

with these challenges (Liebling, 1999). Even in the absence of mental illness or strug-

gles with addiction, people may find the stress and sadness produced by incarceration

to be too much to bear and consider suicide as their only form of relief from the pain

they are experiencing.

In 2019, 8.1% of people housed in state prisons in the United States, who died, did

so by suicide, and this was the highest percentage of self-inflicted deaths since the

Bureau of Justice Statistics began collecting mortality data in 2001 (Carson, 2020).

From 2001 to 2019, suicides increased in the U.S. Federal Bureau of Prisons (BOP)

and state prisons by 61% and 85%, respectively (Carson, 2021). The suicide rate in

state prisons was 27 per 100,000 and 20 per 100,000 in the federal system in 2019

(Carson, 2020).1 Outside of incarceration settings in the United States, the suicide rate

was 13.9 per 100,000 adults and 22.4 per 100,000 adult males (Hedegaard et al., 2021).

Suicide risk may also extend past the expiration of one’s time in prison or jail.

Researchers from multiple countries have found that people recently released from

incarceration tend to die by suicide at a higher rate than people permanently residing

in the free community (Binswanger et al., 2007; Daigle & Naud, 2012; Haglund et al.,

2015; Pratt et al., 2006; Spittal et al., 2014). Since custodial facilities often serve as a