Suicide and Self-Harm – Why is it so High in NYS Prisons?

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The CA has been monitoring the high rates of suicide and self-harm in the state prisons for more than a decade and has repeatedly drawn attention to excessively high rates of harm at certain prisons and in specific locations, such as solitary confinement and residential mental health units, to the Department of Corrections and Community Supervision (DOCCS), the Office of Mental Health (OMH) and the legislature in the CA’s reports and legislative testimonies. DOCCS suicide rate from 2010-16 was 56% higher than the national average for all US prisons. This rate, however, obscures the fact that DOCCS suicides primarily occur at only a few prisons; in 2014-16, five prisons (Auburn, Clinton, Coxsackie, Elmira and Wende) accounted for over half of the 38 suicides during this three-year period, at rates that were three to nine times the national prison suicide rate.  Moreover, 30% of the suicides in 2014-16 happened in solitary confinement, even though those units only account for 8% of the DOCCS population, a rate that was almost six times higher than in DOCCS’ general population. Similarly, there were 666 suicide attempts or instances of self-harm recorded in 2015, which increased to 791 incidents in 2016.  Again, these acts were focused in certain locations. Rates of suicide attempts and self-harm were 11 times higher in solitary than in the general prison population (GP), 16 time higher in the non-punitive mental health units, 28 times greater in the mental health crisis units, and an outrageous 122 times higher in the residential mental health units created to treat patients with serious mental illness who violate prison rules.

But numbers do not explain why this is happening and what needs to be done.  Through our prison visits, conversations with many incarcerated persons, and reviews of DOCCS data and documents, we have identified several factors that contribute to these high rates of self-harm. First, the number of persons with mental health needs in DOCCS has increased dramatically in the last decade, and there are insufficient resources to treat these patients and house them in appropriate mental health residential units in the prisons. Second, DOCCS continues to place people with mental health needs in isolation, despite legislation intended to redirect these patients to treatment units. At the beginning of this year, 25% of persons in solitary confinement were on the OMH caseload, a dramatic increase in the last five years. Third, prison crisis units designed to assess patients who are experiencing a mental health crisis and keep them safe are often punitive in nature, and persons asserting they are thinking of harming themselves are often abused by staff and deterred from seeking help. Finally, DOCCS continues to respond to behavior by persons with mental health needs in a very punitive fashion, and treatment units are dominated by discipline rather than a therapeutic response.  Each of these deficiencies can be corrected with resources and changes in DOCCS and OMH policies, but not until the public demands a change by state policymakers. Until that time arrives, the CA will continue to reveal such abuses and advocate for systemic change.

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