Asking About Suicide Is Vital for Suicide Prevention at Correctional Facilities

Suicide risk identification is critical for saving the lives of both inmates and correctional officers (COs), who are at heightened risk for taking their own lives.

Suicide is the leading cause of death in county jails in the U.S., with a suicide rate three times higher than that of the general population. Suicide is the third-leading cause of death in state and federal prisons. In England and Wales, suicide attempts are six times more likely for sentenced prisoners and 7.5 times more likely for pretrial detainees.

Relying solely on observation is not sufficient for prevention: Many suicidal inmates have no psychiatric illness and present no warning signs.

Suicide among inmates is not just a moral issue but also a financial one. Many of these suicides result in litigation alleging negligence or deliberate indifference. With jury awards that have exceeded $1 million, the National Institute of Corrections has said the results of those lawsuits can be “financially devastating” to a correctional facility.

COs are at risk, too, with a suicide rate up to twice as high as that of the general population. The officers face stressors that are unique to their profession and “pose a serious threat to [their] mental and physical health,” according to a July 2013 Department of Justice (DOJ) report, “Correctional Officer Wellness and Safety Literature Review.” Yet these officers may be hesitant to seek help: “Like police officers, COs have subcultural taboos regarding the acknowledgement of a need for medical or psychological assistance, as such admissions are perceived as a sign of weakness.”

The Columbia Protocol Is Helping Correctional Facilities Save Lives and Target Resources

Suicide is preventable, and asking the right questions to identify who is at risk is a critical first step to ending it. DOJ and World Health Organization best practices include procedures to systematically screen inmates upon their arrival at the facility and periodically throughout their stay to identify those who may be at high risk. Whether used to prevent suicide among inmates or COs, the Columbia Protocol — also known as the Columbia-Suicide Severity Rating Scale (C-SSRS) — is the ideal risk detection tool because it’s:

  • Simple. Ask all the questions in a few moments or minutes — with no mental health training required to ask them. That means, for example, that COs can participate in the screening process by posing the questions to inmates or co-workers.
  • Efficient. Use of the protocol redirects resources to where they’re needed most. It reduces unnecessary referrals and interventions by more accurately identifying who needs help — and it makes it easier to correctly determine the level of support a person needs, such as patient safety monitoring procedures, counseling, or emergency room care.
  • Effective. Real-world experience and data show that the protocol has helped prevent suicide.
  • Evidence-supported. An unprecedented amount of research has validated the relevance and effectiveness of the questions used in the Columbia Protocol to identify suicide risk, making it the most evidence-based tool of its kind.
  • Universal. The Columbia Protocol is suitable for all ages and special populations in different settings and is available in more than 140 country-specific languages.
  • Free. The protocol and the training on how to use it are available free of charge for use in community and healthcare settings, as well as in federally funded or nonprofit research.

“The assessment of suicide risk should not be viewed as a single opportunity at intake, but as an ongoing process.”

Lindsay M. Hayes, Project Director, National Center on Institutions and Alternatives