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Special Housing Unit Management Suicide Prevention¶
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Objectives¶
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Understand suicide risk associated with locked units and single cells
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Identify high risk groups
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mentally ill inmates
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behavior disordered inmates
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sex offender and protective custody inmates
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Discuss management strategies for specific at risk inmates in this SHU
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Review emergency response procedures
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Locked Units¶
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Locked units include SHUs, SMUs, ADX, Seclusion, Extended lock down units, etc.
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Every year between 30 and 80% of inmate suicides occur on a locked unit
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Single Cells in locked units are especially risky for high-risk inmates
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It is recommended that all SHU inmates be double-celled unless there is a compelling¶
reason not to do so.¶
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Reduces isolation
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Reduces privacy
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Provides rescue opportunity
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Single Cells¶
When an inmate cannot be double celled:¶
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Place at-risk inmates in higher visibility cells
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Reduce or eliminate tie-off points
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Increased monitoring of property
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Additional out of cell contacts with psychology
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High Risk Inmates¶
Discuss local policies to ensure specific inmates are not single celled. These may include:¶
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Special notation on Hot List
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Special notation on cell door
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Special notation on SHU boar
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Other
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Good SHU Management is Good Suicide Prevention¶
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Complete SHU rounds as directed by policy and document them accurately
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Observe inmates & report concerns to the SHU Lieutenant, Psychology Services, and/or the next shift, as appropriate
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Respond to inmate concerns and accommodate reasonable requests promptly
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Good SHU Management is Good Suicide Prevention¶
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Staff should wait for assistance prior to entering a SHU cell
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Cut down tools should never be used for any purpose other than responding to a suicide emergency
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Know the location of the AED and how to use it
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Behavior Disordered¶
Inmates¶
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30% suicides are committed by behaviorally disordered inmates in SHU
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At risk for suicide AND accidental death
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Must be assessed by psychology EVERY time they make a new threat of self-harm
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Must be taken seriously!
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Don’t allow negative perceptions or frustrations to impact your professional judgment
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Manage through collaboration between departments
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Working with¶
Behavior Disordered Inmates¶
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Manage with positive reinforcement
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Catch them being good
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Praise progress, not perfection
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Address reasonable requests promptly
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If a Suicide Risk Management Plan is in effect, follow it exactly
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The Plan we will discuss today is not the same as the plan used by the institution when an inmate is in restraints
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A Suicide Risk Management Plan is also NOT:
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Punishment
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Stricter rules
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Extreme deprivation
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Social isolation
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Less work for staff
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Suicide Risk Management Plan¶
The goal of a Suicide Risk Management Plan is to increase inmate safety by decreasing behaviors that create risk for suicide or accidental death¶
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A Suicide Risk Management Plan IS:
- Feedback: immediate and frequent
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Reinforcement: of positive behaviors or neutral behaviors that replace harmful
Collaboration: between psychology, custody, other departments, and executive staff¶
Targeted: self-harm behaviors and other behaviors that place the inmate in danger (cutting, cell fires, etc.)¶
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Creating a¶
Suicide Risk Management Plan¶
Psychology Services identifies key issues through observation of the inmate and input from staff:¶
from staff:¶
High risk behaviors¶
- Elements of the environment that
perpetuate dangerous behavior¶
positive behavior¶
-Reinforcers that may be used to reward¶
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- These are combined into a brief, individualized plan that indicates:
Management strategies¶
- When reinforcers will be provided
What harmful behaviors will trigger more intensive risk management strategies¶
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Enacting a¶
Suicide Risk Management Plan¶
- Present the plan to the inmate; this is
usually done collaboratively by the Captain¶
and Chief Psychologist¶
- Be prepared: Behaviors usually get worse
before they get better¶
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All staff need to adhere to the plan
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Discuss concerns and issues along the
way to ensure staff members are being¶
consistent¶
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Inmate’s Name &¶
Location¶
List Risk Factors &¶
Warning Signs Specific to the Inmate¶
- Discuss Helpful
Interventions: Especially¶
Preventative¶
Interventions¶
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Mentally III Inmates¶
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Approximately 30 to 60% of BOP suicides are completed by mentally ill inmates
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Disorders most frequently include Depression, Bipolar Disorder, and Schizophrenia
Symptoms may include psychosis, poor hygiene, lack of energy, poor appetite, insomnia, agitation, and lack of interest in things that were once of interest¶
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Mentally Ill Inmates¶
- Monitor these inmates closely; look for changes in mood and behavior and report them to Psychology
Build positive rapport with these inmates to assist them with problem solving and meeting their needs¶
During shake downs, ensure medications are not being hoarded and property has not been modified to allow self-harm¶
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• Inmate’s Name &¶
List Risk Factors &¶
Warning Signs Specific to¶
the Inmate¶
- Discuss Helpful
Interventions: Especially¶
Preventative¶
Interventions¶
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Sex Offenders and Protective Custody¶
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Both of these groups are at heightened risk for suicide
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Both groups may be fearful of other inmates
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Both groups may be experiencing shame
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Convey requests to speak to Psychology
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Place in higher visibility cells
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Emergency Response¶
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Always initiate life saving measures
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Ensure the response reflects the emergent
nature of the situation¶
- All staff should carry personal protective
gear¶
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