Civil Rights and Mental Health Care

A critical part of the civil right to medical care is access to mental health care. Prisons, jails, wardens, officers, and medical providers all know that mental health instability is a fundamental issue in the correctional setting. This is particularly true as more adults are incarcerated with serious mental illness. As the number of inmates with mental illness have increased, so has the number of self-harm and suicides. For example, accordance to U.S. Department of Justice, the number of suicides increase from 499 a year to 695 from 2001 to 2019. Suicide account for 5% to 8% of all deaths in prisons and 24% to 35% of deaths in jails making suicide the leading cause of death in jails and the third leading cause of death in prison.

A major contributing factor is the inherent isolation and alienation of incarceration. Incarcerated individuals often face social exclusion, mental illness, and substance abuse—all known risk factors for suicide. These challenges are intensified by the lack of human connection, leaving many feeling hopeless and overwhelmed.

Despite this, many suicides in custody are preventable. National organizations, government agencies, and legislatures have issued policies and guidelines aimed at reducing suicide through increased engagement and oversight. To prevent suicides, facilities must take proactive steps, including:

1.     Comprehensive Screening and Ongoing Assessment especially for those with a history of suicide or self-harm.

2.     Effective Communication between correctional staff, inmates, and mental health providers to identify and address risk.

3.     Timely Crisis Response when an inmate shows signs of distress.

4.     Minimizing Isolation by housing inmates with others or in environments that reduce solitary confinement.

5.     Consistent Observation by monitoring individuals with suicidal ideation or recent self-harm behavior.

6.     Access to Care by Providing Therapy and Medication Management.

The role of isolation in suicide risk is so clear that, in 2019, the New Mexico Legislature passed the Restricted Housing Act (NMSA 1978, §§ 33-16-1 to -7). This law prohibits the placement of inmates with serious mental disabilities in a cell for 22 hours or more per day.

Common Suicide Risk Factors in Inmates:

·       Prior suicide attempts or self-harm

·       Mental illness or substance abuse history

·       Family history of suicide or violence

·       Anxiety, depression, agitation

·       Hallucinations

·       Recent medication changes

·       Insomnia

·       Social isolation or lack of support

·       Interpersonal conflict

·       Upcoming court dates

·       Facility transfers

Correctional staff must remain vigilant, even if an inmate denies suicidal thoughts. As experts emphasize, staff should never rely solely on an inmate’s denial, especially when behavior or history suggests otherwise.

Prevention Measures that behavioral health and psychiatric must implement include:

·       Order observation

·       Create a safety plan

·       Create a treatment plan

·       Provide therapy

·       Admit to an acute care unit when needed

·       Maintain clear, ongoing communication among providers and security

Security Protocols that correctional staff and facility administrators should implement include:

·       House inmates with others when safe and appropriate

·       Use high-visibility cells

·       Eliminate or reduce tie-off points

·       Impose property restrictions

·       Conduct routine security rounds

Self-harm and suicide are far from inevitable or unforeseeable if jails and prisons take the time to provide the mental health services that are required. If you or a loved one has been deprived mental health care in a prison or jail and it resulted in self-harm or suicide, please contact our offices.