Watching

We meet today, as we do every quarter, in a windowless room at the back of the psychology department. Seated behind a lectern are some thirty volunteers, including myself. At the front of the room, Dr. Hart is recounting the ways in which past inmates have killed or attempted to kill themselves while under suicide watch. There was a man at another facility for instance who disassembled the metal slats from the holding cell’s air vent and used them to slash his wrists. Dr. Hart demonstrates by pulling up the sleeve of her blouse and making wild sawing motions across her exposed arm. The inmate companion on duty that night called for help and officers intervened. The man lived. Another inmate, Dr. Hart says, stealthily choked himself to death on toilet paper. “That is why you must not only watch the inmate, you must also listen.”

Every federal prison in the nation has a suicide watch program, the goal of which is to identify potentially suicidal inmates and provide them with help, either through counseling or medicine or both. While undergoing treatment, the inmate is confined to a holding cell, and it is our job as volunteer inmate companions to monitor the inmate and ensure he doesn’t harm himself.

During our orientation meeting in August, Dr. Hart, the chief psychologist, took us on a tour of the holding cell located in the medical department. Actually, there are two holding cells–one wet cell and one dry. The wet cell contains a toilet and a shower whereas the dry cell–intended for the severely troubled–does not (some in inmates have been known to drown themselves in toilets). Both cells have a platform bed bolted to the center of their floors. Dr. Hart said the beds must be low to the ground so that the inmate can’t hang himself from the light fixture. But hanging one’s self, she assures us, would be very difficult because the special safety mattresses and blankets and the smock that the inmate is made to wear. are virtually tamper-proof and impossible to fashion into a noose. Aside from the beds and the one toilet and shower stall in the wet cell, the rooms are little more than concrete boxes., smooth on all six sides, and quite chilly. I noticed the wet cell’s previous tenant had thrown wads of wet toilet paper at the ceiling’s air vent to block the cold air. The toilet paper, having dried and deteriorated, hung from the ceiling in ragged tentacles.

Between the two holding cells is the watch room from which the companion sits and monitors the suicidal inmate. Barred windows on the opposite ends of the room allow the companion to see into either holding cell. While on watch, we must record everything that transpires and denote the time at which it occurs in the log book. During orientation, we practiced creating a mock log on the blackboard: 6:45 am, inmate Smith appears to be sleeping; 7:00 am, inmate Smith appears to be sleeping; 7:12 am, inmate Smith is using the bathroom; 7:15 am, inmate Smith is standing at the door; 7:30 am, inmate Smith is talking about football; 7:45 am, inmate Smith is racing around the bed, notified Control; 7:45 am, staff had me step out while they talked to inmate Smith, everything appears fine now, inmate Smith is lying on the bed.

Dr. Hart recommended that while observing the inmate, we should try talking to him (there’s a vent between the watch room and holding cells through which to communicate). A handout she gave us entitled, “Guidelines for Talking to Someone Who’s Suicidal,” instructs us to focus on the positive aspects of the inmate’s life and steer him into a discussion of his feelings. We must listen “actively” by reflecting those feelings and by asking such questions as “How does this affect you?” and “What other possibilities are there?” We should not minimize what the inmate says or try to cheer him up. We should not attempt to solve his problems or make promises to help him. In the event of an emergency–if the inmate begins to harm or threatens to harm himself–we are to notify Control immediately using the phone posted outside the watch room. If the phone isn’t working or if officers don’t respond, we’re to pull the fire alarm.

Dr. Hart warned us to expect anything while on the watch–flashers, chronic masturbators, guys who smear their feces and urine on the walls and window. One man balled up his feces into what Dr. Hart called a “shit apple” and ate it.

“Do we write that down in the log book?” someone asked.

“Yes,” she said. “You must write down everything.”

At today’s meeting, Dr. Hart is reviewing last year’s suicide statistics. Twenty-nine inmates killed themselves in the BOP in 2012, the highest number ever recorded. That’s more that the twenty-four deaths in 2011 and higher than the historical average of fourteen per year. Nobody can explain the increasing trend.

The majority of inmates who kill themselves in prison are white males between the ages of twenty and thirty-seven. Most are non-violent offenders with no prior criminal background. Many have histories of depression and mental disorders. Fifty percent of all suicides occur within the first twenty-four hours of detention, and fifty percent of those deaths occur within the first three hours. Ninety percent die by strangulation.

Of the twenty-nine suicides in 2012, all victims were male. Twenty-six died by hanging, one died of lacerations, one died of an overdose, and one man, after being released to a halfway house, shot his wife to death before tuning the gun on himself. Dr. Hart goes through each of the twenty-nine cases–the hows, the whens, and, presumably, the whys: one man killed himself only a month before his release. One man hanged himself in a mop closet; another hanged himself in the cell he shared with his uncle. Some of the volunteers in the room respond with murmuring incredulity while others, like myself, remain quiet. I wonder who among us has considered suicide. The chances are high that many of us have. Another man, Dr. Hart continues, killed himself after he was transferred further away from his family; another killed himself after a judge deemed him too mentally ill to be released. A few of the deceased were sex offenders.

I haven’t participated in a watch yet; I’m still waiting for someone to want to kill himself. Carl, a veteran companion who’s served on several watches, told me about the last inmate he monitored here, a young white man who had never seen the inside of a prison before. Carl used his three-hour shift–which ran from three to six in the morning–to initiate the young man. Speaking through the watch room’s vent, he told him where to sit in the chow hall, whom to associate with and whom to avoid, and how to get in and out of the commissary in less that forty minutes. At one point, Carl drew a map of the prison on the back of a sheet of paper and, holding it up to the window, pointed out where the rec yard and barber shop and chapel were. Two weeks later, the young man spotted Carl on the compound and gave him a hug and thanked him for his help.

Dr. Hart says that for many people, the emotions that lead them to consider suicide are brief and temporary. If you can intervene in time and help them though that short period of anguish, they will often come to recognize that there are other, less drastic, less permanent solutions.

“You can save a life,” she says, “simply by being there, watching.”

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