Female Incarceration and Suicide
BY: STACY LIBOKMETO
When Cathy Smythe learned she was going back to prison for grand larceny, she took a knife and tried to slit her own throat.
“I’ve talked myself out of not using [drugs] anymore, not stealing anymore, not sleeping with someone anymore,” says Smythe. “I couldn’t talk myself out of this.”
She added: “I sharpened a knife—the knife I used to cut ribs with. I should’ve died, but God had a different plan.”
Within prisons, Smythe’s story is not unusual. According to a World Health Organization study, suicide “is often the single most common cause of death in correctional settings.” The same study found that female inmates attempt suicide five times more often than women outside of prison. And though incarcerated men have higher rates of completed suicide, female inmates attempt suicide twice as often as male inmates.
Suicide is a big enough problem among women at New York City’s Rikers Island facility that inmates can apply for paid work as suicide prevention aides. Trained fellow prisoners, like former inmate Janet Taveras, can provide an inmate already isolated from her family and community with a sympathetic ear and foster a new, potentially life-saving, connection.
“I would talk to her,” says Taveras of all the women on suicide watch while she was an aide, “because she was someone like me.”
New aides, says Taveras, are trained to keep a careful eye on inmates considered high risk for suicide, including those who are young and had never been to jail before, parents who had killed a child, substance abusers, inmates lacking family or support outside the prison walls, and inmates who are mentally unstable—one of the leading indicators of suicide. Prisoners are most likely to attempt suicide within the first 24 hours of incarceration. Thus, a newly arrived inmate is considered “in danger,” says Taveras.
During her five months at Rikers, Taveras witnessed first-hand the measures to which some women would go to harm themselves. In one case, a young inmate took advantage of an aide’s turned back. In a split second, she slammed a coffee mug down on the ground and took a sharp piece of glass to cut her own wrists.
Many aspects of prison life could account for such despair, including the simple experience of being incarcerated. Though studies on why incarcerated women attempt suicide so frequently are few and far between, a closer look at the statistics on mental health reveals some startling facts. A survey of prisoners published by the U.S. Bureau of Justice Statistics found that female inmates had higher rates of mental health problems than male inmates in all prison settings. In state prisons the difference was stark: 73 percent of females compared to 55 percent of males reported symptoms of serious mental health problems such as mania, major depression and even psychotic disorders.
These mental health disorders may stem from adolescence, and they are particularly pronounced in women, says Dr. Linda Telpin, director of the Psycho-Legal Studies Program at Northwestern University Medical School. Dr. Telpin conducted a study with three other colleagues and found that “females [in juvenile detention] have greater persistence of emotional disorder” that leads to “worse outcomes than males.” “As they age,” the report continues, “they may become suicidal, addicted to alcohol or drugs, enmeshed in violent relationships and unable to care for their children.”
None of this surprises Serena Alfieri. Alfieri is the associate director of policy for the Correctional Association of New York, a non-profit with the unique role of conducting research and policy analysis and recommending advocacy on criminal justice issues for the New York State legislature. The organization is currently involved in an ongoing study of mental health in New York state prisons. In prisons, Alfieri maintains, “most suicides or suicide attempts are due to a lack of mental health treatment.”
Many times the problem with treatment in prisons comes down to what Alfieri calls “overmedication and miseducation” and the overburdening of counseling staff. The Correctional Association study found that each member of the counseling staff at Bedford Hills was assigned a caseload of 75 to 150 women. The caseload, the agency says, meant that instead of providing more in-depth counseling services, mental health professionals spent the majority of their time “completing paperwork and handling urgent questions from inmates.” Inevitably, then, a large part of the burden of preventing suicide fell back on what the study says is a “poorly trained correctional staff.”
Bedford Hills Correctional Facility is the only maximum-security women’s prison in New York state—and the only one the state designates as a “mental health level one facility,” capable of providing intensive mental health services to inmates. The same study found that most officers at Bedford Hills are poorly trained to work effectively with mentally unstable prisoners. “Training is basically not being manipulated by inmates,” says Alfieri. “If you cut up or try to commit suicide, you are looked at as a trouble maker.” Alfieri recalls the case of one woman who continually cut herself. “They treated her as someone who was violating the rules,” she remembers. The behavior continued until finally the woman set her cell on fire. “At Bedford you will see women with marks up and down their arms from suicide attempts,” adds Alfieri.
“I would say that’s old thinking on the part of the Correctional Association,” says Eric Kriss, spokesperson for New York State Department of Corrections (DOCS). “We have trained all of our staff on mental illness. Therefore the staff know it’s not just some person going and doing this. They [the correctional staff] have an understanding there is a reason. You have to deal with the problem in a rational way.” Kriss admits it has not always been this way but in 2002, after being sued by Disability Advocates their perspective shifted. “We recognized we needed to do more,” says Kriss. “It was sort of a new phenomenon.”
The Correction Association report listed a number of recommendations for improving mental health care, ranging from providing more state funding for more prison counselors to providing better mental health training for correctional officers—all things Kriss maintains they have been addressing. “This is something we have been learning,” he says.
In 2007, DOCS and the State Office of Mental Health teamed up and began screening all inmates for mental illness, hired more people, increased the amount of training officers receive, and in the spring of this year partnered with the Center for Urban Community Services to introduce a pilot project called Wellness Self Management that assists inmates with mental illness. In this program, these inmates learn to better manage their illness both during their incarceration and following their release as they transition back to into the outside community.
The solution might not lie in prisons alone. Alternative to incarceration programs (ATIs) for non-violent offenders are growing in popularity among judges, prosecutors and defense attorneys. “Alternative to incarceration programs are becoming part of the culture of the court system in New York City,” says Susan Gottesfeld, associate executive director of the Osborne Association, an ATI advocacy group. These programs allow non-violent offenders to enter structured programs that address the underlying problems leading to crime, such as mental illness, drug use, abuse, or childhood neglect. According to Yvonne Behan of New York State’s Division of Probation and Correctional Alternatives, her agency now funds over 200 ATIs in the state of New York alone. And with a reform of the Rockefeller Laws slated to take effect next year, sentencing guidelines for non-violent offenders will be loosened and judges will have more options to recommend ATIs over prison. To prepare for the influx, over the next two years, New York State will provide an additional $50 million to secular and faith-based ATIs that apply for funding.
Cathy Smythe counts herself lucky. When she last appeared in court for stealing money from her two jobs in order to support her crack addiction, a judge sent her to Teen Challenge, an all ages faith-based ATI program. She finished the program one year ago and now is employed in their administration department full-time. If she had simply been sent back to prison, things might have turned out much differently. In jail, she remembers, “If I had top bunk I’d look down and say, what would happen if I dove headfirst?”