Report shows suicide rates in NC jails lead national average

Disability Rights North Carolina Executive Director Vicki Smith said the group is recommending improvements to jail policies, including staffing, screening and monitoring, to help tackle a problem that begins long before people are arrested.

"The lack of adequate mental health services in the community is a factor of people ending up in jail," Smith said. "Then there's the reality: Our jails are not designed or equipped to provide mental health services."

Distinct from state prisons, where inmates are housed after they've been convicted, jails typically hold people still awaiting trial. They're operated by sheriff's offices and funded by counties.

Smith said the decentralized system makes it harder to ensure proper enforcement of suicide prevention policies across North Carolina.

"If you want a statewide response, there needs to be a statewide requirement," she said.

Among the watchdog group's recommendations are the universal implementation of suicide prevention programs, recurring mental health assessments, adequate mental health staffing and plans to transfer inmates in need of intensive treatment to appropriate psychiatric facilities.

Eddie Caldwell, executive vice president and general counsel for the North Carolina Sheriffs’ Association, said it's no secret that mental illness is common among inmates in county jails, and he said there's nothing in the recommendations that sheriffs don't think should happen in their facilities.

But he said the recommendations can help only if they're fully funded. Jails can't transfer inmates to psychiatric facilities for treatment, for example, if those facilities don't have secure beds available. Caldwell said it's "foolish" to expect inmates to get better treatment after they're arrested than when they're in the community.

"That level of care has got to come from a medical professional," he said. "You can't expect a detention officer to do a medical professional's job."

Smith said there are low-cost steps jails can take to actively reduce suicide by annually training staff on prevention measures and repeating screenings for inmates who may become more suicidal over time. Jail administrators can also make cells more resistant to suicide attempts by removing clothing hooks, gaps and grates.

But she said it's also crucial that local leaders recognize that jails can't substitute for proper mental health care.

"From a county commissioner point of view, this is cost shifting," Smith said. "If we develop good preventative mental health services, in the long run, it would be less expensive than putting people in jail."

Local jails typically see higher suicide rates than state prisons, according to state Department of Public Safety spokesman Keith Acree. The North Carolina prison system saw seven suicides in 2016 across 55 facilities.

"For a system of our size, that put us slightly below the national average for suicides in state prisons," Acree said in an email Wednesday.