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Report: San Diego Jails Face A Suicide 'Crisis'

The door of the San Diego County Sheriff's Department in Kearny Mesa, Dec. 31, 2014.
Tarryn Mento
The door of the San Diego County Sheriff's Department in Kearny Mesa, Dec. 31, 2014.
Report: San Diego Jails Face A Suicide 'Crisis'
Report: San Diego Jails Face a Suicide 'Crisis' GUEST: Aaron Fischer, litigation counsel, Disability Rights California

>>> San Diego County's jail suicide rate has already been the focus of a County grand jury report and in-depth investigative news articles. The organization disability rights California has issued a report criticizing the high number of suicides in San Diego County jails. Over recent years, the number has been the highest of any jail system in California. Since disability rights California has the right to inspect conditions inside any facility that holds people with disabilities, gain greater access to jails and inmate records and previous investigations. Joining me is Aaron Fischer , litigation counsel with Disability Rights California . He is also co-author of the report. Welcome to the program. >> Thank you for having me. >> Based on the data, how prevalent are suicides and suicide attempts in San Diego jails compared to other jail systems in California X >> Over the last several years, San Diego County jail has outpaced any other jail system of similar size in the state of California in terms of suicide deaths, more than 30 suicides in the last handful of years. 2017 is slightly better with only one suicide which is good. What we found in our report is it is not just about the suicides, it is about suicide attempts in people who are suffering due to untreated mental illness inside the jails. Those numbers are also skyhigh for San Diego County jails. >> The San Diego grand jury had its own report last year on jail death and said new safety cells could help address the suicide rate. Had the safety cells helped? >> One of the things the county has done and they do give credit to the leadership within the department to take this issue seriously, is that they have taken steps such as expanding safety cells, which I have to explain for a moment. They are cells that are barren. They are rubber rooms with nothing but a small grate in the floor to use to defecate and urinate. They are very harsh conditions. Many jails and prisons use these but only for very short periods of time, or at least they should be. What we found is that many people are in the cells in San Diego County for long periods of time. They may not be able to engage in acts of self-harm like hanging himself because there is nothing in the cell and they are often without any clothing or even a blanket. It was not helping to treat the mental health condition, see you have people who may be safe for a day or two or three but they still were in dire need of treatment. >> The San Diego County Sheriff's office disputes how the suicide rate is calculated. Their argument has something to do with the high number of white inmates in San Diego jails and how whites generally kill themselves more often than African-Americans or Latinos. Should your numbers take that into consideration? >> The method we use to calculate suicide rates in San Diego County and compared to other counties is a method used by the United States Department of Justice. It is the accepted method of calculating suicide rate. It is very common. There are other ways to look at it and it is fair to look at which populations, whether by race or age or anything else, may be at greater risk of suicide or serious self-harm. What we take exception to is that that somehow is a handicap or gives the county a pass in terms of the suicide numbers they have seen. If anything, if they believe the population is more at risk than in other systems have a greater need to act and to prevent those horrible tragedies from occurring. >> You said the report is recommending San Diego County change the way it uses safety cells. What other changes they recommending for the greater protection of inmates? >> One is to significantly reduce the use of solitary confinement, especially for individuals with mental illness. A second one is to start delivering treatment within the jail. Right now, anything close to meaningful mental health treatment with staff that are trained to provide mental health care in the units with inmate patients, really only happens after somebody reaches such a level of deterioration or attempts suicide. One other thing, San Diego County like many other counties, has an enormous and disproportionate number of people with mental illness. It is costly to care for those people and is very harmful -- in very harmful conditions. Another one of our recommendations to the County is to look at that population and do whatever they can to reduce the number of people with mental illness ending up inside these jails. They can be treated safely and more effectively in the community in many cases. >> You know that San Diego's jails already have a committed mental health staff and strong leaders inside the Sheriff's department. What do these people need to make these changes happen? >> It is for the county to step up and provide the resources so that those leaders and staff numbers can do their work in a professional way. The jails have been understaffed from the mental health standpoint for years. The county is just now in recent months digging its way out. Have a long way to go to have the staffing and resources and space to provide a sort of treatment the people inside the jail need. The other thing we think is critically important is to provide for meaningful oversight, external oversight. You see it in an increasing number of systems, other counties in the state. It provides transparency and accountability for what happens inside these jails. >> I have been speaking with Aaron Fischer, litigation counsel with disability rights California and Erin, thank you very much. >> You can read the report and the County's 18 page response on our website, KPBS.org.

Suicides In San Diego County Jail: A System Failing People With Mental Illness
A report from Disability Rights California on suicide prevention efforts in San Diego County jails.
To view PDF files, download Acrobat Reader.

San Diego County jails continue to face a suicide crisis and there is probable cause people jailed with disabilities are subject to abuse and neglect, according to a three-year investigation by Disability Rights California.

The group is the state’s designated advocacy system for people with disabilities, which gives it the legal right to inspect any facility holding people with disabilities. It found the jails did not have enough mental health staff and criticized the county's use of solitary confinement for people with mental health needs. There were more than 46 jail suicides in the past 13 years, though the annual rate fell to one suicide last year.

The Sheriff’s Department, which oversees the county jails, uses “enhanced observation housing units” for inmates who may be at a higher risk of suicide. Inmates there are kept alone and don’t have access to personal property, including clothes. Disability Rights California quoted a psychiatrist’s report that called the isolation “inhumane.”

“People told us they became more suicidal and depressed by being in these units,” Disability Rights California litigation counsel and report co-author Aaron Fischer said. “And it sends a message to people in the jail that if you say you’re engaging in self harm, you know where you’re going to go. It has a deterrent effect.”

The Sheriff’s Department, which cooperated with the investigation, issued an 18-page response to the report. It disagreed that the enhanced observation or safety cells were harsh or inhumane and said those protocols were designed to prevent suicides.

San Diego's Response to Jail Suicide Report
A response from the County of San Diego and the San Diego County Sheriff's Department to a Disability Rights California report on jail suicides.
To view PDF files, download Acrobat Reader.

“The department wants to be careful not to create a housing option that would encourage other inmates to manipulate the system for personal gain,” Sheriff Bill Gore wrote.

Gore also rejected statistics in the report that San Diego County has the highest jail suicide rates among similarly-sized California counties. San Diego jails have a higher proportion of white inmates than other jails in the state, according to Gore, and whites are more likely to kill themselves compared to African Americans and Latinos. He suggested another way to calculate the suicide rate that would take into account that higher risk population.

“None of this is intended to suggest that the Sheriff’s Department suicide-prevention practices cannot be improved,” Gore wrote. “The Sheriff’s Department takes suicide prevention very seriously and has invested (and will continue to invest) significant resources to recruit and train jail staff, implement effective programs, and create an infrastructure conducive to preventing jail suicides.”

But Disability Rights California wrote in its report that even if a new metric would lower San Diego’s suicide rate compared to other counties, that higher risk population should still spur more action.

“The fact that San Diego County may have a higher-than average number of inmates at elevated risk of suicide only adds urgency to the need for action,” the report said. “Whatever the methodology for evaluating suicide rates, the number of suicides in San Diego County’s jails in recent years is a cause for extreme concern.”

The report comes about a year after the San Diego County grand jury found the jails lacked a clear policy statement on suicide prevention.

Fischer joins KPBS Midday Edition on Wednesday to discuss the report and its recommendations.