S624- Suicide Prevention

Question 1

S624- Suicide Prevention

Question 2

In order to minimize the risk of suicide and suicide attempts in all Department facilities, all staff shall attempt to identify and record suicide risk information on all persons in custody and to intervene as trained.

Question 3

This includes specific current threats, previous attempts, and “_____” behaviors and symptoms

Answer 3

At risk

Question 4

All inmates shall be assessed for suicidal ideation as an integral part of the booking Process

Question 5

All inmates shall be checked for past attempts or threats of suicide by performing a Q-5 query through the Department of Criminal Justice Information Services (DCJIS).

Question 6

Whenever inmates threaten or attempt suicide, an entry shall be made in the Q-5 file

Question 7

Crisis - a decision time of acute danger or difficulty. This can be a social or personal situation brought on by stressful events.

Question 8

a sense of severe hopelessness or generalized negative expectancies which are often manifested with physical symptoms.

Answer 8

Depression

Question 9

Risk factors -those issues, conditions, or situations that may put a person at risk of suicide.

Question 10

thoughts, plans, and/or actions which, if fully implemented, may result in death.

Answer 10

Suicidal Behavior

Question 11

Suicidal ideation - the act of contemplating suicide and fantasizing about the relief from psychological burdens.

Question 12

Suicide attempt - actions taken to deliberately injure or attempt to injure oneself with the intent of causing one’s own death that do not result in death.

Question 13

Suicide - actions taken to deliberately injure oneself that result in death. Not all suicides are preceded by suicidal behavior but are sometimes impulsive acts or occur in a state of panic.

Question 14

the act of deliberately injuring oneself, with little chance of actually killing oneself. Injuring oneself is the objective and is not a suicide attempt. The urge to mutilate is often irresistible and uncontrollable.

Answer 14

Self mutilation

Question 15

Withdrawal – the individual will do very little physical activity, refuses to eat, speak or get out of bed.

Question 16

Mental Health Watch – A tool used by mental health staff to define the schedule of observation and property allowed to inmates assessed as being at risk of harm to self or others. The intent of a mental health watch is to keep inmates and staff safe when an inmate’s behavior is unstable due to mental illness and/or they have been assessed as a risk to themselves or others.

Question 17

The ___________, being the first contact with incoming inmates, will be trained to recognize the signs and symptoms of mental illness and suicide risk

Answer 17

Booking officer

Question 18

In the event that an inmate presents to the booking officer as being at risk, the officer will immediately notify the admitting nurse, the Shift Commander, and the on-site/on call medical/mental health clinician, and initiate constant observation of the inmate until seen by a medical/mental health professional.

Question 19

The admitting nurse will initiate a behavior health assessment of each new admission.

Question 20

An inquiry will be made using the DCJIS database to determine whether the inmate being booked has ever attempted or threatened suicide while in police, county or state custody.

Question 21

This file is referred to as the Lockup Suicide File, and its access code is “Q-5”.

Question 22

Only authorized DCJIS operators may make Q-5 queries.

Question 23

All commitments shall be checked against the Q-5 file

Question 24

If any query is not conducted due to unavoidable circumstances, the Shift Commander shall notify his/her relief in writing (with a copy to AS/OPS

Question 25

Q-5 query forms shall be filed in the Records Office

Question 26

Communication of positive results obtained from this query will be shared with the Shift Commander and the Nursing Supervisor

Question 27

During the admission process, every inmate will be seen and evaluated by a Nurse

Question 28

Whenever an inmate, while in Department custody, attempts to commit suicide, threatens to commit suicide or expresses suicidal ideation, an entry identifying the inmate as a Q-5 shall be made into the DCJIS system

Question 29

Should the intake nurse in booking feel that the inmate presents as an immediate risk for suicidal behavior, s/he will immediately notify the medical/mental health clinician on duty for an immediate assessment

Question 30

At risk inmates will be closely supervised until cleared

Question 31

All referrals shall be assessed within fourteen (14) days, but assessment of any inmate classified as a Q-5 shall be completed within twenty-four (24) hours

Question 32

At any time during incarceration an inmate may be identified by correctional, medical, or mental health staff as being at-risk of suicide. Every verbalized threat of suicide must be taken seriously and responded to appropriately.

Question 33

It is not necessary for an inmate to have actually attempted suicide to be considered at-risk

Question 34

A staff member must remain with the inmate until they are seen and evaluated by a medical/mental health practitioner or transferred to the clinic/infirmary. Document and forward reports.

Question 35

When an inmate attempts suicide by hanging, cutting, ingesting or other lethal means, staff responding to the scene will take whatever steps may be necessary to ensure the life, safety and health of the inmate.

Question 36

Administrative mental health (Q5) watches may be conducted in a segregation unit with orders from the facility psychiatrist.

Question 37

All mental health watch (Q5) rounds will be conducted every fifteen (15) minutes.

Question 38

MH watches in segregation will be conducted every fifteen (15) minutes and routine unit rounds will be conducted every thirty (30) minutes

Question 39

All administrative watches will be discontinued only with orders from the licensed mental health practitioner

Question 40

In the event the inmate was injured and requires medical treatment beyond that which can be provided in the medical unit, the Medical Division will coordinate the inmate’s transfer to a hospital

Question 41

An inmate will be assessed by medical/mental health staff to determine the need for maintenance on mental health watch status whenever they:

Answer 41

◦ express or demonstrate intent to do bodily harm;
◦ express suicidal ideation;
◦ report feelings of depression and anxiety accompanied by suicidal thoughts
◦ or thoughts of self-injury; or
◦ return from a GL c. 123, §18(a) hearing at which the petition was denied

Question 42

Any staff member who witnesses a suicide attempt or threat must also write an incident report for submission to the Shift Commander, the Medical Division, and the Records Office

Question 43

The officer assigned to continuous observation will document his/her observations every fifteen (15) minutes in the unit log

Question 44

A medical/mental health practitioner will determine what clothing/property will be permitted for retention by an inmate under suicide

Question 45

Whenever an inmate is placed on continuous observation status because of suicidal ideation or a suicide attempt, the Shift Commander will be notified.

Question 46

The SC will notify the Records Supervisor of DCJIS to enter the info

Question 47

Inmates will remain on mental health watch status until such time as the medical/mental health practitioner determines that less frequent observation would be appropriate

Question 48

If the inmate no longer requires housing in the Medical Division, the inmate’s status will be changed and the custody staff will arrange for the inmate’s transfer to another housing unit.

Question 49

Lifeline is a model suicide prevention program, which is coordinated by staff trained by the Samaritans of Boston, and is based on the belief that there are times when inmates are more comfortable sharing their fears and concerns with a peer.

Question 50

Individuals selected to partipate as a Lifetime Peer counselor must have good listening skills and care. Upon completion of training they will be added to the list of inmates approved to assist staff

Question 51

The Medical Division will be immediately notified whenever an inmate requests to meet with a Lifeline peer counselor

Question 52

Every effort will be made to ensure that the inmate’s privacy interests are respected

Question 53

Risk Factors & Behaviors

Answer 53

◦ Previous suicide attempts;
◦ Verbalization of suicide threats;
◦ History of mental illness;
◦ Social isolation that accompanies confinement in special management housing;
◦ Giving away prized personal possessions;
◦ Collection and discussion of information on suicide methods;
◦ Expression of hopelessness, helplessness, and anger at oneself or the world;

Question 54

Risk Factors & Behaviors

Answer 54

◦ Themes of death or depression evident in conversation, written expressions, reading selections, or artwork;
◦ Statements or suggestions that the speaker would not be missed if they were gone;
◦ Scratching or marking of the body, or other self-destructive acts;
◦ Recent loss of a friend or a family member (or even a pet) through death or suicide; other losses (for example, loss of a parent resulting from divorce);
◦ Acute personality changes, unusual withdrawal, aggressiveness, or moodiness, or new involvement in high-risk activities; and
◦ Physical symptoms such as eating disturbances, sleeplessness or excessive sleeping,
◦ Chronic headaches or stomach aches, menstrual irregularities, or apathetic appearance.