Sound policy can prevent jail suicides

Marc Bullaro is a retired NYC Department of Correction assistant deputy warden.

In 2021-2022, there were 12 suicides in New York City jails.

Many actions can be taken to prevent detainee suicides, namely ending mass incarceration, decarceration and speedy trials. But what specifically can the Correction Department do to prevent in-custody suicides?

On July 14, The New York Times published an article about Michael Nieves, who was detained in a psychiatric unit on Rikers Island. Nieves was “severely mentally ill” and had “a long history of suicide attempts.” On Aug. 25, 2022, he cut his throat in his cell with a razor provided by DOC for him to shave in the shower that morning. He died five days later. 

Nieves had been diagnosed with bipolar and schizophrenia disorders and had a prior suicide attempt at Bellevue Hospital Prison Ward, where he similarly used a shaving razor to cut his neck but survived after emergency surgery.

The issuing of disposable shaving razors to persons in custody is DOC policy based on NYC Board of Correction Health Care Minimum Standards which gives prisoners the right to shave daily.

In a jail video obtained by The Times, Dr. Robert Cohen, a former member of the Board of Correction who resigned on July 8, criticized DOC staff stating, “this was preventable.” I agree. A severely mentally ill detainee who is suicidal should never be given a razor.

Unsound policies like this are an anchor tied to correction officers pulling them down to drown in a sea of senselessness.

“He should not have been left alone once they believed that he was in possession of a razor,” Cohen said about Nieves. “By policy he should have been taken immediately to the body scanner. He was bleeding to death. The correction officer should have gone into the room, assessed what was going on and should have applied pressure to the area where the blood was coming from.”

Cohen is a physician and was a member of the Board of Correction for 16 years. Interestingly, he opines on what the correction officer should have done. But as a BOC member he should have ensured that DOC policies kept detainees safe instead of providing them with razors.

I ask Cohen, should Michael Nieves have been given a razor?

In his 16 years with BOC, did Cohen ever consider a proposal to repeal the policy or at least challenge the idea of providing razors to severely mentally ill suicidal detainees?

Nieves’ suicide is a tragedy and mistakes were made starting with allowing Nieves to possess a razor which is incompatible with common sense. Policymakers must be judicious and proactive to reduce not increase the opportunity to commit suicide. Instead they implement unreasoning policy and blame correction officers for policy failures.

Many times DOC policy is its own worst enemy. Like eliminating confinement for violent detainees, providing shaving razors to suicidal mentally ill individuals is another example of policy that is illogical, counterproductive to safety and inconsistent with successful management of city jails.

Some detainees should be prohibited from possessing shaving razors based on risk analysis, threat assessment, security status or mental health diagnosis.

Objects that increase the risk of suicide must be taken from suicidal persons, not given to them. As counterintuitive as it may seem, suicidal detainees are prohibited from having shoelaces or a belt but they can still have a shaving razor.

To allow for proper hygiene, an alternative method is needed for severely mentally ill suicidal detainees to shave. DOC should consider requiring a correction officer to supervise a detainee barber that can use an electric razor to shave certain detainees or contracting that responsibility to medical staff. Nationwide, jail and prison barbers regularly provide haircuts to the incarcerated population and in many state prisons incarcerated persons are also staff barbers.

The DOC should also consider appointing a suicide prevention czar to coordinate all DOC suicide prevention efforts. 

Since 80 percent of all in custody suicides nationwide occur in cells, the department should also reduce cell housing if it doesn’t compromise security. Eleven of the 12 in custody suicides cited occurred in a cell environment. It should also create a task force that targets bullying and extortion, both increase suicidal ideations.

Inside cell door windows must be free of any obstruction. DOC must have zero tolerance for detainees that cover their inside cell door window to prevent correction officers from seeing inside the cell. Forbidding those coverings would reduce suicides, overdoses, delayed discovery of deceased detainees and security breaches. Covering the inside cell door window is a DOC rule violation and a crime.

The DOC should also provide in-person suicide prevention training by psychologists and psychiatrists to all correction officers and highly specialized training with a certification to officers that are assigned to regularly supervise mentally ill detainees. It should mandate 100 percent compliance with suicide prevention training.

The idea of no jail suicides is not limited to one’s imagination or wishful thinking. In Fiscal Year 2009 under the effective leadership of former DOC Commissioner Martin Horn there were 13,000 people incarcerated and zero suicides.

It costs the city of New York $3.5 billion annually to hold 7,000 detainees, $20 billion for new borough jails, tens of millions in settlements pursuant to wrongful death lawsuits and the city has already wasted close to $25 million on the federal monitoring team. But when it’s suggested that better suicide prevention training be provided to correction officers, then that’s where they draw the line on spending.

Yet, suicide prevention training saves lives and is cost-effective.