A Closer Look at Suicide Watch
Jason is booked into jail Friday night. On Tuesday, he calls home and finds out that his wife has filed for divorce and obtained an order of protection against him for herself and their kids. He is devastated. Jason comments to an officer while returning to his cell, “It doesn’t matter, I won’t be around to see them anyway.”
The officer radios for someone to bring an ASQ form. He asks Jason the questions, and the responses screen positive for suicide risk. Jason is placed on suicide watch.
As soon as the smock is given to Jason and he is asked to change into it, he states, “I’m fine really, I didn’t mean what I said. I’m just upset, but I’ll be ok.”
What would you do?
Use a validated screening tool for suicide risk
It is not enough to ask a question or two on a booking form. Suicidality can be complex and highly litigated – especially when individuals commit suicide while incarcerated. It is recommended to use a validated screening tool, such as the ASQ, to evaluate a detainee for suicide risk.
There are other validated screening tools your facility may use, but a version of the ASQ (available here) was designed specifically for the correctional environment by the National Institute of Mental Health (NIMH). The benefit of the ASQ form is that it contains the next appropriate steps to take if the detainee screens positive for suicide risk. The ASQ form can be used at any time during incarceration to evaluate and document this important risk assessment. Use a validated screening tool for suicide risk.
Trust your gut
If the detainee answers “no” to the screening questions but you have doubts or concerns, trust your gut. Consider placing the person on suicide watch if you truly feel they are at risk, even if they deny it. Known risk factors for suicide among detainees include the first ten days of incarceration and getting bad news, such as that from a judge, a significant other, or a family member. Screen for suicide risk throughout a detainee’s incarceration, but TRUST YOUR GUT and start suicide precautions as appropriate.
Consult mental health and consider a 24-hour hold
When an individual is placed on suicide watch in jail, mental health should be involved as soon as possible. Qualified mental health practitioners (QMHPs) are specially trained to evaluate individuals in crisis and offer suggestions and strategies to help them cope. Suicide watch can help to keep detainees from hurting themselves, but every person experiences suicidality differently. It requires an individual approach, so a blanket policy on the length of time someone is placed on a suicide watch is NOT recommended. Jails should, however, consider an initial hold period of 24 hours for someone placed on suicide watch to allow time to gather behavioral information and a QMHP evaluation to determine the severity of risk. Only a QMHP or practitioner should order the removal of suicide precautions. This initial 24-hour hold also allows time for documentation which may support the jail in removing suicide precautions when appropriate. When placing a detainee on suicide watch, consult mental health and consider a 24-hour hold.
If you would like additional information, please email training@sparktraining.us.
All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis. WHEN IN DOUBT, SEND THEM OUT. ®