Stopping Starvation in Jail
Mark, a detainee at the county jail, has been placed in a padded cell as he waits on a bed at the state hospital. During rounds, an officer notices that Mark has not gotten up off the floor for a while. When the officer enters the cell to check on him, Mark looks shockingly thin and frail. The officer calls emergency services to take Mark to the hospital, where he is pronounced dead from organ failure due to starvation. The officer is confused since the logs show that Mark was delivered meals on time each day.
Over 60 percent of jail detainees are experiencing a mental health issue of some kind.¹ Eating disorders often co-occur with other mental health conditions, and people who experience psychosis have an even higher prevalence of eating disorders than the general population.²,³ Generally, detainees who experience starvation in jail are experiencing an underlying mental health issue.
Get weight and vitals
Weight should be taken at intake to get a baseline for the detainee. Ensure scales are calibrated and readings are accurate to help identify weight fluctuations throughout incarceration.
It is important to consider the eating and drinking habits of detainees who show signs of potential mental illness. Brain disorders that cause psychosis, depression, and anxiety can also cause someone to not know when to eat or drink, or even when to stop drinking.⁴
Paranoid delusions from psychosis can also lead people to refuse food because they believe it is poisoned or bad, while other delusions may make a person believe they do not need to eat or drink at all.
Detainees experiencing suicidal ideation may attempt suicide by starvation or dehydration. When a detainee is placed on observation for mental health issues, officers, behavioral health staff, and the medical team should collaborate to monitor food and fluid intake. Get weight and vitals of mentally ill detainees.
Rule of 3’s: Starvation & Dehydration
As a general rule, a person can survive…
Round with food & water logs
As a general rule, if behavioral health is monitoring a detainee for mental health issues or psychosis, include food and water logs. Watch for signs of abnormal eating or drinking such as:
Unintentional weight loss
Returning full or mostly full meal trays
Refusing to accept or touch meal trays
Dry sink (not drinking) · Frequent trips to the sink (drinking too much)
Food/drink residue in toilet (flushing food/drink)
Refer detainees to the behavioral health and medical teams when you notice these signs. Do not shut off the water to a detainee’s cell in an attempt to monitor water consumption or to prevent a detainee from over-drinking or flushing food/drink. If the water to a cell is shut off for security purposes, provide 24/7 access to bottled water or an alternative water source.
Providing practitioners with a log can give them insight into a detainee’s physical and mental condition. In Mark’s case, a log would have shown that he was not eating or drinking regularly, and intervention may have prevented starvation. Make food and water logs part of rounding for detainees on behavioral health observation, including suicide watch.
For more information, please contact training@sparktraining.us.
1. Bronson, J. & Berzofsky, M. (2017). Indicators of Mental Health Problems Reported by Prisoners and Jail Inmates, 2011-12, U.S. Department of Justice, NCJ 250612. https://bjs.ojp.gov/content/pub/pdf/imhprpji1112.pdf.
2. Ganson, K., Cuccolo, K., & Nagata, J. (2022). Associations between psychosis symptoms and eating disorders among a national sample of US college students. Eating Behaviors, 45, 101622. https://doi.org/10.1016/j.eatbeh.2022.101622.
3. Guarda, A. (2023). What are Eating Disorders? American Psychiatric Association, https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders.
4. Jenkinson, P., et al. (2024). Interoception in anxiety, depression, and psychosis: a review. eClinicalMedicine, 73, 102673. https://doi.org/10.1016/j.eclinm.2024.102673.
Disclaimer
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!®