From rearranging buildings to retraining staff, Bristol County Sheriff's Office officials are working to create a safer environment for inmates following a string of suicides in its jails over the past few years.

The issues, problems, and solutions are outlined in a recently released report regarding the causes and factors of the suicides, which made headlines over the summer of 2017 after several in quick succession were reported.

The office’s Director of Medical Services and an employee of the office’s mental health provider examined seven suicides reported from May 6, 2015 to June 10, 2017. One was at the Ash Street Jail in New Bedford, while others were in Dartmouth House of Correction on Faunce Corner Road.

In five of the seven cases, the victims were facing major felony charges, including armed robbery, assault to murder, operating under the influence of alcohol, and child endangerment.

All seven had a history of substance abuse. Two were just completing a detoxification protocol at the jail, while two others had recently detoxed.

Six inmates were on "lock-in" status for various reasons. Normally, inmates are housed in dormitory-style buildings with unlocked cell doors, giving inmates access to common areas, recreation, and social opportunities.

Lock-in inmates, however, are housed in locked cells. Outside cell access is controlled and restricted due to disciplinary issues, medical or behavioral needs, or other factors, explained Public Information Officer Jonathan Darling.

Inmates under lock-in status may have anywhere from a few hours out of their cells for recreation and food in the morning and evenings, to 23-hour lockdowns for repeated violent behavior.

Only two inmates who committed suicide were being held in isolated segregation. The others on lock-in status were held in double-bunked cells, but were alone at the time of their suicides.

Many also had family issues prior to their deaths, such as being denied bail money or a family member not wishing or being unable to visit.

Complicating the department’s health care is an increasing number of inmates with substance abuse issues. The report states that in 2010, 1,900 inmates reported substance abuse upon admission. That number rose to 3,341 inmates in 2016.

“The challenge is that mental health has become the responsibility of the prison system, which wasn’t really our charge when [the state] started closing [psychiatric] hospitals,” said Bristol County Sheriff Thomas Hodgson, noting a number of state hospitals closed in the 1990s.

The sheriff’s office has implemented several changes to better train and allow staff to handle the risk of suicide in inmates. A new specialized review committee was formed to supplement the mortality review carried out when a death occurs.

“We look for any ways we might be able to assess any additional needs or chances we might pick something up,” Hodgson said.

Changes identified by the review committee include revisions to segregation policies. Signs of mental illness and suicide are looked for in screening, and certain inmates are classed as "do not house alone" following clearance from mental health watch.

In late 2016, coordination among staff members was improved to better take detox and psychiatric issues into account in determining discipline for infractions

Staff at all levels of the sheriff's office received specialized training to identify high-risk inmates who may have, for example, received bad news at a court appearance or in a telephone call with family.

Physical changes to the jail facilities included larger windows into inmate cells and increased visibility in areas where mental health watches are conducted, which allows guards to better monitor inmates.

Improvements were also made to areas where inmates undergoing detoxification or on a mental health watch are held in segregation. New windows, installed in 2017, are an effort by the department to bring an existing housing unit up to spec to house inmates with mental health issues and who are on mental health watch. It was funded through the department’s regular budget to better serve those populations.

A new behavioral unit in Dartmouth was established to better care for inmates with mental health issues, and grant funding helps care for inmates who do not meet the unit’s admissions requirements. The system bumped up its mental health staffing to six full-time staff, not including those available from the grant funding.

Future challenges including the link between the growing opioid crisis and the risk of suicide among the prison population, limited housing and space for admitted inmates who are at risk for suicide.

No suicides were reported from June 2017 to the present.

From rearranging buildings to retraining staff, Bristol County Sheriff's Office officials are working to create a safer environment for inmates following a string of suicide in its jails over the past few years.

The issues, problems, and solutions are outlined in a released report following a study into the causes and factors in the suicides, which made headlines over the summer of 2017 after several in quick succession were reported.

The office’s Director of Medical Services and an employee of the office’s mental health vender examined seven suicides reported from May 6, 2015 to June 10, 2017. One was at the Ash Street Jail in New Bedford, and the rest were at the Dartmouth House of Correction on Faunce Corner Road.

In five of the seven cases, the victims were facing major felony charges, including armed robbery, assault to murder, operating under the influence of alcohol, and child endangerment. All seven had a history of substance abuse. Two were just completing a detoxification protocol at the jail, while two others had recently detoxed.

Six inmates were on "lock-in" status for various reasons. Normally, inmates are housed in dormitory-style buildings with unlocked cell doors, giving inmates access to common areas, recreation, and social opportunities.

Lock-in inmates, however, are housed in locked cells. Outside cell access is controlled and restricted due to disciplinary issues, unique medical or behavioral needs, or other factors, explained Public Information Officer Jonathan Darling.

Inmates under lock-in status may have anywhere from a few hours out of their cells for recreation and food in the morning and evenings, to 23-hour lockdowns for inmates for repeated violent behavior such as fighting other inmates and guards.

Only two inmates who committed suicide were being held in isolated segregation. The others in lock-in status were held in double-bunked cells, but were alone at the time of their suicides. Many also had family issues prior to their deaths, such as being denied bail money or a family member not wishing or being unable to visit.

The sheriff’s office has implemented several changes to better train and allow staff to handle the risk of suicide in inmates. A new specialized review committee was formed to supplement the mortality review carried out when a death occurs at the facility.

“We look for any ways we might be able to assess any additional needs or chances we might pick something up,” said Bristol County Sheriff Thomas Hodgson.

Changes identified by the review committee include revisions to segregation placement policies. Signs of mental illness and suicide are looked for in screening, and certain inmates are classed as "do not house alone" following clearance from mental health watch.

In late 2016, coordination among staff members was improved to better take detox and psychiatric issues into account in determining discipline for infractions

Staff at all levels of the sheriff's office, from transportation officers to dispatch personnel also received specialized training to identify high-risk inmates who may have, for example, received bad news at a court appearance or in a telephone call with family.

Physical changes to the jail facilities included larger windows into inmate cells and increased visibility in areas where mental health watches are conducted, which allows guards to better monitor inmates. Segregation areas housing inmates on detoxification or mental health watch were also improved.

Improvements were also made to areas where inmates undergoing detoxification or on a mental health watch are held in segregation.

The new windows, installed in 2017, are an effort by the department to bring an existing housing unit up to spec to house inmates with mental health issues and who are on mental health watch. It was funded through the department’s regular budget to better serve those populations.

Complicating the department’s health care is an increasing number of inmates with substance abuse issues. The report states that in 2010, 1,900 inmates reported substance abuse upon admission. That number rose to 3,341 inmates in 2016.

“The challenge is that mental health has become the responsibility of the prison system, which wasn’t really our charge when [the state] started closing hospitals,” Hodgson said, referencing the closure of a number of state Department of Mental Health hospitals during the Dukakis administration.

Even before suicides began making news in 2015, a new behavioral unit in Dartmouth was established to better care for inmates with mental health issues both from Bristol County and in other county prison systems. Grant funding is also providing more care for inmates who do not meet the admissions requirements for the unit. The system bumped up its mental health staffing to six full-time staff, not including those available from the grant funding.

Looking toward the future, sheriff’s office officials are worried about several challenges, including the link between the growing opioid crisis and the risk of suicide among the prison population, limited housing and space for admitted inmates who are at risk for suicide.

No suicides were reported at Bristol County Sheriff’s Office facilities between June 2017 and present.