Lifting the Silence on Suicide within the Ohio Department of Rehabilitation and Corrections - Math Problem Example

343521 - Lifting The Silence On Suicide Within The Ohio Department of Rehabilitation and Corrections   Introduction: Suicide, the act of taking one’s own life, results from complex interactions between biological, sociological, psychological and environmental factors. (Source National Center for Injury Prevention and Control, http://www.cdc.gov/ncipc/factsheets/suicide-overview.htm). According to NCIPC, suicide is the 11th leading cause for deaths in the US. It is also stated by the same source that more people are treated and discharged from hospitals for attempted suicide than admissions of the fatally injured. We have always seen that suicide is a serious, tragic event that devastates individuals, their families and the communities in which they live. It is generally observed that families of victims of suicides are overwhelmed by the event. They are usually held responsible for the same and hence do not volunteer information regarding the same. This project attempts to present a picture of the suicides within the Ohio Department of Rehabilitation and Correction, especially among the Correctional Officers. It also identifies the risk factors and suggests prevention and intervention strategies. The paper attempts to get everyone involved to address the problem exclusively. Ohio This state derives its name from a Indian word that means “large river”. Ohio became the 17th state of the USA on March 1, 1803. It has an area of 44,828 square miles, with Columbus as the capital city, and a population of more than 11 million. (Source: http://www.enchantedlearning.com/usa/states/ohio/) In this seventh populous state of the country, more than 1200 people commit suicide every year. Suicide is the 9th largest cause for deaths in the state. (Source: Ohio’s Suicide Prevention Plan, http://www.ac.wwu.edu/~hayden/spsp/states/Ohio%20Suicide%20Prevention%20Plan%20PDF.pdf) The Department of Rehabilitation and Correction for the State of Ohio (ODRC) has more than 30 prisons under its jurisdiction and supervises more than 45000 inmates living in the correctional facilities of the Department. Besides this, over 30,000 people on parole are also supervised by the ODRC. (As told by Dr. Reginald A Wilkinson, Director ODRC at http://www.cdc.gov/ncipc/factsheets/suicide-overview.htm) Suicides in the Correctional facilities (Adapted from Oral Testimony of Dr. Reginald A Wilkinson, Director CDRC presented to the United States Senate Judiciary Committee, July 30, 2003 at http://www.cdc.gov/ncipc/factsheets/suicide-overview.htm and http://www.drc.state.oh.us/WEB/Articles/article77.htm) The 10 million odd people who are booked into prisons annually, include more people with mental illness, than the mental institutions in the country The correctional administrators, according to Dr. Wilkinson, thus don the role of mental health administrators. This in itself presents an “enormously frustrating” scenario. The principal job of the correctional centers is to incapacitate the prisoners and not hospitalise them as sick people. However, untreated mental illness in the inmates exposes them to the risk of suicide. The suicides in the county jails in the State of Ohio, is approximately 77 per million. This is seven times greater than that the rate in the general population of the state. The rates are not exclusive in Ohio as in most states the trend is rather similar. The Ohio Department of Rehabilitation and Correction is the 5th largest correction system. It operates 31 prisons, and undertakes the probation supervision in 50 of the 88 counties of Ohio. Because of being almost the most crowded of prison facilities of the US, it is all the more relevant to consider the stress related suicide factors in the state and successful suicide intervention. Profile of a correction officer He is a person charged with the security, safety and well being of the inmates of the prison. Care, control and custody of the prisoner rests on his shoulders. Also, he is responsible for the safety and security of the corectional establishment. The State Government, the Federal Govt or the County employs the officer,. USA has approximately about 500,000 correction officers on its payroll. Each officer has either limited or complete powers of arrest. His duties include Maintainence of discipline in the facility Regular check on inmates for hiding of contraband goods or drugs or weapons Preparing reports of inmate-misbehaviour Working in a hostile atmosphers tends to be stressful and besides some facilites may be overcrowded with poor lighting and ventilation, with the officers sometimes working wiithout break to maintains security. (Source: Wikipedia, the free encyclopedia, at http://en.wikipedia.org/wiki/Prison_officer) It is believed that by improving the screening procedures for mentally ill inmates, and by training the staff to identify sign of suicidal symptoms, administrators can provide a “safe and humane” correctional facility, as per the S1194 ( Mentally Ill Offender Treatment and Crime Reduction Act) , for both inmates and the staff within the administrative set-up. Dr Wilkinson has also collaborates with the Director of the Department of Mental health, Ohio, in order to develop ventures to help create effective strategies in correctional facilities, However, with numerous obstacles looming both at the local and state levels, the road to collaboration and intervention remains hugely unexplored, and with a lot of potential for effective research. This sort of interaction and collaboration between the policy makers and practitioners will help new movements and initiatives, especially in states like Ohio, to gain strength. Risk factors The general risk factors for suicide may be briefly summarized as Biomedical include (1) a correlation between calcium channel blockers medication (prescribed for cardiovascular diseases and for hypertension) and suicides, according to a study by Dr. Anne Melander Neurobiological reason: According to Dr. Mann, MD, Professor of Psychiatry, Columbia University, there are three categories of triggers for suicides. They are acute psychiatric illness (95% of suicide attempts are by people with mental illness), substance, alcohol or drug abuse and social/familial crises. The factors that bring about suicidal behaviour are personality of the victim, family and social framework, chronic illnesses, serotonin levels deficiency and alcoholism How does it feel to be suicidal? According to Dr A Alvarcz. “The logic of suicide is different. It is like the unanswerable logic of a nightmare, or like a science fiction fantasy of being projected into another dimension: everything makes sense and follows its own strict rules, yet at the same time, everything is also different, perverted, upside down.” Socio-psychological risk factors Evidence supports the theory that stress of the correctional officers is an important cause that leads to attempts of suicide. Stress among correctional officers is the direct consequence of Inmate crowding Increase in the inmate/security employee ratio Increase in inmate assaults against staff Overall risk of assault for correctional officer Stress related to professional problems and with interaction among the staff Interaction with supervising individuals who do not want to be confined Extra work burdens for staff due to understaffing, shifts, supervisor demands Threat and occurrence of inmate violence, demands and manipulation External stresses – Low salary and poor image in public Addiction to gambling and alcohol Health, burnout at work, early retirement and strained family life (Source: “How Bad is Correctional Officer Stress?” at http://www.ncjrs.gov/pdffiles1/nij/183474.pdf The picture is much the same in other states as a couple of following evidences suggest. Hessle M suggests that occupation hazards of the police, including correctional officers include morbidity and mortality data of the police, that may lead to an increased risk of suicide, everywhere in the US. The suicide rate among Neu York police officers is about 15 per million, according to Marzuk, et al (Markuz et al, “Suicide among the New York City Police Officers”, American Journal of Psychiatry, 2002 159[12). It was also found that male police officers had a higher risk of suicide than the female officers. In the face of such a grim scenario of suicides it is relevant to design a process that exclusively tackles the problem and intervenes effectively. The process design is based on the ideas from the report “Addressing Correctional Officer” by the National Institute of Justice available on internet at http://www.ncjrs.gov/pdffiles1/nij/183474.pdf The process Initial strategies Well qualified staff will be selected for training staff when necessary The need for the process is well emphasized to help it gain momentum Debriefing and one-to-one discussions between the implementers of the programme and the staff to help spread the awareness of the concept and popularize it, weeks before implementation Professionals like statisticians, sociologist, research scholars, spiritual/religious representatives, clinicians involved in the programme The professionals would maintain absolute confidentiality of the staff details investigated during various studies Structure and administrative changes: It is common knowledge that for any process to be effective, its organizational structure should be sound. Let us start with the same. Administrative changes can help infuse a better sense of job security and overall satisfaction. Here are the suggested basic changes - (1) Overtime can be made voluntary (In West Virginia in 1999, the prison facility was under lock and key for more than a week because the officers were overworked. The officers were so tired that they had fallen asleep driving. The shift arrangement can be made more effective. They can be modified to give the officers more number of holidays between two weeks of work.. For example, an officer could work for 5 or 6 days a week and take off the next 4 or 5 days. This will help the officer come back to work every time after a vacation and hence feel refreshed. Regular Interaction between staff members: Twice every month the staff members need to sit down and discuss, various problems, exposure to risk and other irregular occurrences encountered, in order to create a database of solutions. With inputs from the governing agency concerned. The meetings will instill a sense of reassurance among officers, that the State cares about its employees. Special efforts to involve groups that he officers have an affiliation to (unions in program or spiritual leaders), in order to help process reach everyone involved Team building exercise: Teachers, medical staff, correctional and other officers, and community leaders can come together once again to reiterate and endorse team spirit. This facilitates awareness among the other staff about the concerns of the correctional staff. This will result in better understanding and collaboration among the whole administrative set-up. The most important aspect of team building would be discussion and analysis of a critical event. The outcome of the discussion would provide a useful perspective for future reference. The event has to be patiently analysed within different frameworks in which the officer functions. The critical situation may be related to the staff(s)’ exposure to any one or more of the following (1) death or assault (2) Rioting (3) Hostage situations (4) suicide of another member of the staff (5) Natural disasters (6) Arson and accidental fires and the damages caused by it (7) Sexual assault Effective training of new recruits This is an essential strategy that will ascertain a quicker adjustment of the new members within the framework of the prison facility. Counseling: An ever important strategy, counseling can boost the morale and encourage officers to perform consistently, especially those who have been stalled from a promotion or a raise. Focus groups: Research and focus groups are deployed to identify the most important stress related factors peculiar to a specific correction center. The findings can help the Department to provide an exclusive training module for the concerned correctional officers. This unique approach will help every institution within the state to come to terms with its problems and a focused training schedule can help alleviate it to a sizable degree. Strategies to make the process a success: Certain effective means would ensure a successful process Staff appointed would be highly dedicated and committed besides being efficient workers Make the top administrators aware of the program for stronger support and spearheading of causes Appoint special staff to promptly identify staff who show signs of suicide related stress Help the officer immediately by offering a change of location/ duties in order to make him feel less stressed Regular monitoring of program to help review progress of the process Promoting programs for family involvement, along with staff for inculcating a sense of belonging Simultaneous advantages: The unique stress relieving program addressing the problem of suicide, is advantageous to the administration of the correctional facility, because it (1) saves on the money paid overtime to officers who make up for the absentees, who have taken time off due to stress related problems (2) Fewer people take off due to stress (3) Officers take a lesser time to overcome distress and stress and return early to work after a holiday (4) early retirements are effectively stemmed (5) Most officers are well versed with the work culture (5) high morale, better performance (6) obvious reduction in stress related incidents confronted (7) Officers become aware of the administration’s concern for their stress. This results in an increased sense of loyalty and high morale for work in the difficult working environment (8) Spiritual./religious lectures also help alleviate stress to a large extent, and creates a sense of well being to the officer . Important guidelines for running the process Keep the program free from rigorous formality and for infusing a sense of friendly informality Always have professional counseling service handy for officers who may require the same Concentration only on the suicide intervention process in order to keep it in sharp focus It is hoped that this sincere attempt at alleviating suicide related stress could be effective for the Ohio Correctional and Rehabitational Center. On a concluding note, here is a glimpse of suicide prevention strategies conducted in the recent past. The California Highway Police (CHP) has an alarming rate of suicides (5 times the national average) among its officers. The CHP is set to begin an awareness and prevention program that will be conducted statewide next year. (Source “ CHP’s new Danger, Suicide”, LA daily News, Jan 3, 2007) It is known that research is the first step to intervention. A path breaking research (Stack SJ, Tsoudes O) of guards in correctional facilities revealed that a high percentage of them tended to face problems related to suicide stress because of (1) job dissatisfaction (2) stress related to the tough environment (3) burnout The study has revealed that guards have a 39% more tendency for rise of suicide as compared to the rest of the working age population. Conclusion: It is known that stress is the greatest causative factor in creating a suicidal situation. It is for intervention programs and processes to address stress effectively, in order to bring down the rates of suicides both in inmates and the correctional officers of the Rehabilitation centers. The various strategies offered, if are successful in allowing for improved performance of staff, and increased sense of security and safety in the rehabilitation Center, then its purpose is served. Appendix – Graphs The next graph shows the total number of suicide victims for the period in each age group. http://fathersforlife.org/suicides/US_suicide_deaths.htm Causes of death by Intentional Injury United states and Ohio (1996-1998) In the United States In the state of Ohio Causes of death Number of people Percentage Number of people Percentage Firearms 53,156 57.8 1863 56.7 Suffocation 16,469 17. 9 611 18.6 Poisoning 15,280 15.6 549 16.7 Other Causes 7,108 7.7 265 8.1 For the years (1996-1998) Ohio Only Su Source: The CDC State Injury Profiles, available at http://www.cdc.gov/ncipc/StateProfiles/sip_oh.pdf Source: “Atlas of Injury Mortality 1996-98” available at http://www.cdc.gov/ncipc/pub-res/American_Indian_Injury_Atlas/images/Atlas.pdf References 1.National Center for Injury Prevention and Control, http://www.cdc.gov/ncipc/factsheets/suicide-overview.htm 2. Ohio’s Suicide Prevention Plan, http://www.ac.wwu.edu/~hayden/spsp/states/Ohio%20Suicide%20Prevention%20Plan%20PDF.pdf) 3. CDRC at http://www.cdc.gov/ncipc/factsheets/suicide-overview.htm 4. Oral Testimony of Dr. Reginald A Wilkinson, Director CDRC presented to the United States Senate Judiciary Committee, July 30, 2003 at http://www.cdc.gov/ncipc/factsheets/suicide-overview.htm and http://www.drc.state.oh.us/WEB/Articles/article77.htm 5. “Popular cardiovascular Drugs linked to Suicide” Doctors Guide Global Edition at http://www.pslgroup.com/dg/60296.htm 6. Knowlton Leslie. “Scientists study Serotonin Makers for Suicide Prevention. Scientists Study Serotonin Markers for Suicide Prevention”, Psychiatric Times, Vol.XII, Issue 9, September 1995 7. Alvarcz, A, “The Savage God”: A study of suicide”, Random House publication 8. Hessle, M, “Police and Corrections”, Occupational medicine, 2001:16(1) 9. Markuz et al, Suicide among the New York City police officers”, American Journal of Psychiatry, 2002 159 (12) 10. http://fathersforlife.org/suicides/US_suicide_deaths.htm 11. Wikipedia, the free encyclopedia, at http://en.wikipedia.org/wiki/Prison_officer 12. “Addressing Correctional Officer” by the National Institute of Justice available on Internet at http://www.ncjrs.gov/pdffiles1/nij/183474.pdf 13. Source “ CHP’s new Danger, Suicide”, LA daily News, Jan 3, 2007 14. Stack SJ, Tsoud O, “Suicide risk among correctional Officers”, Archives of Suicide Research, Vol. 3, November 3, 1997 Read More