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What is suicide watch? Inmates have found ways around it

Jeffrey Epstein is found dead by suicide in Manhattan jail cell

Federal sources confirmed to the Miami Herald Saturday morning that Jeffrey Epstein was found dead by suicide in his jail cell.
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Federal sources confirmed to the Miami Herald Saturday morning that Jeffrey Epstein was found dead by suicide in his jail cell.

As news of accused sex trafficker Jeffrey Epstein’s suicide in his Manhattan jail cell exploded on social media, one of the questions people have is:

Was he on suicide watch, and if so, how did he end up killing himself?

Epstein’s death comes one day after the release of a damning trove of documents that named his madam and wealthy and powerful men in politics, academia and business who may have been provided with underage girls for sex.

At one point during his jailing, Epstein, 66, was placed on suicide watch. But it appears he was taken off suicide watch since then. Epstein’s death became public Saturday morning.

Christine Tartaro, a professor of criminal justice at Stockton University in New Jersey, said that while Epstein’s death raises concerns about how he was handled behind bars, inmate suicides are common in pre-trial facilities.

“They are the leading cause of deaths in jails,” said Tartaro, the author of “Suicide and Self-Harm in Prisons and Jails.”

Even the fact that Epstein had previously been on suicide watch, then moved off of it, is not unusual in jail settings, said Tartaro. Without access to Epstein’s psychological assessments, it’s impossible to know if his case was handled properly, she said.

“The point of suicide watch is to get them through the initial suicide crisis, and then to work on helping the inmate navigate the correctional environment without attempting suicide,” Tartaro said. “There are situations in which the inmate will feel better, and then regress and become suicidal again.”

According to the U.S. Bureau of Justice Statistics, the nation’s jails had a suicide rate of 46 per 100,000 in 2013, the last reported year. That’s higher than the rate in general society, and in prisons, where inmates have been already convicted.

What is suicide watch?

In general, suicide watch is an aggressive monitoring process used to make sure that someone in some type of custody — either in jail, prison or a hospital — can not kill themselves.

Officials place people on suicide watch when there is a strong risk that the person is vulnerable to suicide — either through warning signs, direct stated intention or previous attempts. Epstein was found on the floor of his cell in a fetal position with neck wounds on July 24, for instance.

People on suicide watch are usually put in an observation room and kept away from potentially dangerous objects — including a belt, fabric that can be fashioned into a noose, or sharp objects, according to Slate.

“Suicide watch is mostly designed to prevent hanging,” Slate reported in 2005.

This means observation rooms usually are sparse, just a mattress on the floor, perhaps. Inmates or patients may be given extra-thick blankets that would prove resistant to tying into a noose or tearing into smaller pieces.

These rooms or cells would theoretically not have protrusions with which to tie something to use as a noose.

Sometimes these people are not allowed to wear clothing and given paper gowns to minimize the risk.

The rooms or cells should have 24-hour surveillance video, Slate says. Jail, prison or hospital staff are also supposed to check in on the person on routine visits at specified intervals, say every hour or even more frequently, depending on the risk assessment. The scheduled checks can also vary so that the prisoner isn’t aware of when guards will come along.

Deaths while on observation

But sometimes a determined person will still stymie law enforcement and die even while on a suicide watch.

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Former New England Patriots football tight end Aaron Hernandez stands during a bail hearing in Fall River Superior Court in this June 27, 2013 file photo taken in Fall River, Mass. Ted Fitzgerald AP

Former NFL New England Patriots player Aaron Hernandez hung himself in his Boston prison cell in 2017 while serving a life sentence for the first degree murder shooting death of his former friend Odin Lloyd in 2013, The Associated Press reported.

Hernandez used a bedsheet tied to his window, prison officials told CNN.

Arcan Cetin, 20, charged with killing five people in a Washington state mall in 2016, hung himself in his cell at the Snohomish County Jail in 2017, CNN reported.

Robert Seman, a triple-murder suspect accused of molesting and killing a 10-year-old girl and then killing her grandparents in an arson fire, jumped to his death from the fourth floor of an Ohio courthouse while in custody, in what police called an apparent suicide in 2017.

Stuart Alexander, known as the “Sausage King” and in a maximum surveillance hospital cell at San Quentin State Prison, was found unresponsive in December 2005, according to the Los Angeles Times.

Alexander, 44, was in prison for killing three meat inspectors in a Bay Area meat processing plant in 2000.

He was in a secure room with just a mattress and 24-hour video surveillance and prison guards who checked in on him every 15 minutes. Prison officials were at a loss to explain how the Sausage King died in its “highest level observation” room, the LA Times wrote.

Turns out Alexander had put on 80 pounds while in custody, had health issues, and it was later determined he died of a pulmonary embolism.

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This undated file photo provided by Cuyahoga County Jail shows Ariel Castro. Castro, accused of holding three women captive in his home for a decade, has been indicted Friday, June 7, 2013, on 329 charges including kidnapping and rape, prosecutors said. T Cuyahoga County Jail AP

Ariel Castro, convicted in the kidnapping and raping of three girls he held prisoner at his Cleveland home for a decade — impregnating one of them — killed himself by hanging in his Ohio prison cell in 2013, WBNS 10TV reported. He was isolated from other prisoners “for his own protection,” officials said at the time.

There is a long history of inmates dying by suicide in prison — in the U.S. and abroad — when they were supposed to be watched.

For example, as far back as April 1945, Nazi war criminal Hermann Wilhelm Göring killed himself the night before he was to be hanged by swallowing a potassium cyanide capsule in his cell in Nuremberg, according to biographers.

“Suicide is often the single most common cause of death in correctional settings,” the World Health Organization found in its Preventing Suicide in Jails and Prison report in 2007.

A Miami Herald investigation into Palm Beach hedge fund manager Jeffrey Epstein's sexual pyramid scheme targeting underage girls– and why he's a free man today.

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Miami Herald Real Time/Breaking News reporter Howard Cohen, a 2017 Media Excellence Awards winner, has covered pop music, theater, health and fitness, obituaries, municipal government and general assignment. He started his career in the Features department at the Miami Herald in 1991.
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