One of the jobs available to federal inmates is a position no one talks about much: suicide watch companion.
The Suicide Watch program exists for inmates who say they are feeling suicidal and ask for help, or are found by the Psychology staff to be at risk of harming themselves or someone else. What is suicide watch? The person who is saying he wants to kill himself is confined to a “strip cell”: A small room as bare as possible, with no sharp corners and there is no toilet or sink. Either the occupant must ask permission to be escorted to a toilet, or he is given a plastic urinal to pee in (and another to drink out of). He must change into a smock made of fabric that cannot be torn and is closed with velcro instead of buttons or zippers; the bedding is made of the same tear-resistant material. Food is served using paper spoons and Styrofoam cups and trays. But the most distinctive feature is the bright, 24/7 light and the large window through which the “suicide companion” on duty watches him every second, making notes about each move, chatting if he wants to talk.
The goal: Give the person nothing with which to kill himself, until the urge passes. The inmate being watched is at the complete mercy of the person assigned to watch him.
A companion’s view
I am one of those suicide companions. I volunteered, even though a good friend raised doubts about the humanity of the process. Why did I do it? I came into the federal prison system (from the Florida system) with a lot of emotional baggage stemming from a childhood of abuse and neglect. I was taken from my home at the age of 10 and then was treated worse by the very people who were supposed to protect me. That’s a story for another day.
Suffice to say I’ve been suicidal myself. In the Florida system, I’d lay on the concrete floor of the strip cell (there was no bed there), sometimes on a vinyl mat, and stare at the walls or ceiling. Often, I’d that put put me eye to eye with feces, blood, spit, masticated food, semen or urine – leftover from previous occupants. It depended on just how conscientious the staff was.
So, now I want to help others. I’ve worked as an orderly in a prison hospital and in crisis stabilization units. But until I arrived at my previous federal prison, USP Tucson, I had never personally interacted with other people who are suicidal.
The process for selecting inmates to serve as suicide companions is thorough. Anyone who wishes to be on “The Watch” must be approved by SIS (Special Investigative Services – basically the BOP’s version of the FBI), the warden and, of course, Psychology. When I was hired to work as a watcher, it took weeks to be approved because they really dug through my file, looking for any sign of trouble: Had I ever hurt anyone, did I do drugs, etc. If you pass all of that, you go to an orientation where they tell you the guidelines and give you a pep talk. “You’ve been chosen because you are special,” they say. Watchers make 40 cents an hour. That’s clearly why inmates are hired to be companions, instead of staff. It would be quite expensive for a CO to sit there hour after hour, 24/7.
Once on the team, you’re given a four-hour introduction and briefed on the do’s and don’ts. For example, we are not allowed to take anything with us to watch duty (books, radios, etc.) except a pen and a cup to drink from. We are drilled on how to interact with a fellow inmate who shows signs of wanting to hurt themselves or behaves in a disorderly or alarming manner. (Some patients “gun,” or masturbate when a female staff member is around.)
I’ve seen inmates in crisis go to extraordinary lengths to exorcise their pain. Mental anguish wants and needs to be seen. Johnny Cash recorded a song before his death titled “Pain.” One verse goes, “I hurt myself today, just to see if I could still feel.” People often label those who try to or commit suicide as cowardly, selfish, weak or grandstanders. But I don’t think they are any of those.
The ‘fakers’
You’d think that on suicide watch, the patients would get a lot of professional attention. They don’t, though, and here’s why: Many people who end up on the watch are “playing the system” to avoid punishment, force a transfer, etc. For example, if someone gets a write-up for using drugs, attacking someone or being a bully, he “goes psych,” thinking that if he acts crazy enough, his charge will be dropped altogether or to a lesser offense. In fact, in my experience, 8 out of 10 people who end up in the strip cell are not really suicidal. And as a result, staff become jaded and skeptical.
A common scenario: A guy on the compound likes to use drugs, so he borrows money or dope. When he senses that word is spreading that he’s bad business, he slices his arm or leg open with a razor he had hidden for that purpose and pushes the panic button in his cell. When the dorm officer walks over to see what the problem is, he finds the guy laid out on the floor with blood all over. The officer hits the alarm, or “deuces” as they call it, and the entire compound comes to a screeching halt. Every inmate hits the ground and every officer assigned as a responder for that shift sprints to that dorm. After he is treated, off he will go to suicide watch.
It’s true that some inmates in watch cells will try to subvert anyone they can to get what they want. I have had guys offer to have outside people put money on my books if I bring them things they want, such as a razor blade, drugs, coffee, etc. When someone offers a suicide companion $100 to slip a razor blade under the door and the companion makes just 40 cents an hour, how often do you think the watcher will comply?
Maybe not suicidal, but in need, yes
But then there are other people who may not be suicidal, but they are clearly mentally ill. I recall when I was in the Florida correctional system and was taken to the hospital for abdominal surgery. The transport van picked up a couple of inmates who had been housed in a “crisis stabilization room” for months. We all wore leg shackles and were handcuffed and black-boxed. (A black metal box is affixed over your handcuffs, then a chain is run through it and wrapped around your waist and secured with a large padlock. The black box prevents you from being able to do just about anything with your hands, and the cuffs are tight, cutting off blood flow.) To distract ourselves from the pain, the fellow next to me and I started to talk. I noticed a deep, raw crease in his face that ran from the hairline down to the bridge of his nose. I asked him what had happened. He told me he had smashed his head into a brick wall over and over again until he fractured his skull. I asked if he was going to the hospital for reconstructive surgery on his forehead. He smiled and said, “No, man, they are going to remove something stuck in my pecker.” He then proceeded to tell me what had happened:
“I’m trying to get a transfer to somewhere else, so I had to act suicidal. I gave up on cutting my wrists; I knew I had to do something completely nuts to get a transfer, so first I beat my head into the wall. That didn’t work either, so one day when I was in the rec area, I noticed that a stretch of the fence wire was loose. I managed to filch a piece of the wire about eight inches long and snuck it into my cell. After rounds, I straightened the wire as best I could and stuck it in the piss hole of my pecker as far as I could. Well, it got stuck and is poking holes in my bladder and other organs. So, the doctors decided it has to come out.” He had a smile on his face through the whole story.
Another example: One day, I was sitting outside of an observation cell for my four-hour shift as an inmate suicide companion when the man I was watching got off the floor where he had been lying, squatted down and defecated right on the floor. Then he started playing with the feces, making little animals that he displayed on the window sill. As instructed, I logged what the inmate was doing in my “contact folder” for him. We are expected to do so, every 15 minutes, with a brief statement such as, “Inmate Joe is lying on his bunk with his eyes closed; he appears to be sleeping and his face is visible.” In this case, I called the control office and notified them of the situation, and they called me back a few minutes later, relaying what the doctor said: “If he wants to play with his own shit he can.”
So, the inmate in suicide watch upped the ante. He started eating his feces, and drinking his urine. I sat there stupefied as I watched him. Then he began to gag and vomited on the floor. He simply pushed his vomit and feces into a pile and ate that too.
When the risk of suicide is real
And then there are the people who are truly suicidal. One of the hardest things I have ever done is to sit watch with someone who really needs help. And there is no way he is going to get it while in a strip cell that doesn’t even have a toilet. A psychologist only comes by for a few minutes at a time, usually in the early morning hours before they even get to their offices. He or she will swing by with their backpack and a big Styrofoam cup of hot coffee to chat with their patient for a few minutes, then they are off to deal with all the other guys on their case roster.
Most staff simply don’t care what’s going on with a prisoner. If an inmate smears himself with feces and says, “If you kick me out on the compound I swear I will kill myself; I don’t care anymore,” the CO will probably say, “So?” Imagine instead if the CO replied, “Hey, listen, what’s going on that’s causing you to feel so bad that you want to die? What about your family, your children, don’t you want to see them again? Come on, let’s talk it out, man. How about first you get you in the shower to get cleaned up, and I will have your cell cleaned while you are in the meantime? I’ll see if I can get the chow hall to send over something for you to eat. How’s that sound, man, that sound good to you?”
It always amazes me when I occasionally come across a veteran officer with enough room left in their heart to care about anything close to that. When I informed inmate Joe what the doctor said, he seemed shocked. Then he told me he was going to have to up the ante in his game. And he went so far south it even caught me by surprise. And it’s hard to surprise me. A day or two later, I was on watch and I walked over to check on Joe. He had started punching himself in the face so hard that he knocked some of his teeth loose, then reached in and pulled them out. He used one of those teeth to cut his leg open, so deep they had to take him to the hospital because he had almost severed the femoral artery.
So, when all is said and done, what do I think of the suicide watch program, and whether inmates should be used as watchers? After being involved in the mental health programs in both the state and federal systems, I have yet to actually see any benefit.
Staff make the suicide watch cells as harsh as they can get away with. They freely admit this and say the reason is they must not encourage inmates to declare themselves in need of help just so they can get away from whatever situation they may be in on the compound.If an inmate declares a mental health emergency, they will be treated harshly from the word go.
Bottom line: The root cause of the problem is the collapse of this country’s public mental health system and the use of prisons, particularly those that are high security, to house mentally ill people. A penal institute is the wrong environment. So many people end up in prison who are mentally handicapped, autistic or some combination of a variety of disorders and there is no way a system that prioritizes security can deal with them. The court turns a blind eye to this issue as does the prosecution. There are people here who are completely childlike in their mental abilities, or so mentally dysfunctional that all they can do is color pictures all day long. Why are they here? Where is the budget for the mental health staff? Do they really think a correctional officer is the right person to deal with someone who is autistic or has an IQ of less than 60? Once they are released, the vast majority of these individuals return at some point.
So, in the end, the suicide watch program – and the broader approach to mental health in the American penal system – is merely a bandaid on a festering dysfunction.
