An investigation by the San Francisco Chronicle found that the suicide rate inside California prisons rose to a new high in 2018 and remains elevated in 2019, despite decades of reform efforts.
In 2018, the Chronicle reports, there were 34 total suicides in a system that imprisons 129,000 people, for an annual rate of 26.3 deaths per 100,000 people.
That rate is the highest in California since at least 2006, and it's higher than the national average for state prisons (20 per 100,000 in 2014) and federal prisons (14.7 in 2018). From 2001 to 2014, according to the Bureau of Justice Statistics, twice as many people killed themselves in California cells than in the entire federal system, which has more prisons and more incarcerated people. There were 448 total suicides in California prisons during that period and 222 in federal prisons.
After increasing for four straight years, the suicide rate in California prisons may continue to rise in 2019. The Chronicle reports that 26 incarcerated people have committed suicide so far this year.
The Chronicle's investigation traces the suicides to the state's failure to provide proper mental health care, even though the state has been under federal court order to remedy its "systemic failure . . . to deliver necessary care to mentally ill inmates" since 1995.
In 2011, the U.S. Supreme Court in Brown v. Plata upheld a court order requiring California to release up to 46,000 people to relieve serious overcrowding and remedy grossly inadequate medical and mental health care in the state's prisons. "A prison that deprives prisoners of basic sustenance, including adequate medical care," the Court held, "is incompatible with the concept of human dignity and has no place in civilized society."
Justice Anthony Kennedy specifically observed that mental health care was abysmal. "Prisoners in California with serious mental illness do not receive minimal, adequate care,” he wrote for the Court. "Because of a shortage of treatment beds, suicidal inmates may be held for prolonged periods in telephone-booth sized cages without toilets."
But as the California State Auditor found, prison officials still "failed to provide the leadership and oversight necessary to ensure that its prisons follow its policies related to inmate suicide prevention and response." The state auditor's investigation and reports from court-appointed experts describe "a pattern of identifiable and describable inadequacies in suicide prevention" in the corrections department.
These failures include:
- long wait times for mental care
- high vacancy rates for prison psychiatrists
- failure to monitor inmates with suicidal tendencies
- failure to perform 30-minute welfare checks
- falsification of welfare-check logs
- failure to refer sick inmates to a higher level of mental care
- lack of suicide prevention training for prison staff
- dangerous delays in performing CPR
- cells with ventilation grates that make it easy for inmates to hang themselves
The Chronicle uncovered troubling evidence of prison officials' indifference to suicide. Court expert reports and investigations by county coroners show that many people who commit suicide in California's prisons have displayed previous signs of self-harm or suicidal intent, and their bodies are routinely discovered in a state of rigor mortis, which takes two to four hours to appear. In 2017 alone, four people who killed themselves laid dead in their cells for hours as rigor mortis set in, despite welfare checks on their cells every 30 minutes.
The California Department of Corrections and Rehabilitation has made some reforms since the court stepped up its monitoring of suicides in 2013. Some cells were retrofitted to make them suicide-resistant, and the department created a suicide assessment tool that remains unproven.
But in July, a federal court found that the department still isn’t doing enough to prevent suicides and criticized the state for delaying court-ordered fixes. "While some progress is being made," the court wrote, "a substantial amount of work remains, and implementation is dragging out and taking too long."
Incarcerated people and advocates told the Chronicle that a big part of the problem is that California prison officials punish people who seek help.
If an inmate expresses a desire to harm himself or herself, a typical response is removal from the regular housing unit and placement in an isolation cell, said Keith Wattley, an advocate and attorney who specializes in parole hearings.
"Their idea of suicide watch is to wrap you in a mattress suit and put you in a cell by yourself until you don’t have these feelings anymore,” George "Mesro" Coles-El, who has been at San Quentin State Prison for neary nine years, told the Chronicle. "I don’t feel like that’s a very effective way to treat someone who feels like their life should end prematurely."
Isolation units are cinder block rooms, sometimes with padded walls, where people are held with no clothes. Sometimes they are allowed to wear a "mattress suit," which is a padded smock intended to serve as blanket, clothing, and a mattress.
"It's absolutely the case that people are discouraged from seeking help, and so they don't, and so they hurt themselves," Mr. Wattley said. "And help isn't really help. It's not meaningful."