By Taylor Knopf

Suicide and drug overdose deaths are on the rise in North Carolina jails, according to a recent report released by Disability Rights NC. There have been 17 suicides so far this year, up from 12 in 2018. And the number of jail overdose deaths more than doubled from 2017 to 2018.

About 80 percent of jail suicide deaths occured within an inmate’s first 12 days in jail. These were people who had been arrested, but not yet been convicted of a crime.

Disability Rights lawyers say that the N.C. jail system needs to update its 25-year-old rules in order to make the facilities safer for inmates and decrease the rates of suicide and overdose deaths.

The report recommends that all North Carolina jails have an active suicide prevention program, improve screening for mental illness and substance abuse, and update officer observation protocols.

“Being arrested and jailed in North Carolina carries with it an unacceptably high risk of death or serious injury,” the report authors wrote. “The continuing rash of deaths and related lawsuits demonstrate the urgent need for changes to protect our jailed NC residents.”

Updating old rules

State agencies were ready to adopt proposed jail rule changes from the Department of Health and Human Services’ Division of Health Service Regulation (DHSR) in 2018, but objections from the NC Sheriffs’ Association and individual sheriffs stalled them from going into effect.

The sheriffs objected to eight rule updates, including some that would have made changes to the way officers must observe inmates during their rounds to make sure they are safe. Several investigations into suicide and overdose deaths found that officers failed to properly check on inmates before their deaths, according to the Disability Rights report.

The proposed rule changes would have enhanced screening of inmates for physical and mental health issues upon admission to jail. Another rule change would have required all jails to implement a suicide prevention program.

In a letter of objection, the Sheriffs’ Association states that the proposed changes are either unclear or exceed the authority of the DHSR. For example, the sheriffs maintain that their officers should have the discretion to check on inmates in-person during supervision rounds or monitor them from a secure location, depending on the situation.

A graph that shows that suicide and overdose deaths are on the rise in North Carolina jails
Infographic credit: Taylor Knopf

The jail rule amendments are set to go into effect after the state legislature reconvenes in the spring of 2020. Disability Rights Attorney Susan Pollitt said state lawmakers have the ability to file a bill that could delay the rules further.

Overdoses and costly settlements

In addition to suicide deaths, drug overdose deaths in jails are climbing. Disability Rights reports that there were four overdose deaths in 2017 and  jumping to 11 deaths in 2018.

The majority of overdose deaths took place within an inmate’s first 24 hours in jail, according to the report. These could have been prevented with better screening of inmates when they are admitted to jail, the report said.

“In many cases, jail staff failed to notice obvious signs of impending overdose and the person died without receiving proper medical attention,” authors wrote. “In some cases, jail staff ignored warning signs that included reports of ingesting large amounts of drugs.”

 Culture shift: For years, advocates for criminal justice reform and law enforcement officials have lamented the fact that jails and prisons house more people with mental illness than medical facilities. And there’s been a shift in the way sheriffs approach mental health across the state.

There are 47 North Carolina counties participating in the Stepping Up Initiative, a data-based program that brings together law enforcement and mental health professionals to help counties track the number of people with mental illnesses coming in and out of their jail system. The goal is to keep them out of incarcerated settings and find them proper care.

As part of the initiative in Pitt County, there’s a designated mental health navigator helping inmates with mental illness find resources as they exit jail. Meanwhile, over in Mecklenburg County, the jail opened a new voluntary psychiatric unit.

Pollitt said it’s not uncommon for people to use or ingest all of the drugs in their possession prior to arrest to conceal them and avoid additional charges. Sometimes they will even notify jail staff, which was the case with a woman who overdosed and died in the Buncombe County Detention Facility.

According to the Disability Rights report, the mother of six repeatedly told jail officers and an on- duty nurse that she had taken a large amount of methamphetamine to hide the drugs from her parole officer. She was placed in a cell by herself, became unconscious and was declared dead a few hours later at the hospital.

Several of these deaths have led to lawsuits. In the Buncombe County case, the victim’s family is seeking $25,000 in damages. The family’s lawyer told Disability Rights the damages could be as high as $3 million, which has been the case in other states.

“North Carolina cannot ignore the increasing number of residents suffering and dying in its jails,” the report authors wrote. “Any perceived savings from allowing the current lethal conditions to continue will likely be exhausted by future legal fees and penalties resulting from unnecessary in-custody deaths.”

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Taylor Knopf writes about mental health, including addiction and harm reduction. She lives in Raleigh and previously wrote for The News & Observer. Knopf has a bachelor's degree in sociology with a...