By Elizabeth Thompson
North Carolina jails saw a record number of deaths due to suicide or substance use in 2020, according to a new report from Disability Rights North Carolina (DRNC).
There were a record number of 56 deaths in North Carolina jails in 2020, despite estimates that nationwide lockups reduced their populations by a quarter in just months due to the COVID-19 pandemic, the report found. Of those deaths, 32 were due to suicide or related to substance use, an increase from previous years.
By comparison, there were 30 people who died from suicide or substance use in the state’s jails in 2019 and 22 in 2018.
The rise in deaths by suicide occurred despite new regulations requiring jails to have suicide prevention programs. Jails are required under state law to “be operated so as to protect the health and welfare of prisoners and provide for their humane treatment.”
“This report demonstrates North Carolina needs more stringent oversight of our jails,” said Susan Pollitt, Criminal Justice Supervising Attorney at DRNC, in a press release.
“That the number of deaths by suicide actually increased during the same year jails were required to put in place suicide prevention programs should be an emergency wake up call to legislators, sheriffs, jail administrators, and our communities.”
Oversight over jails
Unlike the North Carolina prison system, which is controlled by the state government, jails across the state are controlled by individual, elected sheriffs. Comprehensive oversight and monitoring of jails is hard to come by.
Even statewide records that DRNC collects to track jail deaths take a long time to receive, and a number of reports are required to determine the actual cause of death, NC Health News previously reported. It’s almost impossible to track non-fatal drug overdoses or attempted suicides.
State Rep. Carla Cunningham (D-Charlotte) filed a bill at the state legislature in May which would have required the state Department of Health and Human Services to conduct compliance reviews following reports of an attempted suicide.
Cunningham started looking into jail oversight after a 17-year-old died in the Mecklenburg Jail North Juvenile Detention Center.
“I started looking at it closely and saw that yes, these things were happening in facilities,” Cunningham previously told NC Health News in an interview. “And that it really is not a lot of oversight or a collection of the data … The information is there, but you’ve got to dig for it.”
The bill didn’t pass during the legislative session. Cunningham said one reason it may not have moved ahead is because some legislators didn’t want to put “additional stressors” on sheriffs.
As a former nurse, Cunningham said data is key in the medical field, and jails often become safety nets for medical and mental health crises. Mental health issues are personal to Cunningham, whose son has an intellectual disability and has been diagnosed with schizophrenia and bipolar disorder.
Health crises in jails
People with serious mental illness are 3.5 times more likely to be sent to a jail or prison compared to a hospital.
This is partly because some illnesses, such as substance use disorder are criminalized. Police are also often called to respond to people in mental health crises and transport them to the hospital in handcuffs, a practice known as involuntary commitment. NC Health News previously reported on this practice and its consequences.
Jails, especially smaller jails, often do not have the resources to help people with medical conditions. Local jail deaths due to drugs or alcohol intoxication have more than quadrupled across the country from 2000 to 2018, according to national data compiled by the federal Bureau of Justice Statistics. Experts expect these numbers to only get worse, as more powerful drugs such as fentanyl take over the drug supply.
North Carolina reported a 40 percent increase in overdose deaths statewide in 2020 compared to 2019, a recent report from the state Department of Health and Human Services found.
”A single life lost to an overdose is a life we should have saved,” DHHS Sec. Kody Kinsley said in a press release. “Stress, loss of housing and loss of employment for those in recovery caused by the COVID-19 pandemic has led to a backslide in our fight against substance use disorders.”
In order to prevent future deaths, DRNC recommended that jails:
- Require sweeping state-wide suicide prevention measures in the state jails.
- Give incarcerated people “adequate medical care.”
- Improve transparency about conditions in the state’s jails.
- “Adequately fund” NCDHHS’s jail regulation unit.
- Take part in Stepping Up campaigns which fight mental illness with treatment instead of incarceration.
The North Carolina Sheriffs’ Association did not immediately respond to a request for comment from NC Health News.
It released an update of its Report on Law Enforcement Professionalism in January, which recommended funding to “increase and make mental health and substance abuse resources more readily available in North Carolina” and making mental health professionals, instead of police, responsible for the transportation of an individual in a mental health crisis.
“These appalling in-custody deaths are the direct result of NC’s continued failure to improve mental health and substance use services in NC jails and communities,” Pollitt said in the press release. “We cannot allow this inhumane suffering and loss of life to continue when there are remedies that can be affordably and effectively implemented.”