From strangulation to head-bashing, suicides can be harrowing, if not sometimes creative.
Suicide is the leading cause of death in American jails (Hayes and Rowen, 1988) and the third leading cause of death in American prisons (Bureau of Justice Statistics, 1998). Prisoners are at a much higher risk of suicides than the general public, and especially those who have been recently sentenced. See this Suicide Risk Scale used by some correctional agencies to assess suicide concerns among offenders, or this Suicide Fact Sheet for Corrections Officers.
While suicide is more difficult to accomplish in prison, prisoners often employ a number of different and creative methods when attempting suicide. Without easy or legal access to drugs, weapons, or willing assistants, inmates often use painful, even tortuous, methods of ending their lives. Correctional agencies, such as the Prison Service of England and Wales, attempt to moderate inmate opportunity to commit suicide by designing cells with high security window grills, immovable plate- safe ventilators, rectangular, floor-mounted safe-skirting heater pipes, and fixed resin-clad storage units (Burrows, Brock, Hulley 2003). At many prisons suicide assessments are conducted at intake, and if suicidal tendencies are discovered, the inmate is placed in a specially-supervised ward that is periodically checked by staff no fewer than every 15 minutes. Inmates at these wards are usually only allowed hospital-like garments and a single blanket, and are sometimes placed in restraint chairs, if symptoms are severe.
It is unclear whether many of these developments work or not. Many of the risk-factors for suicidal behaviour in prisoners resemble those for non-prisoners, such as substance-abuse, mental health facility-admittance, acute psychoses, and psychiatric morbidity (Shaw, Appleby, Baker 2003); it may be more efficient and cost-effective to assess and monitor these indications on a regular basis than attempt to redesign the living environments of potentially millions of inmates. In addition, many methods of suicide are varied and sometimes ingenious, to the point where many superintendents or wardens have publicly acknowledged that institutions, regardless of how much protection they afford the prisoner, will seldom be "suicide-proof." A spate of these different methods is outlined below.
The most common methods of suicide, for a number of reasons, are hanging and strangulation, and the most common ligature points for strangulation are window bars, followed by bed fittings. Inmates spend most of their time alone in their cell, where they have access to bedsheets, time, and privacy. Inmates also use wires, ropes (usually taken from a workplace), shoelaces, socks, or belts. The most typical regiment for strangulation involves propping oneself up on a stool or chair, tying a makeshift rope around an overhead pipe, fixing a firm knot around the neck, and kicking away the chair underfoot. This method usually takes about 5 minutes. Some have used pencils, as short as a few inches, to simulate a tourniquet with shoelaces. Some have tied their necks and a radiator pipe and simply continuously twisted their bodies to eventually cut off the circulation. Some inmates have successfully hanged themselves from no more than 6 inches off the floor, and from vertical pipes on the walls as opposed to horizontal pipes on the ceiling.
Asphyxiation has also been achieved by using a plastic bag to cut off air circulation. In July 2002, Australian inmate Bradley William Rapley affixed a plastic "property bag," used for holding cigarettes, around his neck with blankets and towel fragments. Others, such as a suicide in Colonie, NY, used their prison socks to tighten the same sort of bag. A Belfast prisoner in September of 2005 confounded experts by employing a "bizarre" series of knots to secure a plastic bag around his head and successfully commit suicide. John McGrath made 6 knots from laces, shirts, and towels, covered his mouth with a plastic bag, and stuffed bits and pieces of the bag up his nose. Knot expert Michael Lucas said that McGrath had likely prepared the knots in advance, using "granny knots with a left twist," and doing them in proper sequence (1 September 2005 Belfast News Letter).
Drugs are the next most common method of killing oneself. An inmate at Kingston Penitentiary once collected individual doses of carbon tetrachloride (cleaning fluid) on a regular basis from offices for two years as a prison office cleaner, so that he would finally have enough to damage his kidneys beyond repair and kill himself.
Rubbing alcohol (methylated alcohol) has also been used in the past, bought from messengers and other inmate cleaners. A fatal methyl alcohol overdose is usually preceded by intense periods of vomiting, blurred vision, muscle spasms, and acute pain. Permanent blindness, often after a period of a week or two, results. Rubbing alcohol appears to be unrestricted by national boundaries. Five inmates in Manila in 1996 were celebrating the election of a gang leader, Napoleon Montealegre, when all fell ill and one later died in hospital after drinking a cocktail made up of 1.5 liters of rubbing alcohol (Reuters, 16 February 1996). A year later in Bucharest, 16 inmates were hospitalized and two later died from an overdose of a methylated cocktail they had made from supplies in the furniture workshop.
Ethyl Glycol, or antifreeze, is sometimes acquired from radiators or air compressors. Fatal overdoses are preceded by abdominal cramps, weakness, vomiting, quickened heart rate and respiration, headache, coma, and blurred vision. Death results from kidney destruction, brought on by a particular acidic byproduct of antifreeze, oxalic acid, which destroys the tubules of the kidney and results in uremia, hepatomegaly, liver necrosis, and toxic degeneration of our brain's basal ganglia (which controls our sympathetic, physiological regulatory functions such as respiration and heart rate). In 2001 an inmate thrown in the drunk tank of an Anapolis jail later died from antifreeze poisoning, which investigators believed he had drunk from mixing orange juice and vodka in a container he had found in his vehicle (Associated Press, 8 February 2001). In Pensacola in February of 2005, an Escambia County commissioner facing a prison term for bribery, extortion, and grand theft, committed suicide by ingesting an undiscolsed amount of antifreeze and other toxic agents. His badly decomposed body was found a month after his death (The Tallahassee Democrat, 18 February 2005).
Mice pellets, possessing strychnine, have been shown to cause death, but are undesirably accompanied by severe convulsions.
Mace, containing myristin, is also fatal in high enough doses, producing hepatic necrosis. Both mace and nutmeg, similar to many methylated amphetamines and catecholamines, both produce distinctive hallucinogenic properties, albeit accompanied by severe nausea, dysphoria, and general feelings of illness. Turpentine and other similar cleaning poisons are common items in a prison environment, and can have fatal, if not chronically-painful, effects.
Falls have proven to be effective for those prisoners who have access to under-supervised heights. In 2005, Greg Cornell jumped from the second-storey tier inside the St. Joseph County Jail in South Bend and died later at a local hospital.
Typewriter cleaning fluid has been used in the past, and is particularly fatal by its liver-poisoning qualities.
Of course, most any psychoactive drug that can produce toxicity can be fatal in high enough doses. However, high doses may be particularly difficult to obtain in prison. As a possible solution, inmates may administer heavily adulterated compounds, or combinations of drugs that have a synergistic effect, such as taking benzodiazepines (Diazepam) with hypnotics or sedatives (alcohol, barbiturates), depressing respiration and causing death. Cyanide has also been smuggled in to prison on occasion, providing a particularly quick and lethal method of self-execution.
Self-inflicted wounds represent the third most common method of suicide. These most often include slashings, involving forks, bolts, knives, needles, razors, and bits of wire. Some swallow foreign objects. For example, one woman in Kingston Penitentiary broke a water glass against her cell wall, wrapped the broken pieces in damp toilet paper-ball, then swallowed it, resulting in fatal bowel perforations that would take 6 days to kill her. Inmates have also used paper clips to slash their wrists, but razor blades, which are preferred, are often accessible enough. Others have cut their throats, necks, and stomachs, but a few have also slashed their thighs. Sometimes, victims slash combinations of these body sites simultaneously, or combine slashings will drug overdoses, ensuring a death if one or the other methods fails. Slashings are not unheard of in condemned convicts just before their execution date. A more chilling case of suicide was that of Thai baby-slasher Sawai Palaphol, who repeatedly bashed his head into the prison wall until he collapsed, dead. One pathologically suicidal woman in a Warm Springs mental hospital tried to commit suicide by slashing her arms with a broken light bulb, by swallowing seven AA batteries and two razor blades, and by eating two-thirds of a tennis shoe, according to the Great Falls Tribune.
Most prison suicides remain private and acceptably ignored by fellow inmates and correctional staff, unless the victim is high-profile, or a so-called "bug." Media reports are similarly disinterested, and usually report the suicide in a pragmatic, non-analytical, presupposing fashion.
When discussing factors contributing to the desire to kill oneself while incarcerated, the answer seems self-evident; social isolation, harsh discipline, lack of privacy, constant threat of violence, fear, guilt, hopelessness, and depression all take a heavy toll on the human spirit. However, several common stressors typically precede an inmate suicide: 50% of suicide victims in New York prisons recently experienced inmate-inmate conflict, 42% experienced recent disciplinary action, 40% were in a state of fear, another 42% were physically ill, and an overwhelming 65% had either lost "good time" privileges or had severed relationships with friends or family. Many suicide victims saw a mental health service-provider before their suicide, but the majority of suicide victims are not mentally ill (Way, Miraglia, Sawyer 2005).
While increased security measures have likely reduced the number of suicides (and likely increased the total budget of correctional departments), the motivation to commit suicide must be equally considered in prevention. This, however, represents a paradox, particularly for lifers: how do we make an inmate want to live within a disciplinary environment that makes the inmate want to die? The traditional methods of preventing suicide used on the outside do not work on the inside, nor are they acceptable among the many proponents of retributive-punishment. Treatment programs remain a successful alternative, and fit well into the existing prison structure, although there is a reluctance to employ programming that does not target the needs that put the offender in jail, in the first place. More research needs to be done to conclusively establish the proper prevention of suicide in prison.