Licking County Jail seeks solution to suicide jumps | The Newark Advocate | NewarkAdvocate.com
NEWARK -- In nine months, at least three inmates required hospitalization for jumping from jail modules, leaving sheriff's office supervisors questioning how they can make the space safe.
"It's something that's happening in jails across the country," Licking County Sheriff Randy Thorp said.
But at least three area jails aren't facing the same problems, administrators said.
One concern is how the jail was designed. The Licking County jail has several modules with tiers and open spaces so deputies can monitor inmates, Thorp said.
On March 28, a male inmate in module C jumped about eight feet onto a pingpong table he had slid into position earlier, Licking County Sheriff's Office Capt. Tom Brown said.
The inmate was taken to Licking Memorial Hospital for treatment and was released shortly afterward. He was not on suicide watch, Brown said.
On Nov. 19, a female inmate was flown to Grant Medical Center in Columbus after falling about 15 feet toward tables in the center of the women's module. She was treated and returned to jail.
On July 12, an inmate died of injuries he sustained after jumping from a railing in module B.
Many jails were built with open spaces, but some sheriffs are questioning whether that's the safest configuration, Thorp said.
The Muskingum, Fairfield and Delaware county jails were not built with open designs, making jumps difficult if not impossible, administrators said. The three facilities have not had inmate suicides in recent years.
"The physical plan is different," said Lt. Randy Wilson, Muskingum County jail administrator.
Thorp said his office is looking at alternatives, such as putting up a net, but that could restrict visibility or introduce flammable materials into the space, Thorp said.
"We are looking at a netting or screening," said Brown, adding that jail personnel need to be sure the new material is appropriate for the facility.
Some changes were made in 2011 after two inmates died after hanging themselves and another died from injuries sustained in a jump. Jail officials assigned deputies to specific modules so they would better understand the behavior of inmates in those areas, Brown said.
Deputies also advised visitors to let deputies know if their incarcerated relatives expresses suicidal thoughts or seem off, Brown said.
Another concern is the growing number of incarcerated people with mental health issues, Thorp said.
Licking County Jail's year-end reports indicate more people with mental health and substance abuse problems are housed there, Brown said.
It's the more mild conditions that have increased; serious mental health problems have not changed in the past 10 years, said Bob Hammond, chief of the mental health bureau for the Ohio Department of Rehabilitation and Correction.
Ohio's prison system prioritizes those inmates who require more management and psychotropic medications, such as schizophrenia or head injuries, Hammond said. About 10,000 prisoners fall into that really severe category, he said.
The prison system has options for housing potentially suicidal individuals ranging from four residential treatment centers or intensive outpatient programs to including them in the general population, Hammond said.
Jails do not have as many options, he said.
In Licking County, a mental health staff of three assesses people entering the jail; the facility is accredited by the National Commission on Correctional Health Care and American Correctional Association, Thorp said.
That differs from the Muskingum, Fairfield and Delaware county jails that contracted with outside agencies for mental health treatment.
But many people in jail should probably be elsewhere receiving help, Thorp said.
"We aren't really suited to be a mental health facility," Thorp said.
The space isn't therapeutic, said Brown, adding that deputies have to lift a person in a wheelchair in and out of bed.
"We're not equipped for that," Brown said.
Jessie Balmert can be reached at (740) 328-8548 or jbalmert@ newarkadvocate.com.
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Medical Specialists Will Try to Reduce Excessive Diagnostic Testing
The new initiative by the medical specialty groups recognizes that many medical tests and procedures are not only wasteful, but also cause more harm than good. The American Board of Internal Medicine and Consumer Reports will jointly sponsor an educational program called 'Choosing Wisely', aimed at changing the attitudes and habits of physicians and patients. Among the commonly overused tests that will be the target of re-education are: EKG's, mammograms, prostate studies, and MRI, CT, and stress cardiac imaging.
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How does this initiative from other medical specialties apply to psychiatry? The dis-infatuation with ubiquitous screening in the rest of medicine should provide a needed check on the premature and unrealistic DSM-5 ambition to achieve a 'paradigm shift' toward psychiatric prevention. DSM-5 plans to introduce many new diagnoses that straddle the heavily populated boundary with normality. The DSM-5 rationale (consciously borrowed from what has been tried with such mixed success in the rest of medicine) is to screen early and treat expectantly in order to reduce the lifetime burden of illness. This would be a wonderful goal if only there were available tools to realize it. Truth be told, psychiatry does not now have any method to allow for accurate early diagnosis and we also have no preventive treatments of proven efficacy. If DSM-5 doesn't come to its senses, millions of people will be misidentified, over-diagnosed, and over-treated with medicines that can cause very harmful complications.
It is sadly ironic that DSM-5 has caught the early screening, prevention bug precisely when other specialties were already discovering its risks and dangerous unintended consequences. We should learn from, not copy, painfully earned experiences in the rest of medicine and avoid expanding our boundaries before we can safely do so.
And, on another note, cautions about overuse of existing laboratory testing should also be applied to the long awaited and much hyped biological testing for Alzheimer's dementia. An Alzheimer's profile is still only a research tool, at least a few years away from being ready for clinical practice. But even when ready, the risk/benefit and cost/benefit analysis of widespread Alzheimer's testing should be given the kind of searching scrutiny that is only now revealing the risks and limitations of excessive screening. The lesson learned- it is not always a good idea to screen for something just because we have a test that lets us do so.