- Associated Press - Sunday, October 1, 2017

ROANOKE, Va. (AP) - The voicemail told Clifton Antonio Harper’s family to come to the hospital as soon as they could.

His father and stepmother waited an hour in the Carilion Roanoke Memorial Hospital lobby before they learned that their 22-year-old son, an inmate at the Roanoke City Jail, was being treated on the seventh floor. He was on life support after attempting suicide by hanging.

“By this point they had already done a brain activity test on him and it had shown that there was no brain activity,” said his stepmother, Natasha Harper. “They still had an officer at the head of the bed and one by the door and he was still shackled to the bed.”

The next day, the family made the decision to take Clifton off life support, she said.

Harper, who died on Dec. 8, 2015, is one of seven Roanoke jail inmates who have died while in jail custody since 2013, according to an analysis of records provided by the jail and the Roanoke medical examiner’s office. He is also one of five people to die by suicide while in jail custody during that time period. All five inmates were found hanging, four from bed sheets.

Over the past five years, suicides at the jail have come in waves. There were no suicides in 2013 and one in 2014. Two occurred in 2015 and two more so far this year. When averaged across that time period, the jail’s suicide rate - 162 per 100,000 inmates - is more than triple the national average of 50 suicides per 100,000 local jail inmates. That average was calculated by the U.S. Department of Justice using statistics from 2014, the last year for which such numbers are available. In comparison, the suicide rate for the general population in America is 19.5 per 100,000 people, according to World Health Organization statistics from 2015.

“It’s an astronomically high suicide rate,” said Lindsay Hayes, project director for the National Center on Institutions and Alternatives, a group that consults with prisons and jails to reduce suicides. “Any jail that has a suicide rate that far above the national average, that speaks to a problem. Because the national suicide rate is based on all sizes of jails, from the smallest county jail to the largest jail, it’s a good barometer on whether or not you have a problem.”

Sheriff’s office Maj. David Bell said that all staff in the city jail have recently gone through mental health training, and that the jail is working with a medical provider to implement new screening practices to identify inmates with mental health needs.

“If we knew the answer to that, we’d definitely be taking steps to resolve it,” he said, when asked why the jail’s suicide rate at the jail is so far above the national average. “We’re always trying to evolve our processes and make them better. We’re not standing pat.”

Sheriff Tim Allen, who was elected in 2013, oversees the jail. He said the facility houses 10,000 people a year and has an average daily population of 560. Many of those inmates, he said, have mental health issues. In February, he told the Roanoke City Council that the jail is the city’s largest mental health service provider. During a recent interview, he said 43 percent of inmates, on average, are on prescribed psychiatric medications.

Western Virginia Regional Jail Superintendent Bobby Russell said about 38 percent of the inmates at his jail - which has an average daily population of 860 - are on mental health medication. Officials at the other large jail in the region, New River Valley Regional Jail, did not respond to a request for the same information.

The city jail is not the only one in the region with a higher-than-average suicide rate. The New River Valley Regional Jail, which reported three suicides in the past five years, has a suicide rate of 71 per 100,000 inmates, just above the national average. One of those deaths occurred in 2015 and two in 2016. No suicides were reported over the past five years at the Western Virginia Regional Jail, Roanoke County-Salem Jail, Franklin County Jail or Botetourt-Craig Regional Jail.

Greg Winston, who was named superintendent of the New River jail in September 2016, said he has perceived an increase in inmates with serious mental illnesses but does not know whether that is supported by data.

“When they get arrested and the judge sends them to jail, we don’t have the option of saying we don’t have bed space. We have to take them in,” he said.

Nationally, the number of suicides in local jails has ticked upward in the past few years, as indicated by mortality statistics released by the U.S. Justice Department. Between 2009 and 2014, suicides in local jails increased 28 percent. Even when comparing individual years, the increase is notable: From 2013 to 2014, the suicide rate increased by 8 percent nationally, from 46 suicides per 100,000 inmates to 50.

David Fathi, director of the American Civil Liberties Union’s National Prison Project, said a third of jail deaths nationwide are attributed to suicide. Heart disease is the second most common cause. He said the upward trend in suicide rates can largely be attributed to the country’s lack of a public mental health system.

“I have enormous sympathy for prison and jail administrators who are essentially being asked to run a mental health facility,” Fathi said. “But they need to make an accommodation for that like they would with physical illnesses.”

Close scrutiny

Allen said the Roanoke City Jail has several training programs designed to increase employees’ abilities to spot potential mental health and suicide risks, and he said he recently expanded from two to three times a year a training program that specifically addresses suicide.

He said inmates also undergo a lengthy medical and mental health screening during the booking process, and later are screened again when the jail determines where they should be housed. Deputies also are trained to spot indications that an inmate might be suicidal once they are housed in the jail.

“If another inmate comes up and says, ‘He’s giving away all his belongings,’ this is kind of unusual. If he says, ‘It’s been nice knowing you,’ protocol is to have him placed on suicide watch and to have him seen immediately by medical staff,” Allen said. “But that may not always happen. They may not exhibit that in front of us.”

Allen said he has added more medical rounds for people in restrictive housing sections, so inmates will have more eyes on them and medical needs will be documented thoroughly. He touted a program, started in 2014, that offers inmates a discharge plan that connects them with mental health services. It also helps participants with needs such as housing, in an attempt to reduce recidivism.

“We continue to look for prevention methods,” Allen said. “I’m looking into developing a pocket-sized prevention guide for each member so they can constantly have them on hand.”

Inmates can also request to see mental health staff, including counselors or psychiatrists.

At both the Roanoke and New River jails, inmates who are flagged as suicidal are placed on suicide watch, which means all of their clothes and belongings are taken from them. They’re searched, then they’re placed, naked and alone, in a cell that is constantly lit. They are supposed to be seen immediately by mental health staff.

At the Roanoke jail, inmates under suicide watch are monitored by cameras. At the New River jail, such inmates may be recorded, depending on where they are in the jail. Both Winston and Allen said suicidal inmates are given a “modesty smock,” a tear-resistant garment that covers their otherwise naked body. Deputies at both jails are supposed to check on suicidal inmates every 15 minutes to monitor their conditions, as opposed to the rounds made every 30 minutes for inmates in the general population.

Winston said “suicide-resistant” modesty blankets and sleeping bags also are available, and Roanoke inmates also may request suicide-resistant blankets, Bell said. At both jails, these are the only items that an inmate under suicide watch may have in his cell.

Such methods, while meant for the safety of inmates, can seem humiliating and punitive, Fathi said.

“It leads some prisoners to deny that they feel suicidal when they really do, or, when they leave watch, claim that they’re not suicidal when they still are,” he said.

Inmates on suicide watch usually are not allowed to have phone calls or visits. Hayes said jail supervisors typically cite the safety of inmates when justifying such policies, but cutting them off from outside contact might not be helpful in the long run.

“Even if you have a toxic relationship with a loved one, if you have an adverse reaction to a phone call, medical staff can observe that while you’re on suicide watch,” Hayes said. “There’s many times when you’re receiving bad news, and that often triggers suicidal thoughts and behaviors. If you’re not under observation at the time, you can attempt suicide successfully.”

Fathi said regardless of when an inmate attempts suicide, it’s the jail’s responsibility to prevent it.

“In a sense, there’s really no excuse for suicide in any jail or prison because by definition these are environments of total control,” Fathi said. “They control what the person does, where they go. So when a suicide happens, it happens by definition because the facility wasn’t doing their job.”

Between Jan. 1, 2016, and Aug. 31, 2017, Allen said 316 inmates in the city jail were placed on suicide watch. During an interview last week, he declined to say whether any inmates who died by suicide during his first term, including Harper, were on suicide watch at the time of death, saying that he would not speak to specific cases within the jail because there could be “legal issues” involved, or because answering such questions could compromise ongoing investigations.

‘Talk sense into him’

Clifton Harper had been in jail for at least nine months before he killed himself.

In April 2015, he was convicted of statutory burglary and grand larceny charges stemming from a May 2014 offense, according to online court records. Although a news release sent by the jail after his death said he was booked into the jail on those charges on March 17, 2015, online court records and a 2015 email from Roanoke police spokesman Scott Leamon indicate he was in the jail on Feb. 5, 2015, when he was charged with assaulting a deputy.

Harper was scheduled to go to trial in November 2015 on the assault charge, but the case was continued. He came to court in November to have his trial rescheduled; it was the last time Natasha Harper saw her stepson.

During his incarceration, she said the family kept up with Clifton through regular phone calls and visits. But those slowly tapered off. Sometimes, jail officials told the family that Clifton did not want visitors, his stepmother said. Other times, she said she was told he was on suicide watch and was not allowed in-person visits because he might pose a threat to the other inmates.

Before his arrest, Clifton Harper was diagnosed with borderline schizophrenia and bipolar disorder, his stepmother said. When he was on suicide watch, Natasha Harper said she and other family members called jail officials repeatedly, asking to visit him. She said Clifton was placed on suicide watch more than once while he was in the jail, though she is uncertain of the exact number of times.

“We could probably talk sense into him,” she said. “Give him some hope.”

The day before he was taken to the hospital, Harper said she attempted to visit him but was told he was on suicide watch and was turned away. The next day, at the hospital, she said a jail official also told her that her stepson was on suicide watch.

On Monday, however, Bell said the jail has never had an inmate die by suicide while on suicide watch. He declined to answer questions about Harper’s case.

Natasha Harper said she has attempted to contact the sheriff’s office multiple times with questions since her stepson’s death. She said her calls have not been returned.

When Allen was asked about that on Friday, he said he had to take another call and hung up.

Bell said Monday that jail officials do their best to answer questions posed by family members, but that requests for information made by those who are not immediate relatives may not be answered.

“We’ve been responsive to family members when the questions have been made in the proper manner,” Bell said. “It’s not like we’re closing the door to the families. I just had someone last week call about meeting up and talking and I’m meeting with that person tomorrow.”

The number of suicides at the jail has been taken up as a political talking point by one of Allen’s two opponents in the November election. Roanoke County police officer McLaren “Mac” Westland said in a recent news release that the number of deaths at the jail is “shocking.”

Westland said he’s troubled by what he sees as the sheriff’s lack of transparency on inmate deaths. That same perceived lack of transparency prompted Natasha Harper and others to organize a rally to urge the jail to review screening practices that catch suicidal inmates, and to adopt better practices, if necessary.

“Jail deaths are not an uncommon thing in any facility, whether it’s a small facility or a large facility,” Westland said. “They’re going to happen, but it’s expected not at the rate that we see it in Roanoke City. Going to the Roanoke City Jail shouldn’t be a death sentence.”

Tuesday night, more than a dozen protesters showed up to that rally in front of the Roanoke City Jail. Many carried signs with slogans like “No more jail deaths” and “The Roanoke City Jail doesn’t keep us safe.”

John Jones, the father of 35-year-old Joshua Jones, also attended the rally. His son died in the jail on Sept. 9 after he was found hanging by a bed sheet in his cell. Since then, Jones said he’s called jail officials repeatedly. He was initially told that the family would be provided an incident report after the sheriff’s office had completed their investigation. His calls haven’t been returned, he said.

“It’s ridiculous,” Jones said. “It’s a small jail in a small town. They should have been doing their job.”

Harper said that each new death - and especially each new suicide - reported by the jail sparks anger.

“I do feel like, at the least, this is death by neglect,” she said.

___

Information from: The Roanoke Times, https://www.roanoke.com

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