BACKGROUNDER: DETENTION FACILITY SUICIDE PREVENTION

& MENTAL HEALTH POD

April 2017

ROUTINE CELL CHECKS

Whether a detainee is deemed urgent or non-urgent, the staff follows state guidelines that
mandate detention officers to directly observe detainees twice within the same hour on an
irregular basis. The routine checks are increased to four times within the hour, if a detainee is
intoxicated (BAC above .15), verbally abusive, displaying erratic behavior or under suicide
observation.

MENTAL HEALTH SCREENING

The Criminal Justice Resource Center (CJRC) provides mental health care at the detention facility.

Upon their arrival at the Durham County Detention Facility, all detainees undergo a screening
process. Currently, detainees complete a brief state-issued questionnaire with limited screening
capability during the booking process. An intake form helps the staff to categorize detainees
with mental illness as either urgent or non-urgent. Detainees are assigned to a clinician and
administered medication, if necessary. The intake and screen system is paper-based.

A $228,000 federal grant will help fund the Jail and Mental Health Collaboration Project, a
partnership between the Criminal Justice Resource Center and the Durham County Sheriffs
Office. The project will update the screening process and serve nearly 3,000 detainees during
the implementation phase. The electronic process will target detainees who are identified with
mental illness or co-occurring disorder during the booking process or at any point during their
stay in the detention facility. The project launch date is pending.

CRISIS INTERVENTION TRAINING

The detention staff receives Crisis Intervention Training to help them to properly engage
detainees in distress and to diffuse potential conflicts.
SUICIDE DATA
The Sheriffs Office lists the total number of suicide attempts, and completed suicides in its
annual budget proposal that is submitted to the County Board of Commissioners. This act of
transparency has been the standard practice of the Sheriffs Office for several years.

SUICIDE ATTEMPT DEFINED

Experts with the Criminal Justice Resource Center provide mental health services at the
detention facility. In their expert opinion, a detainee who engages in a behavior that could have
SUICIDE ATTEMPT DEFINED (continued)
been lethal in nature, requiring extensive off-site medical care, is considered a suicide attempt.
According to the mental health staff, detainees who engage in some form of self-harm are
evaluated by the mental health supervisor and psychiatrist. They determine the incident and
determine whether it was a suicide attempt or self-injury (with or without intent).

SUICIDE PREVENTION
In 2002, the Sheriffs Office sought help from two independent criminal justice consultants after
a series of suicides from 1996 to 2002. At the time, Linda Hayes and E. Eugene Miller made several
recommendations that were implemented and continue today. They are as follows:

Detention Officers trained and certified in First Aid and CPR

Manual resuscitator (Ambu Bags) and AEDs throughout the facility
Utilization of Emergency Rescue Tool (cutting tool)
Conduct mortality reviews after each detainee death

SUICIDE GRILL INSTALLATION

If a detainee is classified as a suicide risk, they are placed under observation. All suicide
observation is conducted in Pod 3B where the bars in the cells were modified and are considered
hazard-proof. The Sheriff's Office is trying to establish a Mental Health Pod in Pod 3A. The bars
in the windows in 3A were modified as well.

The installation of suicide prevention grills over the vents above the doorway of a cell is an
ongoing process, and it has been a priority in recent years. Its a time-consuming process because
the prevention grills must be custom made for each cell vent. Also, installation can only take
place during warmer months when the HVAC system can be shut off to prevent the circulation of
fumes from the welding work.

The proposed Mental Health Pod is a priority and will require additional personnel, but
recruitment and retention of detention officers have been a significant challenge. As soon as the
Agency can hire and train detention officers, the Mental Health Pod will be operational.

SUICIDE PREVENTION GRILL COST

The Sheriffs Office would like to equip all cells with suicide prevention grills. On average, the
agency tries to install about 20 grills each year. For fiscal year 2017, the Sheriffs Office received
approximately $25,000 for suicide prevention grills. The department received $23,000 for FY
2016, $21,120 for FY 2015, and $19,479 for FY
2014.

RECRUITMENT & RETENTION FOR MENTAL HEALTH POD

The Sheriffs Office has received funding for twelve additional detention officers who would
receive specialized training to work in the upcoming mental health pod. The facilitys first mental
health pod is scheduled to open by the end of 2017.
RECRUITMENT & RETENTION FOR MENTAL HEALTH POD (continued)
The Agency is now seeking applicants to the Sheriffs Office who are willing to earn a dual
certification in Basic Law Enforcement and detention services. There are deputies in our recent
graduating class that hold dual certification, a move that Sheriff Andrews thinks will help address
staffing shortages agency-wide in the future. The Sheriff has asked the Board of Commissioners
to approve funding ($942,264) for retention and recruitment. To compete with surrounding
counties and other agencies, the Sheriff Andrews would like to offer salary incentives of two
percent for employees with an associate, bachelor or Advanced Law Enforcement Certificates;
and five percent for employees with a masters or doctorate.